Doulas

Background

Birth doulas are trained nonclinical professionals who provide emotional, physical, psychosocial, and informational support to pregnant, birthing, post-pregnant people, and their families.

Evidence supports doulas improving outcomes across a range of metrics for this population, including infants, and a larger positive impact for Black, Indigenous, and other people of color. There has long been support in Washington for increasing access to doulas, especially for people on Apple Health.

2024 Legislative session

During the 2024 legislative session, Governor Inslee signed Engrossed Substitute Senate Bill 5950 into law authorizing the Health Care Authority (HCA) to implement a doula benefit for Apple Health (Medicaid) clients. HCA was allocated funding for:

• An Apple Health doula reimbursement.
• Design and recommendations for a doula hub and statewide doula referral system.

2023 Legislative session

During the 2023 legislative session, Engrossed Substitute House Bill 1881, codified under chapter 18.47 RCW, created birth doulas (doula) as a new health profession in Washington. The rules establish the profession’s education, training, and certification requirements.

This resulted in a voluntary credential, meaning that an individual does not need to be credentialed in Washington state to provide doula services. However, the title “state-certified birth doula” cannot be used unless the person has the Department of Health state birth doula credential.

Learn more by visiting Department of Health’s Birth Doula webpage.

What services are covered?

The Apple Health (Medicaid) birth doula benefit covers:

• One prenatal intake visit
• Continuous labor and delivery support
• 20 hours for additional prenatal and postpartum visits, including one comprehensive postpartum visit

For more details about coverage, see the birth doula services billing guide.

How to enroll as a provider

To become an Apple Health (Medicaid) birth doula, providers must:

• Complete voluntary birth doula certification with DOH
• Obtain their National Provider Identifier number (NPI)
• Enroll with ProviderOne

To learn more about provider enrollment, visit Become an Apple Health provider.

Doula services updates

HCA is working with partners to finalize birth doula rules. This process will not be complete by January 1, 2025. HCA plans to use the emergency rulemaking process outlined in the Administrative Procedure Act (Chapter 34.05 RCW).

Emergency rules are effective immediately upon filing with the Washington State Office of the Code Reviser and for 120 days from the filing date. The emergency rules will allow the doula benefit to go live on January 1, 2025 while HCA continues working with partners to complete the standard rulemaking process.

To stay connected to our doula work, subscribe to the doulas mailing list.

Sign up for rulemaking notices.

Materials and updates

Older items are available upon request.