Companies Should Offer Doula Care for Their Employees. Here's Why

It’s good for moms and babies, yes, but also for the bottom line.

Helping pregnant and new parent employees helps companies.

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Editor’s note: In recognition of Black Maternal Health Week, April 11-17, and in solidarity with efforts to address America’s maternal mortality and morbidity crisis, we are issuing an urgent call to companies: Cover doula care.

What if there was a service that made giving birth a safer experience for moms and babies, helped support families in those early few weeks, and helped lower overall health care costs? There is. It’s doula care.

A doula is a non-medical professional who provides emotional support during pregnancy and labor. This can include educating moms about pregnancy, helping them understand different treatment options, planning for childbirth, and advocating for clients during labor and delivery. Many doulas continue to support their clients in the postpartum period, encouraging breastfeeding initiation and providing mental health support. And there’s a huge amount of research showing that doulas improve outcomes for moms—both physically and mentally.

The American College of Gynecologists and Obstetricians (ACOG) states that doula care is “associated with improved outcomes for women in labor.” According to one study, women who worked with a professional doula had fewer cesarean births, and were less likely to experience serious complications like uterine ruptures and hysterectomies. Moms working with doulas were also less likely to die from pregnancy-related causes, which is particularly important given our current maternal health crisis—the US has one of the highest maternal mortality rates in the industrialized world, and data shows that Black moms are much more likely to die than white ones. Other studies show that moms working with a doula were less likely to have a low birth weight baby, more likely to initiate breastfeeding, and less likely to have negative feelings about their childbirth experience.

The emotional support a doula provides complements the work of medical system providers. “Traditional medical establishments are not structured to offer the continuous care that is necessary and essential to support those who are pregnant,” says Cassandre Charles, a birth doula and the VP of Consumer Marketing at digital health platform Ovia Health. “For BIPOC women, especially Black women who are three times more likely to die at birth then non-Black women and who make up a majority of the workforce, it would be a grave disservice for companies to not offer doula services as an employee health care offering. Doulas fill the gap that hospitals simply can’t.”

The benefits are clear—which is why doulas deserve to be compensated appropriately for their services. The cost of doula care varies by region, business model, and how long you want to work with a doula for. It might cost somewhere between $600 to $2,000 to hire a doula for pregnancy and birth services, with additional postpartum offerings costing an average of $25 to $35 per hour. Families preparing for a new baby might not have the extra cash to hire a doula. That’s why companies should provide a doula care benefit as part of their standard healthcare offering.

“Doula care is preventive care, and we know preventive care saves costs in the long run,” says Laura Parry, LCSW, a Utah-based therapist specializing in perinatal mental health. While companies may balk at covering doula costs upfront, research suggests that hiring birth doulas is, in fact, a cost-effective strategy.

A 2020 Health Care Cost Institute (HCCI) report found that “average spending per vaginal birth nationally was $12,235… average spending per C-section, in contrast, was $17,004.” A 2016 report from the National Partnership for Women & Families estimated that widespread doula care would reduce C-section births by roughly 28 percent. “The reduction in cesarean births from the use of doula care could save Medicaid at least $646 million per year, and private insurers around $1.73 billion annually,” a press release on the research explains. Doula care could also generate cost savings through reducing other preventable labor complications, like the usage of forceps and vacuums during birth.

“For employers interested in the wellbeing of their employees as well as their own bottom line, providing doula services as part of their employee health care offering makes basic sense,” says Britta Bushnell, Ph.D., a childbirth educator, doula and the author of Transformed by Birth. “In my work with birthing families, those with doula support during labor and/or postpartum adjust to new parenthood more easily and with fewer traumatic experiences that can lead to long-term issues, and the potential to need far more expensive and time-consuming additional medical or mental health services.”

Katja Pigur, senior director of programs and business development at the ‎Maternity Care Coalition, says that the overwhelming evidence about the health benefits of doula support should be enough to convince companies—but another bonus is that this might make companies more appealing to new employees.

“Employers are also taking care of their branding,” she says. “They want to attract the talent of the female workforce, they want to attract families. And people out there in the workforce these days look at more than just a salary. They look at benefits, they look at work-life balance, and support through the entire life cycle—not just if they are young and healthy. Offering doula benefits helps them be an employer of choice and attract talent.”

Providing this benefit is also a way for companies to live up to the pledges they made in response to the Black Lives Matter movement. A 2020 research report by Seramount (formerly Working Mother Media) found that 52 percent of Black women were considering leaving their jobs in the next two years, and companies who build a truly inclusive environment may be able to prevent those departures. Experts say that while we work on overhauling health care systems and systemic injustices, doula care is an incredibly important tool in birth equity (allowing all families the same opportunities for safe, joyful births). Providing doula care may show Black families that employers are not only aware of the racial disparities in maternal mortalities—but are providing an evidence-backed tool to make birth safer.

According to a 2020 report released by Great Place to Work and virtual health clinic Maven, roughly 43 percent of new moms leave the workforce within a year of having a baby—and that was prior to the COVID-19 pandemic. However, the report says companies can provide services like childcare and paid parental leave to help prevent employee burnout and improve employee retention. Investing in doula care is another way to show support for working parents, which could be linked with higher employee retention and satisfaction down the line.

"A mother who is healthier and happier is going to be a better employee and an even richer asset to a company,” says Julie Arvan, a postpartum doula and the founder of Nesting Days. “The physical and emotional help doulas provide results in less anxiety and stress, less emotional trauma and postpartum depression, better bonding, a healthy frame of mind, and an all-around feeling of wellbeing. Ultimately, all of this helps her make the transition back to work easier—and while being a mother, too."

Ultimately, Pigur says, companies providing this benefit will help the US get closer to offering doula support for all families—regardless of employment status.

“Our goal is that this should be the service that is available to everyone,” she says. “No matter where you are financially, no matter if you are employed or not employed. Because it's another tool in your toolkit when you give birth.”