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NM doulas will be eligible for Medicaid reimbursement under new state law
Closeup of a doula assisting a pregnant woman by placing a belly band while she's sitting on a fitness ball, providing support and comfort during pregnancy. ()
In a step intended to improve maternal and childhood outcomes in New Mexico, doulas will soon be able to enroll as Medicaid providers in the state.
The Doula Credentialing Act, passed during the recent legislative session and signed by Gov. Michelle Lujan Grisham on March 21, goes into effect on July 1. The act requires the Department of Health create a voluntary credentialing process for doulas, which will make the birthworkers eligible to receive Medicaid reimbursement.
As defined under the law, doula means 'a trained, nonmedical professional who provides services, including health education, advocacy or physical, emotional or social support, to a person during the pre-conception period, pregnancy, childbirth or the postpartum period to promote positive health outcomes.'
HB214 also establishes a Doula Credentialing Advisory Council; requires hospitals and freestanding birth centers to create policies to allow doulas to accompany patients during particular services; and creates a Doula Fund to support the provisions of the bill.
New Mexico Doula Association Executive Director Melissa Lopez-Sullivan told Source NM that the health department, the Health and Human Services Department, Medicaid, Managed Care Organizations and community-based organizations are currently all working together to finalize a 'provider toolkit' to help doulas navigate Medicaid processes.
Several doulas have certified with NMDOH and some have already contracted with Medicaid Managed Care Organizations,' Lopez-Sullivan told Source in a written statement. 'These are major milestones — because of them, Medicaid beneficiaries in some areas now have access to doula services as a covered benefit, many for the first time.'
She added that the doula association and its partners will soon offer 'technical assistance and enrollment support,' as well as 'culturally grounded training,' to further assist doulas in their work in New Mexico communities.
Rep. Doreen Gallegos (D-Las Cruces), lead sponsor of HB214, told Source NM that the overall goal with the bill has always been to 'serve a larger number' of patients in the state and that care will start right away in July.
'A doula can help in so many ways,' Gallegos told Source. 'It's hard to sometimes make decisions when you're under that kind of stress and having somebody that's there with you, that can help walk through the process, that maybe is familiar with the doctors at the facility that you're at, or if you're doing a home birth, if things start to go sideways, that you have somebody to consult with.'
She added that healthcare access is limited in New Mexico, particularly in the more rural communities, and expanding the reach of doulas will help meet the needs of more pregnant people.
'Sometimes you just have questions and sometimes medical professionals are so busy because they're in such demand right now, that they don't get to answer all those questions,' Gallegos said. 'Or if you have something in the middle of the night that you're not sure about and you have this relationship with this doula, it can really [help].'
Lopez Sullivan told Source that the bill formally acknowledges the work doulas, particularly community-based doulas, do in the state and provides a path 'toward economic sustainability.'
'Many doulas have been doing this work—quietly and powerfully—for decades, without compensation or institutional support. This legislation acknowledges their expertise and makes space for them to lead within maternal health systems,' she wrote. 'For patients, especially Black, Indigenous, rural, and LGBTQIA+ families, this law opens new access to care that centers their identities, values, and choices…In a state where Black and Indigenous birthing people face the greatest maternal mortality, HB214 represents a necessary shift toward equity and dignity.'
N.M. 'far above the national rate' even as maternal deaths increase across the country
According to a 2023 report released by the March of Dimes, a national nonprofit organization that advocates for maternal and baby health, a third of New Mexico counties are described as maternity care deserts, where access to medical care is limited or nonexistent. The report also notes that about 18% of New Mexico women do not live within 30 minutes of a birthing hospital, compared to the national average of 9.7%, and 23.3% of birthing people received little or no prenatal care compared to 14.8% nationally.
Gallegos described doula care as a 'wraparound of services' as well, because these providers not only assist patients before a child is born, but after as well, as parents settle into life with a new baby.
'I think that's problematic for New Mexico that we are losing doctors, and so we've got to have an environment that helps keep doctors in New Mexico so they can practice. And we also open it up to different types of holistic type of help that people can choose,' Gallegos said. 'We'd better give people options to what fits their lifestyle and what makes them the most comfortable and making sure that they can make decisions that are best for themselves and for their families.'
Maternal death reviews get political as state officials intrude
Lopez-Sullivan said she believes HB214 sets a good foundation for care in New Mexico, but the state needs to continue to invest in 'community-rooted care' and providers; ensure the systems HB214 create actually work in favor of doulas; establish long-term support for the doula workforce, including training and fair compensation; and expand midwifery and other community birth options.
'Improving maternal outcomes also means supporting midwives and community birth centers—especially in rural and Indigenous communities. These models offer holistic, accessible, and culturally resonant care that families trust,' Lopez-Sullivan wrote. 'By investing in midwifery and Indigenous-led care, we can further reduce preventable harm and build the systems our communities deserve.'
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