Birthing families require immediate support.
Qualified doulas are ready and willing to serve. Families are being denied the right to choose one. This was never about a lack of demand. It is about a systemic failure to inform Californian birthing families on Medi-Cal and provide access to doulas.
Reliance on a narrow definition of "lack of demand" is unsustainable when the majority of California families haven't been empowered to exercise their right to a doula, and remain unaware of the improved birth outcomes they provide, or have not fully utilized the Medi-Cal Doula coverage they are entitled to.
Support improving birth & postpartum outcomes and increasing doula access.
Doulas are a vital part of the solution, and families need access now. California set a statewide Bold Goal to reduce health disparities for the hardest-hit populations by 50% by 2025 — last year. The state has failed to reach that goal. Now we need to act.
Every year, more than 40,000 families in LA County — and over 150,000 across California — give birth through Medi-Cal. Each one has the right to a doula of their choice. Not whichever doula a plan happens to have on a list. The one who speaks their language, shares their culture, and they trust to advocate for them.
Health plans are allowed to stop contracting doulas once their network is deemed "adequate" for demand. But that math is broken at the root: most families are never told the benefit exists, so measured demand stays artificially low — and plans use that suppressed number to declare they have "enough" doulas and turn away qualified providers who are ready to serve.
Meanwhile, PAVE-approved doulas wait months and even years for contracts. Claims go unpaid. Families who do find a doula they trust are told that doula can't be contracted in time. The demand is real and the doulas are ready. The barrier is the system in between — and it's one the plans and DHCS can fix.
And the care itself isn't in question: ACOG and the Society for Maternal-Fetal Medicine recognize continuous doula support as one of the most effective strategies for improving birth outcomes — without adding medical risk. Families have a right to care that is proven to work.
Families may choose a doula of their choice — including offering a Letter of Agreement so a trusted, not-yet-contracted doula can serve them in time. Don't cap the network before every family has access.
Contract more doulas to meet families' real needs, and stop delaying or denying contracts for doulas already PAVE-approved to serve high-risk communities.
Cover administrative costs and process claims promptly. End the payment delays and denials that make this work financially unsustainable for an independent, non-clinician workforce.
Eliminate insurance requirements — like umbrella and cyber coverage — that are financially out of reach and don't fit the doula profession. Bring transparency to billing and claims.
Who signed
The people who signed are exactly the community this benefit was built for: the families who receive care and the doulas who provide it, in every region of the state.
Individuals and organizations who put their names on the record in support of families' right to doula care.
The very members plans say aren't asking — adding their own names to the demand.
In their own words
Signers were invited to share why this matters. Here are a few of their voices.
Standing together
Doulas, birth collectives, community health organizations, legal advocates, and care providers across the state added their names alongside individual signers.
Add your name
The letter is still gathering signatures. Add your name to urge California's Medi-Cal managed care plans to remove the barriers between families and their right to a doula of their choice.