Oregon’s New Doula Coverage Mandate
What It Means for Families and for Wildwood Birth
At Wildwood Birth, we believe that every family deserves accessible, compassionate, evidence‑based support throughout pregnancy, birth, and postpartum. And we understand the meaningful impact doula support can have on maternal and infant health outcomes. So we’re thrilled to see a statewide policy taking a critical step towards that vision: Oregon’s Senate Bill 692 (SB 692) now mandates insurance coverage for doula care — from prenatal to postpartum.
What Is Senate Bill 692?
Senate Bill 692 was signed into law in 2025, and went into effect on January 1, 2026. It builds on Oregon’s longstanding history as a leader in perinatal care access by making doula support a covered benefit not only through the Oregon Health Plan/Medicaid, but now through private health insurance plans that already cover pregnancy and childbirth as well.
Here’s what SB 692 does:
Requires private insurers that cover pregnancy and childbirth to also cover doula services and postpartum doula services — with no prior authorization, referral, or medical signature needed.
Establishes a community‑based perinatal provider access program to increase culturally competent and community‑specific support.
Expands coverage definitions to include not just labor and delivery support, but prenatal and postpartum care as well.
Strengthens transparency by requiring insurers to share clear information about how policyholders can access these services.
Creates a structure for expanding access and workforce training — including funding for culturally specific organizations and doulas.
Limitations of SB 692:
While this new bill takes a meaningful leap forward in recognizing the importance of doula care to our communities, it’s not a perfect solution — yet. Here are a few key limitations that still impact both doulas and the families who rely on them:
No Required Reimbursement Rate
The bill mandates that insurers must cover doula services if they already cover pregnancy and childbirth — but it does not specify a minimum reimbursement amount. As a result, most insurers are currently offering around $1,500 per birth, a rate that falls well below the standard fees for most experienced doulas. This means many families may still need to pay out of pocket to access care, or might be severely limited in their choice of doulas.No Mandate for In-Network Coverage
The law does not require insurance companies to contract directly with doulas or create in-network provider options. Instead, doulas may remain out-of-network providers, meaning families must navigate reimbursement processes on their own, usually after paying up front.Limited Scope of Covered Services
While SB 692 expands coverage for doula care, it only mandates a minimum of 24 hours of postpartum services in addition to labor and delivery support — and doesn’t require coverage beyond that baseline. Health plans may approve additional hours based on individual need, but they aren’t required to do so. This means families in need of more extensive postpartum support (especially those with medically fragile infants) may still need to pay out of pocket.Access Depends on Systems That Aren’t Fully Built Yet
Many doulas and organizations (like Wildwood) are still in the process of becoming credentialed with insurance companies, building new scheduling and billing infrastructure, and ensuring all systems are HIPAA-compliant. Until these systems are fully in place — and reimbursement rates reflect the value of this care — access remains limited, especially for marginalized communities who stand to benefit most.
These limitations don’t take away from the power of this bill — but they do point to the continued work needed to make truly equitable, sustainable doula care a reality in Oregon.
Support That Honors the Whole Perinatal Experience
SB 692 takes a big first step in ensuring that perinatal care isn’t just about the moment of birth — it’s about support that begins during pregnancy and continues through the early months of parenthood — and in fact, this coverage can be utilized through the first year post-birth.
Postpartum care is essential. Up to 24 hours of postpartum support are covered, which could equal three overnight visits or up to six daytime visits. This hands-on support after birth offers invaluable emotional support, practical care, education, and advocacy — supporting healing, mental health, nutrition, and family bonding.
This expanded scope reflects growing evidence that continuous, culturally responsive support leads to better outcomes — from greater satisfaction with the birth and postpartum experience to reduced stress, improved breastfeeding success, and decreased risk of postpartum mood disorders.
Wildwood Birth Is Growing With This Change
As your Portland doula team, we’re deeply invested in making doula care accessible to all families. In that spirit, we are actively working to become a Medicaid billing hub and are pursuing credentialing with private insurers so that doulas in our collective can bill directly for their services.
This means:
Families working with Wildwood doulas may soon access care through both Medicaid and private insurance.
Doulas will have strong support and billing infrastructure — helping them focus on caring for families rather than navigating complex payment systems.
We’ll continue to advocate for trauma‑informed, culturally specific care that honors each family’s story, needs, and values.
We know that these policy changes are just one piece of the puzzle — true access will happen when doulas are empowered, respected, and fairly compensated for their expertise and hard work so that they can show up for families fully. SB 692 moves us closer to that future, though more work remains to be done.
Integrating doula care into the medical billing world is complicated, and many community-based providers are still catching up. At Wildwood, we want to be transparent about the process — and the barriers — we are working to navigate.
Systems Overhaul & HIPAA Compliance
One of the biggest shifts involves building new systems from the ground up. Until now, doulas have operated outside of the health care system, and the profession has not been bound by HIPAA regulations. With SB 692, that’s changing — and any doula who bills Medicaid (OHP) or private insurance must now become fully HIPAA-compliant, just like any other medical provider. That means investing in secure documentation platforms, updating contracts and workflows, and retraining teams — all of which takes time, labor, and financial resources.
Reimbursement Rates Are Still Too Low
The current reimbursement rates offered for doula services through Medicaid and some private insurance plans who are matching the Medicaid rate is about $1,000 dollars less than the average Wildwood birth doula rate. While this is a start, it doesn’t yet reflect the true value of the physical, emotional, logistical, and energetic labor involved in doula care. The truth is: doula work is demanding, and most doulas have historically subsidized their clients' care with unpaid hours or second jobs (which are hard to balance because of the unpredictable nature of birth and doula work!). For doula care to be sustainable, it has to be fairly compensated. We’re hopeful that reimbursement rates will rise again this year.
When care providers are paid a livable wage, they can care for themselves, their families, and their communities. And that translates to better care for everyone.
Credentialing Takes Time
Our final step is the credentialing process, and credentialing with insurers can take months. We’re currently deep in this process, and we appreciate your patience as we move toward our goal of becoming a Medicaid billing hub and fully credentialed provider for select private health plans.
In the Meantime: Superbill Support
While we work toward direct insurance billing, we’re still doing everything we can to help make doula care more accessible right now. If your insurance plan offers out-of-network reimbursement, Wildwood is happy to provide a superbill — a detailed receipt you can submit to your insurer for potential coverage. Every plan is different, so we encourage you to contact your insurance provider to learn what might be possible for you and what their requirements are.
Final Thoughts
If you’re expecting — or simply exploring what support options are available — this new mandate likely comes as welcome, exciting news. Doula care offers evidence‑based, person‑centered support that meets you where you are during one of the most tender and important moments of your life.
Wildwood Birth would be honored to guide you through navigating these changes, understanding your benefits, and helping you find the support that feels right for you and your family.
Questions about insurance coverage? Want support navigating the process or learning how doulas can support you on your journey? We’d love to help.
