This report explores the use and demand for doula support among individuals with employer-sponsored insurance (ESI) in the United States, drawing on a 2025 survey of over 2,500 recent births. While doulas are proven to lower costs and improve maternal outcomes, their uptake remains limited, with most users self-paying and many families facing barriers to coverage and access.
While interest in doula support is high, nearly half of respondents perceive it as difficult to find a doula, and over a quarter need more education about the potential benefits of doula care. The findings highlight actionable opportunities for employers and health plans to expand coverage, improve care navigation, and educate families, making doula support more accessible and equitable.
Some key takeaways from the analysis:
- Only 20% of ESI respondents used a doula during their most recent birth, but those who did highly valued the support and were willing to pay for it.
- 76% of ESI respondents expressed interest in doula support for future pregnancies, yet 48% reported that finding a doula would be extremely or somewhat difficult.
- Over one-quarter (28%) of interested respondents were unfamiliar with what doulas do, with lack of awareness most common among younger, lower-income, rural, and first-time parents.
- Respondents indicated they would be willing to pay an average of $1,400–$2,200 out of pocket for doula services, with willingness to pay varying significantly by income.