Texas Has a High Rate of Preterm Births and Other Maternal and Infant Health Challenges.
Texas continues to have a higher rate of preterm birth than the national average. Babies born too early or too small can experience long, expensive hospital NICU stays and long-term health problems, such as birth defects, asthma, hearing loss, developmental delays, or disabilities that can affect their ability to be healthy and succeed in school.
Additionally, Texas has a higher rate of low-risk cesarean birth than the national average. A low-risk cesarean birth is when it is the mother’s first birth, the baby is at least 37 weeks, and the baby is in the head-down position. Cesarean sections are associated with higher rates of maternal mortalities and morbidities and have common complications like infection and hemorrhage.
Mental health conditions, like postpartum depression and anxiety, continue to be one of the top causes of death associated with pregnancy in Texas.
Doulas Help Reduce Preterm Births, C-Sections, Postpartum Depression, and Other Costly Health Challengers That Are Prevalent in Texas.
A doula is a non-medical health professional providing physical, emotional, and educational support for women and their families throughout the prenatal, birth, and postpartum periods.
There is strong bipartisan support for access to doulas. Project 2025 says, “doulas should be an active option for all women whether they are giving birth in a traditional hospital, through midwifery, or at home.”
Studies continue to link doulas with reduced rates of preterm births and low birth weight babies as well as increased rates of breastfeeding. Additionally, women who received doula care during labor and birth showed a 65% reduction in odds of postpartum depression and anxiety and 53% lower odds of cesarean delivery than those without doula care. Cost-savings associated with having doula support during birth are estimated at around $1,000/birth.
When Dell Children’s Health Plan and Amerigroup Texas offered doula services to their members in 2024, 94% of clients reported their doula had an ‘extremely’ or ‘very’ positive impact on their birth, and 85% said having doula support helped them better communicate with their health care provider.
Texas Should Improve Access to Doulas by Covering Their Services Under Medicaid.
Texas Medicaid, which covers nearly half of the births in the state, does not cover doula services, putting doula support out of reach for many Texas moms.
Building on efforts in 2023, the Legislature should direct the state to cover doulas in Medicaid during pregnancy, birth, and the postpartum period. A total of 27 states — such as Florida, Oklahoma, and others — reimburse for doula coverage through Medicaid, more than double the 12 states from 2022.
