Pregnant women on Medi-Cal have a new option for support before, during and after delivery.

Cecily Salazar is a doula, a non-medical support person trained and certified to care for pregnant women before, during and after giving birth. “It stemmed from my own birthing experiences,” says the mom of two boys.

Her first birth experience was traumatic, so the second time she educated herself and worked with a doula, who supported her through the birth. “It was empowering for me,” Salazar says. She became a doula herself in 2019.

Doulas have been around since the 1980s but have not been well known until more recently. They’ve been operating independently, but because research has shown the benefits of doulas – their work has been linked to increased positive delivery outcomes, fewer C-sections, lower epidural use and reduced anxiety and stress during the birth process – the California Department of Health Care Services added doula services as a Medi-Cal benefit in January 2023.

Last year, the Central California Alliance for Health – the Medi-Cal provider for Monterey, Santa Cruz, San Benito, Mariposa and Merced counties – signed on to provide doula services and nearly a year later, starting April 1, two doulas will be available in Monterey County for Alliance members. The agency is actively recruiting for more doulas to join as providers.

Dr. Dianna Diallo, a pediatrician and medical director with the Alliance, says adding doulas to the medical team caring for mothers and babies is a valuable step. “The way I see it, the more the better, because really, especially for new moms, it’s just such a vulnerable, isolating time,” Diallo says. “Healthy mommy, healthy baby.”

Doulas typically meet with expecting parents ahead of the birth, providing information and answering questions. They can be present during the birth if requested, serving as a support through labor and delivery. About a week after the birth they meet with parents and baby as a follow-up.

Signing up doulas was slow going at first, since there is a process for doulas to become Medi-Cal providers, as well as a process for reimbursements. The Maternal Mental Health Task Force, part of Bright Beginnings Early Childhood Development Initiative in Monterey County, worked to facilitate conversations between the Alliance and doulas and is now recruiting to add more doulas to the Medi-Cal network.

Sonja Koehler, director of Bright Beginnings, says joining benefits the doulas, the health care system, the mother, child and the community as a whole. Including doula services for members of the community who might not be able to afford the services on their own “elevates the importance of this work,” Koehler adds.

The Alliance is offering incentives for doulas who join, including 150 percent of the state Medi-Cal fee-for-service rate, and personalized support through all steps of certifying as a Medi-Cal provider, reimbursement and other challenges. The agency is also offering grants to health organizations that recruit doulas, including a $10,000 bonus grant for recruiting bilingual doulas.