# Doula rules in the United States This guide covers what this site's sources say about doulas in the United States: voluntary registries, state Medicaid payment, private certification, and why coverage does not guarantee access. Updated 2026-10-20. Country: United States. Also on the [web page](https://doulas.fyi/guides/doula-rules-in-the-united-states). # Doula rules in the United States Rules for doulas differ from state to state. This guide uses only the public sources listed on this page. It is not legal or medical advice. This site does not hold the rules for every state, so check your own state. ## Voluntary state registries Some states publish a registry of doulas, and Oregon runs a certification programme instead. A registry is not a medical licence. Minnesota publishes a Registered Doula Registry through the Minnesota Department of Health. The department states that participation is voluntary and that it does not verify the accuracy of the information. The Virginia Certification Board also keeps a doula registry. Its terms forbid downloading and commercial reuse, so this site does not use it. ## Medicaid payment by state As of March 2026, 26 states and Washington, DC reimburse doula services through Medicaid, according to the NASHP state tracker. Coverage is typically a package of prenatal visits, support during the birth and postpartum visits. The doula must be enrolled with the state or its managed-care plans, and some states need a referral. The trackers list about 3,153 USD per birth in California, 1,470 USD in Colorado, 2,700 USD in Michigan, 1,428 USD in Maryland, 1,300 USD in Nevada and 1,165 USD in New Jersey. Massachusetts caps near 1,750 USD per pregnancy. New York, Washington, Virginia and Oregon also reimburse doula services. Oregon certifies birth doulas as Traditional Health Workers. Minnesota was one of the first state Medicaid programmes to pay for doula care. The trackers mark some states as partial: Arizona, Delaware, Florida, Kentucky, New Mexico, North Carolina and Pennsylvania. Delaware authorised coverage in January 2024, but details were still being finalised. These figures change. Use the Medicaid doula coverage checker on this site, then confirm with your state Medicaid agency. ## Coverage does not guarantee access KFF Health News reports that fewer than 1 percent of Medicaid births in Virginia used a doula in the first two years of the programme. The article also notes that coverage is not the same as access. Ask any doula whether they are enrolled to bill your plan. ## Private certification DONA International, CAPPA and INELDA are examples of doula certifications. This site lists the certifications a business states on its own site. Ask what a certification means to the doula, because programmes differ. ## What this means for you Check each listing for a certification and for Medicaid acceptance. A blank field means the fact is not stated, so ask the doula. Doulas, programmes and states each set their own terms. Read the provider page before you book. Ask your state Medicaid agency before you rely on coverage. For free or low-cost support, browse the community doula programmes category. ## Sources - [Minnesota Department of Health - Registered Doula Registry](https://www.health.mn.gov/facilities/providers/doula/registry.html) - [NASHP - State Medicaid Approaches to Doula Service Benefits](https://nashp.org/state-tracker/state-medicaid-approaches-to-doula-service-benefits/) - [Black Health - State Medicaid Doula Coverage Tracker](https://blackhealth.org/medicaid/doula-coverage) - [KFF Health News - Many States Cover Doula Care, but Access to a 'Birthing Bestie' Is Often Out of Reach](https://kffhealthnews.org/public-health/doula-care-medicaid-access-expectant-parents-state-policy-virginia/) - [Oregon Health Authority - Traditional Health Worker Doula Certification](https://www.oregon.gov/oha/THW/Pages/Doula.aspx) ## Questions ### Does it matter if my doula is on a state registry? It may matter if you want Medicaid to pay. Coverage needs a doula enrolled with the state or its managed-care plans. Ask the doula whether they are enrolled. ### Where can I find the rules for my state? This site does not hold the rules for every state. Ask your state health department or Medicaid agency. Ask a qualified professional for legal advice. ### What is Oregon's Traditional Health Worker programme? Oregon certifies birth doulas as Traditional Health Workers. The Oregon Health Plan was one of the first Medicaid programmes to pay for doula care. Check the Oregon Health Authority page for details. > **Not medical advice.** This site is a directory, not a clinical service. A doula gives emotional, physical and informational support, not medical care. Always talk with your midwife, doctor or other licensed clinician about medical decisions.