Summary#
This bill would require the VA to run a five-year pilot program to provide doula support to pregnant and recently pregnant veterans who are enrolled in VA health care. The pilot would expand the VA's Whole Health model to include up to 10 doula sessions per veteran and would test effects on birth, mental health, and veteran engagement with VA care. The goal is to improve maternal, infant, and mental health outcomes and to integrate doula services into VA care for women veterans.
- Main change: Create a VA pilot program offering doula services to covered veterans through eligible community providers and VA-coordinated arrangements.
- Who qualifies: Pregnant or formerly pregnant veterans enrolled in the VA patient enrollment system.
- Service limit: Up to 10 sessions per veteran (3–4 prenatal, 1 during labor, 3–4 postpartum). Postpartum visits may use VA Video Connect (telehealth).
- Locations: Sites in six Veterans Integrated Service Networks (three with the highest share of female enrollees and three with the lowest) plus at least one VISN serving frontier areas and higher-risk populations (including American Indian/Alaska Native veterans).
- Payment cap: The Office of Women’s Health may recommend payments but no payment to a doula for a veteran may exceed $3,500.
- Timing: The VA must set up the pilot within one year of the bill’s enactment and run it for five years. Annual reports to Congress are required.
What it means for you#
- Women veterans who are pregnant or postpartum: You could be eligible for up to 10 sessions with a doula while enrolled in VA health care. These sessions can be before, during, and after birth, and some postpartum visits can be virtual.
- Doulas and community maternity providers: Eligible entities may participate and be paid to provide services under the pilot. The bill asks the VA to consider all types of doulas, including community-based and traditional doulas.
- VA medical centers and staff: Participating facilities must host a Doula Service Coordinator (working within the existing Maternity Care Coordinator role) to manage referrals, payments, and reporting. The Office of Women’s Health will coordinate the pilot.
- Veterans in rural/frontier areas and higher-risk groups: The pilot must include at least one VISN that serves frontier areas and populations with higher maternal mental health risk, which could improve access tests in those regions.
- Taxpayers and Congress: The bill authorizes funding as needed for fiscal years 2027–2032 and requires annual reports and a final recommendation about wider adoption.
Expenses#
No public fiscal estimate or detailed cost breakdown is included in the bill text or the supplied material.
- The bill authorizes “such sums as may be necessary” for FY2027–2032; no dollar total is specified.
- The Office may recommend payment amounts, but the bill caps payments at $3,500 per doula per veteran.
- This could mean additional VA administrative costs (for coordinators, training, oversight, telehealth support, and payment processing), but the bill does not provide estimates.
- No publicly available information on total expected program cost, savings, or offsets is included in the supplied material.
Proponents' View#
The bill appears intended to address gaps in maternity and mental health care for women veterans and to test whether doula support helps.
- The bill appears intended to improve maternal, infant, and mental health outcomes for veterans.
- It appears intended to improve veterans’ experience of maternity care and help veterans develop and follow birthing plans.
- The pilot aims to integrate doulas into the VA’s Whole Health approach and to measure impacts before deciding on wider adoption.
- Including training guidelines on military sexual trauma and PTSD suggests a focus on tailoring doula care to veterans’ needs.
- The location choices aim to test the model in both high- and low-concentration female-veteran areas and in frontier/high-risk populations.
Opponents' View#
The bill leaves several implementation and cost questions open that could raise concerns.
- One concern is that the bill does not specify total funding, so the overall cost to VA and taxpayers is unclear.
- The $3,500 cap is per doula per veteran, but the bill does not say how many veterans would receive services, so total program cost is unknown.
- The bill requires training guidelines but does not set national standards for doula qualifications, certification, or oversight; quality and consistency of care could vary.
- The pilot is limited to selected VISNs and runs five years, so results may not show how the model would work nationwide or for all groups.
- Administrative burdens—hiring coordinators, managing payments, tracking sessions, and providing technical assistance—could increase VA workload without specified resources.
- It is unclear how the pilot will ensure enough doulas are available in remote or underserved areas, or how eligible entities will be selected and approved.