While some significant employers now offer doula coverage, including Walmart and Microsoft, access remains limited, especially for marginalized communities. Doulas provide continuous physical, emotional, and informational support before, during, and after childbirth.

Advocates are pushing for Medicaid reimbursement for doulas in Washington to extend access, highlighting the need to address long-standing health inequities. Despite progress, many Washingtonians still lack access, and in other states, doulas often work for free due to limited resources. However, advocates remain hopeful that mainstream insurance and healthcare systems will catch up to the evidence supporting doula support.