Expanding Access to Doula Care to Improve Maternal Health with Dr. Cynthia Brown

Summary

Podcast Summary: Expanding Access to Doula Care to Improve Maternal Health

Podcast: Becker’s Healthcare Podcast
Episode: Expanding Access to Doula Care to Improve Maternal Health with Dr. Cynthia Brown
Air Date: December 13, 2025
Host: Liz Kaslow
Guest: Dr. Cynthia Brown – Medical Director and Clinical Lead for Women’s Health, Elevance Health

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Episode Overview

This episode spotlights Elevance Health’s groundbreaking move to expand doula services from Medicaid into select employer-sponsored health plans, aimed at improving maternal health outcomes and tackling disparities. Dr. Cynthia Brown discusses the development, evidence base, and long-range benefits of doula care, offering both data-driven analysis and practical insights for healthcare leaders.

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Key Discussion Points & Insights

Dr. Cynthia Brown’s Background & Role (00:22 – 01:38)

• Dr. Brown, an OB/GYN with 20 years of clinical experience, now directs women’s health initiatives at Elevance Health.

• She focuses on improving outcomes, addressing health inequities, and optimizing the healthcare experience for women, especially around maternal health.

• Collaborates broadly within Elevance (clinical teams, health plans, public policy), evaluating evidence and designing scalable programs such as doula care.

  “My purpose here is to advocate for women…addressing inequities, and overall improving the experiences for women across all stages of their health journey with a special emphasis on maternal health.”
  — Dr. Cynthia Brown (00:29)

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Expanding Doula Coverage: Medicaid to Employer Plans (01:40 – 04:44)

• Rationale: United States maternal health complications are on the rise; both outcomes and care experience need bolstering.

• Evidence Review: Doula care frequently emerges in research as highly effective—providing emotional, physical, and educational support during pregnancy, birth, and postpartum.

• Key Outcomes with Doula Care:

  • Higher rates of carrying to full term
  • Fewer low birth weight infants
  • Reduced NICU admissions
  • Fewer C-sections
  • Improved postpartum mental health

  “Our public policy institute conducted some research studies and the results showed that women who had doula support were more likely to carry to full term…had reduced NICU admissions, they had less C sections, and then they had better postpartum mental health.”
  — Dr. Cynthia Brown (02:50)

• Implementation Journey:

  • Initial pilots focused on Medicaid populations most in need, showing clear improvement in confidence, understanding, and birthing outcomes.
  • Needed to build credentialing, reimbursement, and network infrastructure to scale.
  • As of 2025, members in select employer-sponsored health plans can select doulas as in-network providers.

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Doula Care & Racial Disparities in Maternal Health (04:44 – 06:19)

• Maternal health disparities cut across income and education; lack of feeling heard/support is a key issue.

• Doulas, especially those from the community, foster trust and create culturally aligned care.

• Access expansion removes insurance barriers and provides support proven most impactful in underserved groups.

  “Families who work with doulas often have smoother experiences…better emotional well being, and this is even stronger…in underserved communities, especially when paired with community-based doulas who understand their culture and their language.”
  — Dr. Cynthia Brown (05:21)

• The key mechanism: Doula-client trust leads to women voicing needs and concerns, crucial to complication prevention.

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Long-Term Value and Cost Savings (06:20 – 07:41)

• Mechanism of Savings: Supported women engage earlier, follow care plans, and address issues before escalation.

• Health Outcomes with Financial Impact:

  • Reduced C-sections, preterm births, and NICU admissions all cut significant healthcare costs.
  • Support extends to mental health and substance use issues—two leading causes of postpartum maternal deaths.

  “Mental health and substance use are two of the leading causes of postpartum maternal deaths in this country…So by having doulas involved, that’s creating meaningful long term value.”
  — Dr. Cynthia Brown (06:54)

• Bottom line: Doulas create safer pregnancies, healthier babies, and more empowering experiences for mothers.

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Advice for Healthcare Industry Leaders (07:42 – 08:56)

• Dr. Brown strongly encourages organizations to consider doula coverage—noting “it works” and is backed by Elevance’s research and pilots.

• Doulas provide crucial emotional anchoring and help women navigate the complexities of the healthcare system.

• Expanding access is a vital opportunity to “elevate both the member experience and health outcomes for moms and babies.”

  “Pregnancy is such an incredibly vulnerable and stressful time…members just want to feel heard, supported and guided…Doulas really help provide that continuous presence.”
  — Dr. Cynthia Brown (08:13)

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Memorable Quotes & Timestamps

• “Social support is one of the most consistent predictors of better health outcomes.”
  — Dr. Cynthia Brown (02:27)

• “This shared understanding then builds trust. And when women feel safe and understood, they’re more likely to speak up about their needs and their concerns. And this is really the key to preventing complications.”
  — Dr. Cynthia Brown (05:48)

• “We advocate for doula care at Elevance Health because it works...It’s clear that doulas help women access the care that they need. The result is healthier, safer pregnancies and deliveries.”
  — Dr. Cynthia Brown (07:56)

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Key Takeaways by Segment

• 00:22 – 01:38 — Dr. Brown outlines her mission and women’s health leadership.
• 01:40 – 04:44 — Evidence and infrastructure for scaling doula care; announcement of employer plan coverage.
• 04:44 – 06:19 — Doulas as a solution to maternal health disparities, especially when community-based.
• 06:20 – 07:41 — Long-term member and cost benefits of doula coverage.
• 07:42 – 08:56 — Call to action for leaders: invest in doula care for measurable improvements in maternal and family health.

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Conclusion

This episode elucidates the critical role doulas play in maternal care, how legacy insurance barriers are being dismantled, and the quantifiable improvements in maternal outcomes. Dr. Cynthia Brown’s expertise and passion shine as she makes a compelling case for industry-wide expansion of doula access—a call echoed by Elevance’s research and piloted results.

Transcript

[A]

Hello everyone. This is Liz Kaslow with the Becker's Payer Issues podcast. I'm thrilled today to be joined by Dr. Cynthia Brown, medical Director and Clinical lead for Women's Health at Elevance Health. Thanks so much for chatting with us today. And just to get started, I would love to hear a bit more about your career background and could you give us a bit of an overview on your current role at Elevance? Sure.

[B]

Thanks, Liz, and thanks for having me on your program today. So, as you said, my name is Cynthia Brown. I am a board certified obstetrician and gynecologist. I've practiced clinically for 20 years prior to coming to Elevance and now I serve as the medical Director for Women's Health at Elevance Health. Basically my purpose here is to advocate for women. I focus on impacting outcomes, addressing inequities, and overall improving the experiences for women across all stages of their health journey and really with a special emphasis on maternal health. So my role is really one of looking for opportunities for improvement. I identify drivers and barriers to that improvement and then collaborate with lots of people in order to put all those pieces together and find solutions that work for our members. I collaborate with our clinical teams in all lines of business, our local health plans, our public policy institute, and then our community based partners as well. And we evaluate the evidence, design new programs, and we look to scale solutions that improve member experience and outcomes like doula care that we're talking about today.

[A]

Yeah, I'm really excited to talk about this solution with you. So just for context, for the first time, some Elevance Health affiliated employer health plans will include doula services. So can you elaborate on that expansion? Because originally there was some Medicaid plans. There were some Medicaid plans that had doulas for several years. But how did that grow to these employer plans?

[B]

Yeah, absolutely. So as we saw maternal health complications rising nationally, we knew that we needed solutions that not only improved clinical outcomes, but strengthened the care experience for our pregnant women. And when we looked across that evidence, doula care consistently surfaced as one of our most promising approaches. So doulas just to kind of level set our trained non clinical people who provide emotional, physical and educational support during pregnancy, childbirth and the postpartum period. They are not clinicians, they don't do deliveries. They really are social support. And social support is one of the most consistent predictors of better health outcomes. And it's one of the strongest protective factors across the entire prenatal period. So when we have good support we have less stress, we have less stress, we have better mental and physical health. So our public policy institute conducted some research studies and the results showed that women who had doula support were more likely to carry to full term. They had fewer birth weight infants, they had reduced NICU admissions, they had less C sections, and then they had better postpartum mental health. And all of these outcomes were meaningful from both, obviously a clinical perspective, but also for the member experience. So typically when we implement programs, we pilot them, and we usually pilot them in the groups where there's the greatest need or we can, you know, make the most impact. So we started in Medicaid and our research there showed, our experience there showed that members receiving doula support navigate their pregnancy with better confidence, they have better understanding and emotional well being, and they had better birthing outcomes. So then we had to take the time to build the infrastructure that's needed to really bring doulas into our network at scale. So this meant things like establishing credentialing pathways, developing reimbursement models across all our states, partnering with doula organizations to grow the workforce that reflects the communities we serve. But as a result, in 2025, members in select employer sponsored health plans can now search for and select doulas just like they would any other in network provider. So in the same way that you would look for a cardiologist that met your needs or a dermatologist, you can now search for doula who addresses the needs of your whole family during pregnancy, delivery and the postpartum time.

[A]

That's great to hear, and I want to follow up on some of those outcomes in just a moment. But racial disparities are particularly prevalent with maternal health outcomes. So can you talk about how doulas may address these gaps?

[B]

Absolutely. You know, we know that maternal health challenges affect women across all backgrounds. And even women with higher income or advanced education can face poor experiences and outcomes simply because they don't always feel heard and supported. So for many families, doula care has been out of reach because it wasn't traditionally covered by insurance. Expanding this access helps remove that barrier and it gives women, more women, the support that they need deserve. Families who work with doulas often have smoother experiences. They have less unnecessary interventions, they have more success with breastfeeding, they have better emotional well being, and this is even stronger. These benefits are even stronger and well noted in underserved communities, especially when families are paired with community based doulas who understand their culture and their language and their lived experience. So this shared understanding then Builds trust. And when women feel safe and understood, they're more likely to speak up about their needs and their concerns. And this is really the key to preventing complications. At the heart of it really, doulas create a more personal, culturally aligned and supportive experience for all moms. And that's really a pretty powerful way to address long standing gaps in maternal health care.

[A]

Yeah. So can you talk a little bit about what sorts of long term savings these investments in doulas could lead to for elevance?

[B]

Yes, I'm glad you asked that. You know, it really starts with the member experience. When women feel supported, they engage earlier, they ask more questions of their providers, they are more likely to adhere to their care plan, and then they get help before these small issues turn into big complications. You know, mental health and substance use are two of the leading causes of postpartum maternal deaths in this country. And as I said before, social support is one of the strongest protective factors across pregnancy and postpartum in its ability to reduce stress and to improve mental health. So doulas provide this as well. They also, you know, as I've said before, those who have doula care have reduced C sections, they have less preterm births, they have less NICU admissions, and these are all events that have really significant cost. So by having doulas involved, you know, that's creating meaningful long term value. So again, overall, what matters most is really that doulas are creating safer pregnancies, healthier babies, and a more positive, empowering experience for moms.

[A]

So I wanted to wrap this up by getting some of your final thoughts and advice for other industry leaders as they focus on maternal health. And if they're considering possibly expanding to.

[B]

Include doula coverage, my advice for other industry leaders is to definitely consider doula coverage. You know, we advocate for doula care at Elevance Health because it works. You know, we've done the research, we've run the pilot programs, and it's clear that doulas help women access the care that they need. And the result is healthier, safer pregnancies and deliveries. You know, pregnancy is such an incredibly vulnerable and stressful time for people, and members just want to feel heard, supported and guided, not just in the delivery room, but really throughout the entire journey. So doulas really help provide that continuous presence and by helping people navigate what can be accomplished. Complicated healthcare system, it helps ease anxieties, it empowers them, and it basically just improves outcomes and is a great, you know, expanding access to them is really one of the opportunities all of us have in this industry to elevate both the member experience and health outcomes for moms and babies.

[A]

Well, thank you so much, Dr. Brown. We really appreciate having you. And to our listeners, if you'd like to listen to more podcasts from Becker's Healthcare, you can visit Beckershospitalreview.com thank you.

[B]

Thanks, Liz.