Article

What happened with doulas in the state budget?

July 6, 2023
Read time:
Download Fact Sheets
Register now
Share this resource
Subscribe to our Newsletter
By subscribing you agree to with our Privacy Policy.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Download this as a PDF

Community Solutions has been working for several years with the legislature and both the Kasich and DeWine Administrations to improve women’s and maternal health in Ohio. One key element of this work is expanding access to doulas. When we learned that one of Governor DeWine’s budget vetoes was related to doulas, we had to dive in and figure out what happened.

 Doulas are professionals trained to provide non-medical, emotional and physical support throughout a woman’s pregnancy, childbirth and postpartum.

First, a quick description of why doulas are so important. Doulas can play a vital role in the lives of people who give birth and their families. Doulas are professionals trained to provide non-medical, emotional and physical support throughout a woman’s pregnancy, childbirth and postpartum. While a doula may work alongside medical staff to create a comfortable environment, a doula’s primary role in the medical setting is to serve as an advocate for the family he or she works for. This is especially important for women of color who have significantly higher rates of maternal mortality and morbidity compared to white women. Having an advocate in health care settings is literally an issue of life and death.

Doulas in the state budget

There have been efforts, now spanning three General Assemblies, to create a certification process for doulas and require that Medicaid pay for doula services. This certification is necessary for Medicaid payment of doulas as a provider type. Legislation in the 133rd and 134th General Assemblies to achieve this stalled out, so we looked to the budget in the 135th General Assembly, House Bill 33, as a vehicle to finally get this done! It was a windy path to get here (the House added in language to expand access to doulas, the Senate removed it, it was added back in in the Conference Committee. Trace the entire budget process.)  

Ultimately the legislature passed the budget on June 30, 2023 with language that creates certification for doulas through the Board of Nursing and includes Medicaid coverage of doula services.  

Here’s where the confusion starts…one of the Governor’s 44 vetoes deleted SOME of the text in the section of the bill where the doula certification process and Medicaid coverage are created. We know this has created a misunderstanding by some in the media, and likely beyond, that the Governor vetoed the entire section of the bill that expands access to doulas. This is not the case. In a nutshell, here’s what is in versus out from the budget language:

  • Language that establishes doula certification and specifies that the rules for issuing certificates to doulas will be developed through the Board of Nursing IN
  • Medicaid coverage of doulas IN
  • Language that made doula services a 5-year pilot program OUT  
  • By vetoing the pilot, this program is now permanent
  • Language that named specific organizations that could certify doulas OUT  
  • Certifying entities will be determined by the Board of Nursing
  • Language naming specific organizations that needed to be represented on the doula advisory board within the Board of Nursing OUT  
  • The advisory board will be comprised of at least 13 members spanning maternal/infant health organizations, public health, current doulas, a consumer and with a goal of including people who represent areas with higher rates of maternal and infant mortality and greater disparities.
  • Language that required a report on outcomes OUT  
  • The Governor’s veto message cited this as duplicative of other reporting requirements.We are hopeful that this is helpful in understanding what happened during the budget process, as it relates to doulas (we’ll certainly explore more in the coming weeks and months). This is an issue that Community Solutions has been working on for many years now and we are eager to work with the Board of Nursing, the Department of Medicaid, organizations and people across the state who know how important it is to expand access to doulas.
 At the end of the day, Ohio is on a path to permanently cover doula services.

At the end of the day, Ohio is on a path to permanently cover doula services which will lead to healthier outcomes and expand access to a service that we know can help to reduce maternal and infant mortality.

Download Fact Sheets

Ohio Statewide Data

Download

Wood County

Download

Wyandot County

Download

Williams County

Download

Washington County

Download

Vinton County

Download

Wayne County

Download

Warren County

Download

Van Wert County

Download

Union County

Download

Tuscarawas County

Download

Stark County

Download

Summit County

Download

Trumbull County

Download

Shelby County

Download

Seneca County

Download

Scioto County

Download

Ross County

Download

Sandusky County

Download

Richland County

Download

Putnam County

Download

Huron County

Download

Portage County

Download

Preble County

Download

Pike County

Download

Pickaway County

Download

Perry County

Download

Noble County

Download

Paulding County

Download

Ottawa County

Download

Morrow County

Download

Muskingum County

Download

Morgan County

Download

Montgomery County

Download

Meigs County

Download

Monroe County

Download

Miami County

Download

Mercer County

Download

Marion County

Download

Madison County

Download

Medina County

Download

Mahoning County

Download

Lucas County

Download

Lorain County

Download

Logan County

Download

Licking County

Download

Lawrence County

Download

Lake County

Download

Holmes County

Download

Jackson County

Download

Knox County

Download

Jefferson County

Download

Hocking County

Download

Henry County

Download

Highland County

Download

Harrison County

Download

Hancock County

Download

Hardin County

Download

Greene County

Download

Geauga County

Download

Guernsey County

Download

Hamilton County

Download

Gallia County

Download

Fayette County

Download

Fulton County

Download

Franklin County

Download

Fairfield County

Download

Erie County

Download

Darke County

Download

Defiance County

Download

Coshocton County

Download

Delaware County

Download

Cuyahoga County

Download

Crawford County

Download

Columbiana County

Download

Clinton County

Download

Clermont County

Download

Clark County

Download

Champaign County

Download

Carroll County

Download

Athens County

Download

Ashtabula County

Download

Brown County

Download

Butler County

Download

Belmont County

Download

Auglaize County

Download

Ashland County

Download

Allen County

Download

Adams County

Download

Lake County

Download

Geauga County

Download

Cuyahoga County

Download

All Municipalities Geauga County

Download

All Municipalities Lake County

Download

All Municipalities Cuyahoga County

Download

Thompson

Download

South Russell

Download

Russell

Download

Parkman

Download
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Download report

Subscribe to our newsletter

5 Things you need to know arrives on Mondays with the latest articles, events, and advocacy developments in Ohio

Explore the fact sheets

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique.

No Related Fact Sheets

Explore Topics

Browse articles, research, and testimony.

Poverty & Safety Net
Article

A look at the Ohio House-passed version of the state budget

Community Solutions Team
April 28, 2025
Medicaid
Article

What’s at stake in Ohio? Reimagining the new Medicaid

Brandy Davis
April 28, 2025
Poverty & Safety Net
Article

Eighteen health and human service levies in May election

Kyle Thompson
April 28, 2025
Maternal & Infant Health
Article

Infant and early childhood mental health: Bridging gaps and ensuring early intervention

Tamikka James-Haygood
April 28, 2025
Poverty & Safety Net
Article

Connecting with legislators at Policy Advocacy Days

Kyle Thompson
April 21, 2025
Poverty & Safety Net
Article

AIDS Funding Collaborative community briefing at The Centers on April 29th

Julie Patterson
April 21, 2025