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2024 Grants Challenge

Doula Access for All

This grant will support marginalized communities by diversifying and expanding the doula workforce to ensure barrier-free access for pregnant and birthing people of color in Los Angeles. The program will address systemic barriers and offer sustainable solutions, increasing the number of doulas covered under the Medi-Cal doula benefit and improving maternal and infant health outcomes for BIPOC individuals, thereby reducing the reproductive crisis impacting communities of color.

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What is the primary issue area that your application will impact?

Health care access

In what stage of innovation is this project, program, or initiative?

Expand existing project, program, or initiative (expanding and continuing ongoing, successful work)

What is your understanding of the issue that you are seeking to address?

The infant and maternal mortality rates among Black women and communities of color are rising, historically impacting low-income, undocumented, and marginalized groups at an alarming rate. Despite the abundant healthcare options in Los Angeles, 17 hospitals have closed their maternity wards, disproportionately affecting the poorest patients who have lost critical access to care.
Since the passage of Roe v. Wade, CA has seen a substantial increase in out-of-state abortion care, with LA leading these numbers. However, the effectiveness of the Medi-Cal doula benefit has been limited by low enrollment caused by overwhelming barriers—less than 400 doulas in the entire state are currently enrolled, and more than half are not located in LA County where thousands are becoming pregnant and birthing everyday. This underutilization stems from insufficient awareness among potential beneficiaries, a learning curve for providers and doulas, and administrative complexities in the enrollment process.

Describe the project, program, or initiative this grant will support to address the issue.

Recognizing that Black women are over 3 times more likely to die from pregnancy-related causes than White women, and that communities of color face the highest risk of preventable adverse birth outcomes, while white women lead the doula industry and generally serve clients with lower risk; this funding will support us in reducing the racial disparities in maternal health outcomes by ensuring that LA residents receive the respectful and personalized care they deserve. Our training program is actively expanding the availability of culturally competent doula services specifically tailored underserved birthing people throughout LA County. Through comprehensive, full-spectrum training, we are equipping doulas with the necessary skills to deliver sensitive and supportive care, addressing historical traumas and implicit biases prevalent within healthcare settings. Emphasizing recruitment from diverse backgrounds, the initiative ensures ongoing mentorship and support for doulas to maximize their impact on improving birth outcomes and reducing maternal and infant mortality rates among marginalized communities. In tandem, our Doula Medi-cal and PAVE portal trainings are dedicated to educating doulas, healthcare providers, community advocates, and potential clients about the Medi-Cal doula benefit and its associated resources. We cover essential topics such as eligibility criteria, enrollment processes, benefits of utilizing doulas as a non-medical intervention, and best practices.

Describe how Los Angeles County will be different if your work is successful.

We've demonstrated success by training over 400 doulas, with a significant percentage serving clients within LA County. This groundwork shows our capability and impact. However, we have learned that there remains a dire need for every Angeleno in every community in LA County to have direct access to a doula, regardless of their race or socioeconomic status. To meet this need, we will increase the visibility of our programs through enhanced outreach and education efforts, ensuring that more people are aware of and can access the supportive, culturally competent healthcare they deserve. This will foster stronger community support networks, with doulas acting as advocates and allies within the healthcare system. Ultimately, we want to influence policy changes and systemic reforms, encouraging broader adoption of inclusive practices that prioritize the needs of diverse communities. Leading to healthier outcomes and greater well-being for all families.

What evidence do you have that this project, program, or initiative is or will be successful, and how will you define and measure success?

The Doula for All initiative is an active program, with the PAVE trainings also already implemented. We measure success through a comprehensive monitoring and reporting system. This includes tracking the number of trainings conducted in LA County, the # of participants who successfully complete our training programs, and the number of doulas enrolling in Medi-Cal. We also monitor the continued support provided to our doulas and the families they serve within LA County. This data collection enables us to quantify our impact, assess our reach within the county, and evaluate the enrollment and utilization rates of Medi-Cal services. We actively participate in community events centered on birth justice and healthcare access throughout LA. Additionally, we expand our collaborations with community-based organizations and educational institutions to ensure we are providing sustainable resources and addressing disparities directly.

Approximately how many people will be impacted by this project, program, or initiative?

Direct Impact: 200.0

Indirect Impact: 5,500.0