Doulas and Birthworkers

A doula is a non-clinical professional who provides physical, emotional, and informational support to moms before, during, and after childbirth, including continuous labor support.

A doula is not a replacement for a medical professional or appropriate prenatal care.   Doulas can work alongside medical teams to support the family.

A doula can build strong, trusting relationships with families and help to keep them safe during this vulnerable time in life.

Doula Care Supports Healthier Babies

  • Doula support leads to better birth outcomes, improving newborn health and creating a more positive birth experience.
  • Babies are more likely to be breastfed when parents have doula care, reducing the risk of many illnesses.
  • Parents with doulas have a lower chance of delivering a baby with low birth weight.
  • Preterm births cost the healthcare system over $26 billion annually, with expenses for preterm infants being 10 times higher than for full-term infants in the first year.

Doula Care’s Role in Reducing Maternal Deaths

Doulas were included in a recent report titled, Preventing Maternal Mortality in Montana issued by the Montana Maternal Mortality Review Committee, which is housed at the Montana Department of Public Health and Human Services (DPHHS).

SYSTEM LEVEL RECOMMENDATIONS

  • Public and private insurance providers should provide reimbursement to support patients throughout the perinatal period through support such as case management, licensed doulas, community health workers, and resource groups.

REPORT RECOMMENDATIONS

  • Multidisciplinary health care teams that include care coordinators should engage with and coordinate care with other providers involved in the care of pregnant patients to ensure continuity of care.
  • Doulas, social workers, care coordinators, and/or other support team members should provide support and follow-up care of patients during the postpartum period, including information on how to access free and virtual postpartum support groups.

Expanding Access to Doula Care Through Policy

In 2025, HMHB and the Montana Doula Collaborative worked to advance legislation supporting a community-based doula workforce that meets Montana’s needs. Fair reimbursement is essential, especially for rural doulas traveling long distances to support families.

A Medicaid benefit for doula services would expand access for rural, Indigenous, and low-income families while ensuring doulas earn a living wage. At least seven states reimburse doulas $1,500+ per birth, recognizing their impact. To maintain autonomy, participation in state reimbursement programs should remain optional.

Montana’s best approach is voluntary certification, ensuring professional recognition while keeping doula care flexible and community-driven.

Click HERE to view and download a handout to help with talking about doulas.

Doulas Help Under-Resourced Communities

For many Montana families, access to maternity care is a significant challenge—especially in rural and Indigenous communities.

  • 65% of rural Montana counties are designated as “maternity care deserts”, meaning families must travel five times farther for care compared to those in counties with full maternity services.
  • 92% of Montana counties with an American Indian/Alaska Native (AI/AN) majority are considered maternity care deserts.
  • Limited access to care increases the risks of stillbirth, preterm birth, severe maternal complications, maternal death, and NICU admissions.
  • Doulas play a critical role in bridging these gaps by providing continuous support, improving health literacy, and addressing social support needs.
  • By expanding access to doula care, we can improve birth outcomes and support healthier families across Montana.

Doulas Help Reduce Economic Strain

Maternal health complications create financial stress for families and communities.

  • Health complications lead to missed workdays and reduced maternal employment, impacting household income and workforce participation.
  • Doula care helps lower the risk of maternal health complications, easing the economic burden on families and strengthening communities.

Doulas Support the Urgent Need to Address Maternal Health

Maternal health in the U.S. is in crisis, and Montana faces even greater challenges.

  • In 2022, over 800 maternal deaths occurred nationwide—more than double the rate of most high-income countries.
  • Montana’s maternal mortality rate is 40.7 deaths per 100,000 births, significantly higher than the national average of 22.3.
  • Severe maternal complications, or severe maternal morbidity, affect 194 per 10,000 births in Montana—35% higher than the U.S. average.
  • Two-thirds of maternal deaths happen after birth, highlighting the need for better postpartum care.
  • Maternal mental health is a growing concern — ~15% of Montana mothers experience postpartum depression, while ~27% experience perinatal depression, both exceeding national estimates.

Doula Support Significantly Reduces the Risk of Poor and Costly Health Outcomes

  • 24% decrease in preterm births
  • 37% decrease in cesarean births
  • 64% decrease in postpartum anxiety and depression

Investing in doula care leads to healthier pregnancies, safer births, and stronger families.

The Indigenous Birthworker Network of Montana is a growing community dedicated to honoring birth as ceremony and strengthening Indigenous birthing practices. Meeting every third Thursday of the month from 6:00–7:30 PM, the network offers ongoing education, mentorship, and connection for Indigenous Birthworkers across the state. Through these gatherings, members expand their impact by supporting families, creating Family Care Spaces, and ensuring that Indigenous birthwork remains rooted in tradition and community for future generations.

If you are a Birthworker interested in joining the network, fill out this form: https://forms.gle/A9x5JAHXJzna2oyS6.

The Montana Doula Collaborative is a statewide organization dedicated to supporting all perinatal doulas, including but not limited to Indigenous Birthworkers and Recovery Doulas. We provide resources, community support, and advocacy to elevate the role of doulas in improving birth outcomes across Montana.

Convened by a dedicated group of doulas from across the state, the Collaborative works to educate the public and promote the benefits of doula care.

Visit the website at www.montanadoulacollaborative.org/.

Join MotherLove Season 4 Podcast cohosts, Emily and Cass, in conversation with Dorothy, who works with families at all stages of pregnancy and birth, and has been instrumental in increasing options for birthing families in the Butte area.

Guest: Dorothy Troutman, BSN, RNC, C-EFM, CLC, SBD, SpBCPE, CCE, CEIM, Certified Body Ready Pro, and Body Ready Birth Educator – Doula (Sacred Birth Doula Services); Labor and Delivery Nurse (Intermountain Health St. James Hospital)

Visit the MotherLove podcast website at https://hmhb-mt.org/podcast/.

The Montana Legislature can advance doula care by supporting SB 319.  SB 319 will:

  • Establish “doula” as a licensed occupation overseen by the MT Department of Labor and Industry.
  • This license will create a legal definition and scope of practice that insurance providers can use to reimburse for these critical services, increasing access to doula care for Montanans.
  • Allow Montana Medicaid to reimburse for doula care and services.

To learn more, download our PDF.

Looking for a Doula or Birthworker in Montana?

Visit the LIFTS Online Resource Guide to find doulas and birthworkers in Montana. If you’re practicing in the state, we encourage you to list your services to connect with families in need.