Increasing access to doula care in the Commonwealth of Kentucky

At UnitedHealthcare, our mission is to help people live healthier lives and help make the health system work better for everyone. Committed to improving maternal and infant health outcomes in Kentucky, UnitedHealthcare is implementing a doula pilot program to improve access to doula support and a doula capacity program to enhance doula workforce development.

Current state of birth outcomes in Kentucky

According to the Centers for Disease Control and Prevention, mothers living in Kentucky experience rates of pre-term and low-weight births (LWB) that are above the national average.^1,2,3 Defined as under 5 lbs 8 oz, the rate of LWB in Kentucky stands at 9.12%. The rate of pre-term births – occurring prior to 37 weeks of pregnancy – in Kentucky is 11.97%. Babies born pre-term have higher rates of morbidity and disability including respiratory, ocular and auditory challenges as well as developmental delays and cerebral palsy.⁴ LWB is also associated with higher rates of morbidity and inhibited growth and cognitive development.⁵ According to the Centers for Disease Control and Prevention, pre-term births and LWB accounted for 16% of infant deaths in 2020.⁴

Risk factors for pre-term and LWB include lower education and employment levels, chronic stress, maternal health conditions and limited access to preconception and prenatal care.^6,7

Individuals living below the poverty line are more likely to experience barriers including access to transportation to medical appointments, access to resources for a healthy lifestyle and access to prenatal care. According to the U.S. Census Bureau, 16.5% of Kentucky residents lived below the poverty line in 2022 – a rate 5% higher than the national average for the same year.

Doula pilot program

Through the doula pilot program, UnitedHealthcare Community & State is partnering with The Doula Network to provide comprehensive doula support to individuals who are pregnant in five markets including Kentucky. The goals of this program are to improve maternal and child health outcomes, reduce cesarean and pre-term births and evaluate the impact of increased doula support on health outcomes in Kentucky.

Members will be matched with doulas who have a similar background, race and language. They will receive four perinatal doula visits as well as doula support during labor and will be screened for social drivers of health to ensure connection to appropriate resources. Members will additionally receive in-person labor support and 24/7 on-call support from 37 weeks through childbirth.

Doula capacity program

The doula capacity program aims to increase the number of doulas in the workforce and thereby increase access to doula services for members. Through this program, UnitedHealthcare Community & State is providing $198,000 in funding to the Birthing Advocacy Doula Training (BADT) and Cornerstone Doula Training organizations to cover scholarships for doula training as well as continuing education for certified doulas. BADT scholarships will cover full-spectrum doula training with topics including birth and disability, addiction, recovery and more. Cornerstone Doula Training scholarships will cover topics including labor and birth, induction and common pregnancy labor procedures, fetal positioning and harm reduction.

Along with these two programs, UnitedHealthcare Community & State is driving initiatives aimed at improving birth outcomes and access to holistic support through its relationships with local doula organizations.

UnitedHealthcare’s continued commitment

UnitedHealthcare Community & State’s investment in access to doula care and workforce development supports the recent push to utilize doula services in managed care organizations.⁸ By reducing financial barriers to doula training and increasing access to services, UnitedHealthcare advocates for change within maternal health care. Through expansion of emotional and educational support offerings, UnitedHealthcare works to invent a future that makes health care work for everyone.