Role of Doulas in Improving Maternal Health and Health Equity Among Medicaid Enrollees, 2014‒2023

Overview

Journal Am J Public Health

Specialty Public Health

Date 2024 Oct 2

PMID 39356988

Authors

April M Falconi

Leah Ramirez

Rebecca Cobb

Carrie Levin

Michelle Nguyen

Tiffany Inglis

Affiliations

Soon will be listed here.

Abstract

To assess the relationship between doula utilization and health outcomes of females enrolled in Medicaid-affiliated plans in the United States. In this retrospective, observational cohort study, we used Medicaid claims data from a national health insurer to compare health outcomes between females who used and who did not use a doula (2014-2023). We conducted propensity score matching using a 1:1 case‒control match, without replacement, and fit logistic regressions to analyze the relative risks for maternal health outcomes. The study population included 722 matched pairs with and without a doula. Results indicate females with doulas had a 47% lower risk of cesarean delivery and a 29% lower risk of preterm birth, and were 46% more likely to attend a postpartum checkup (all differences < .05). Doula care is associated with improved health outcomes among Medicaid enrollees. Doulas have garnered increasing interest from policymakers as a strategy to address increasing trends in maternal morbidity and persistent health disparities. This study provides evidence from Medicaid enrollees across the United States that doula care can improve maternal health. (. 2024;114(11):1275-1285. https://doi.org/10.2105/AJPH.2024.307805).

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