Description: Labor-Public Workshop

Location: 368A Heady Hall

Title: Can Doula Care Reduce Birth-Related Disparities?

Abstract: Despite leading the world in medical spending and innovation, the United States continues to experience a crisis in birth-related health outcomes. High levels of spending and medical technology innovation have failed to improve outcomes like infant and maternal mortality, so other approaches must be examined. In this paper, I study the effect of Medicaid coverage of doula services in the birthing process. Using variation in timing of coverage start dates and comparing non-covered Medicaid births to Medicaid births with the option of covered doula services, I find that Medicaid support for doula services increases the likelihood of a doula being present at delivery by 15-30%. Due to the small share of births ever involving a doula, this effect is small in absolute terms (only .9% of Medicaid births involve doulas, even after Medicaid coverage begins) but represents a meaningful percentage change. Medicaid births with doulas present are generally healthier than those without a doula present, with fewer failed labor attempts and a lower likelihood of early delivery and low birth weights. This project also aims to assess heterogeneous effects by race and to measure the predictors of doula use among the Medicaid population to inform future research and policy meant to improve birth-related outcomes.