States and private insurers are adding Medicaid and employer plan benefits for doula support to lower cesarean rates and preterm births. Companies like Pomelo Care and Maven Clinic vet certified doulas and handle billing and claims so providers can focus on patients.

This article examines how systemic racism drives higher rates of maternal mortality and complications among Black birthing people in the U.S. It reviews policy fixes—such as paid leave, telehealth expansion, and the Momnibus Act—alongside health-care reforms like diversifying the perinatal workforce and boosting midwife and doula access, and highlights community organizations leading local efforts.