Investing in Doula Sustainability: A Free Guide for Funders
Doulas reduce cesarean rates by nearly 40 percent. They shorten labor. They lower the odds of a low Apgar score. Payers already know this. Several states have built Medicaid reimbursement structures around it.
What almost none of them have funded is the person doing the work.
The math on this is not close. Replacing one burned-out healthcare worker costs an average of $61,000. Burnout costs the broader healthcare system an estimated $4.6 billion a year, and doulas are not even counted in that figure, because doulas are barely studied at all. The workforce producing outcomes payers are willing to reimburse is leaving the field faster than it can be replaced, and the reimbursement systems built around that workforce have no answer for why.
That is the gap this guide is for.
Investing in Doula Sustainability is a 15 page resource built for investors, funders, and capital allocators already writing checks in reproductive health, or thinking about it. It walks through the evidence base, breaks down what Medicaid reimbursement does and does not cover, and includes a practice sustainability calculator that shows the real margin a doula is working with once unpaid on-call time and overhead are counted in. It closes with a due diligence framework: the questions to ask before a check gets written, and what to listen for in the answers.
This is not a pitch. It reads like the memo you would want a portfolio analyst to hand you before a meeting.
A few things worth knowing before you open it:
- It includes the full evidence base on doula outcomes, section by section, with sourcing.
- It breaks down Medicaid doula reimbursement rates and what they leave out, state by state where the data exists.
- It has a practice sustainability calculator you can run with a real doula's or organization's numbers, not illustrative ones.
- It ends with a due diligence framework you can bring into your next conversation with a doula-serving organization.
The guide is available here, for subscribers: