Startups are getting in on the growing doula industry

Doulas, a support role for birth and postpartum care, are slowly but surely becoming more popular.

As of March 2026, 33 states and DC cover doula care through Medicaid or are in the process of implementing Medicaid coverage, according to the nonprofit National Health Law Program.

Private plans are also coming around. UnitedHealthcare is among the most recent payers to roll out an offering for doulas—nonmedical professionals who assist clients through pregnancy, birth, postpartum, and other life transitions. United said on March 16 that by the end of 2027, up to 7.2 million members could potentially access maternal and infant health doula support through their employer’s health plan.

Expanding coverage addresses demand from employers that want to offer more health benefits, Rhonda Randall, EVP and chief medical officer of UnitedHealthcare Employer and Individual, told Healthcare Brew. There’s also evidence that links doula care to a reduction in risky and costly procedures like cesarean sections and premature deliveries, particularly for Black patients.

“These types of benefits have outcome improvements beyond just healthcare costs,” Randall said. “They are important investments for the health of [the] workforce.”

Startups step in. Payer coverage for doula care brings new hurdles to both sides, and women’s health companies are trying to ease the transition.

Pomelo Care, a virtual medical care company for women and children valued at $1.7 billion, acquired a large national network of doulas in 2024. Pomelo now has about 350 doulas in its network alongside other types of providers and services, spokesperson Julie Halpin told us.

The startup vets doulas’ credentials, then helps them manage unfamiliar insurance hurdles like documenting care, submitting claims, and getting paid, Marta Bralic Kerns, Pomelo’s founder and CEO, told us.

“It’s a really big shift for the industry…going from doulas operating very independently, typically on a cash pay basis, where they find their own customers,” Bralic Kerns said.

Maven Clinic, another virtual women’s and family health company, also helps facilitate reimbursement for in-person doula care and offers virtual doula services.

The company selects its doulas based on hours worked and whether they have been certified from a reputable credentialing organization like DONA International, alongside other factors like cultural competency, according to Maven Chief Medical Officer Neel Shah.

Different plans and state Medicaid programs have a “patchwork” of varying standards for their doulas and reimburse different amounts, Shah said, but they generally require doulas to be certified by the state or organizations like DONA.

“Historically, these kinds of services have lived outside the healthcare system without a formal reimbursement mechanism,” Shah said.

Maven began offering some level of doula care in 2015, shortly after its 2014 founding, but has seen demand spike over the last few years, Shah said.

“One of the things that’s been proven out of the last couple of years is that there is a lot of demand for doulas. People want them, and they make outcomes better, and so that’s why United is paying for them, and a lot of Medicaid [plans] are paying for them too,” Shah said.