FINDINGS:
- Doulas perform a valuable service and both doulas and consumers cite numerous potential gains from an expansion of services in Massachusetts.
- Massachusetts has a foundational group of experienced, dedicated doulas on which to build a more robust network of community-based practitioners.
- Doula support services are largely paid out of pocket, making it difficult for doulas to keep costs affordable for consumers while also earning a living wage.
- In addition to economic barriers, other factors that complicate efforts to expand use of doula services include workforce development issues and consumers’ lack of familiarity with doula services.
- Doulas and consumers call for accessible, equitable doula support services, and a commitment from the health care system to explicitly address racism and discrimination in birthing care.
- Limitations of and expense associated with current training and certification standards must be addressed, particularly for doulas who will work with Black birthing people
- Credentialing and compensation decisions will impact the effectiveness of proposals to expand access to doula support services.