Utah Senate passes bill that would provide Medicaid coverage for doula services


Boram Kim


Senate Bill 192 passed the Utah Senate unanimously on Wednesday. The bill would require the Department of Health and Human Services to submit a state plan amendment to cover doula services under Medicaid. 


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The bill’s sponsor, Sen. Luz Escamilla (D – Salt Lake City), introduced an amendment ahead of the vote that defined doula services as “non-medical advice, information, emotional support, and physical comfort provided to an individual during the individual’s pregnancy, childbirth, and postpartum period.”

“[SB 192] is a simple piece of our journey towards better maternal health,” Escamilla said, speaking on the Senate floor. “I think we’ve done a lot of bills this session, and this will just be one [solution] in that toolbox to bring better services to our [expecting mothers], especially first-time moms that need that support.”

Research shows that pregnant women who engage with a doula have better outcomes and lower incidence of C-sections. Sen. Michael Kennedy (R – Alpine), whose wife happens to be a doula, endorsed the measure and spoke to its importance. 

“The most significant event in life outside of death is birth,” Kennedy said. “And the idea of having a plan is what doulas can help these individuals with. Many times, the obstetrician, gynecologist, the certified nurse midwife or so on, whoever is delivering the baby, won’t have any sort of time to discuss these components of, ‘How is this delivery going to happen and what is the support person going to do to give you the support that you need?’ So to the sponsoring senator, I’m very supportive of this bill and excited about the possibility for more public insight into the power that doulas can bring …” 

Rep. Rosemary Lesser (D – Ogden) introduced two bills this session, House Bills 84 and 85, that would expand Medicaid postpartum coverage duration and income eligibility. If passed, postpartum coverage would be extended to 12 months and expanded to women at or below 200% FPL.

Kylee Alejandre, a certified birth and postpartum doula and owner of Utah Valley Doulas (UVD), said all of these policies would have a tremendous impact on the equity and outcomes of doula services. 

“We would love to see [SB 192] pass,” Alejandre said. “Doula care right now is very much a luxury service just because it’s pretty costly to be able to support the doulas doing the work. A lot of people can’t afford it. And it’s a very important service for parents to have the support that they need during pregnancy, during the birth, and also postpartum.

We do a lot of postpartum care. And that’s a very sensitive time for parents. It’s a very difficult time for a lot of parents and we feel that parents are pretty neglected when it comes to that postpartum period especially.”

While the state lacks regulation around doula services, UVD requires its doulas to undergo training and certification, which the agency can provide. Alejandre says postpartum doula services offer overnight or daytime care aimed at supporting the mother’s recovery after childbirth. The work can encompass sibling care, pet care, household chores, evening monitoring so the mother can sleep, and anything else that supports her postpartum well-being. 

SB 192 has advanced to the House for consideration.