Michigan has invested $3.5 million in doula services for low-income mothers through its Medicaid program, as part of a state initiative to improve maternal and infant health outcomes. Since the program began providing Medicaid coverage for doula services on January 1, 2023, through summer 2025, Michigan Medicaid has reimbursed more than 16,000 doula services to more than 3,000 beneficiaries.
The Doula Initiative
The Michigan Department of Health and Human Services launched the Doula Initiative in 2023. Coverage has expanded to include 12 months of doula care with 12 visits during pregnancy and postpartum, as well as hospital delivery. The state created rules around qualified training and established a 25-member Doula Advisory Council.
More than 1,000 doulas are now on the state’s registry, surpassing the 2028 goal of 500. Approximately 720 doulas have completed state-approved training programs and are Medicaid-enrolled providers. State rules require training in communication, coping, labor support, and newborn care, with candidates needing to be at least 18, have a high school diploma, and complete approved training.
“We were one of the first states in the nation for Medicaid reimbursement, and what makes us unique is that we have community-based doulas that are part of our initiative,” said Dawn Shanafelt, director of the division of maternal and infant health.
Impact on Birth Outcomes
A 2024 Citizens Research Council report shows that research demonstrates doulas are associated with better delivery outcomes, including reduced cesarean sections, premature deliveries, and shorter labor. Michigan increased Medicaid reimbursement rates substantially in 2024, resulting in potential doula earnings per Medicaid pregnancy more than doubling.
Michigan recorded the lowest infant mortality rate in its history in 2023, with 607 infants under age one dying and a rate of 6.1 deaths per 1,000 live births—a decrease from 2022’s 6.3 rate. Deaths among Black infants fell to 11.9 deaths per 1,000 live births in 2023, though this rate remains nearly three times that of White infant deaths. Michigan’s preterm birth rate is 10.3%, while Detroit’s stands at 15.6%.
Training Community-Based Doulas
The Birthworkers of Color Collective, a California-based nonprofit, has trained doulas in 22 states including Michigan since 2024. In April 2024, its first Michigan training program trained 27 doulas with state funding. In 2025, the group hosted three trainings: two in Detroit and one in Flint. “A lot of research shows that sometimes people prefer to have their care support reflect them, and that can increase their positive health experiences,” said Stevie Merino, founder of the collective.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.macombdaily.com/2026/01/09/michigan-pays-3-5m-for-doulas-so-low-income-moms-have-healthy-births/