Virginia’s Medicaid Doula Coverage Falls Short as Families Struggle to Access Support

In 2022 Virginia became the fourth state to reimburse doula services through Medicaid, part of a broader effort to curb the state’s high maternal mortality rate. The program, now available in 26 states and Washington, D.C., faces practical obstacles: doulas must navigate extensive paperwork, receive modest reimbursements of $859 per pregnancy, and often wait weeks for payment. Consequently, only 19 doulas in Northern Virginia accept Medicaid, and fewer than 1% of Medicaid births have utilized doula support.

Critics such as Taja Iglesias, co-chair of the state doula task force, and Kenda Denia of Birth in Color call for streamlined certification and higher rates, while Iglesias opts to fund care outside the system. The gap between policy and real-world access leaves many low-income families without the “birthing bestie” many hope for.