Why I Won’t Be Accepting or Credentialing with Insurance

As a full spectrum doula committed to nurturing families through some of life’s most sacred transitions, I want to share openly about an important decision I’ve made for my practice: I will not be accepting or credentialing with insurance providers.

This is a choice rooted in care—both for the clients I serve and for the sustainability of my work. I believe in transparency, and I want you to understand the reasons behind this decision.

Doula Work Belongs to the Community, Not the System

Doula support has always been a grassroots practice, built on trust, connection, and community wisdom. It comes from a long lineage of people supporting one another through birth, loss, postpartum, and all that lies between—not because it was profitable, but because it was necessary. This work was never meant to be medicalized, institutionalized, or turned into a line item on a billing statement.

When doulas are absorbed into systems like insurance, we risk losing what makes this care so powerful: autonomy, cultural integrity, flexibility, and personal relationships. Instead of centering the family and their needs, the focus shifts to compliance, documentation, and policies set by systems that often don’t understand the heart of what we do.

Insurance Reimbursement Rates Don’t Reflect the Value of This Work

While I believe deeply in making doula care accessible, insurance companies currently reimburse at rates that don’t come close to honoring the time, skill, and emotional labor involved. Massachusetts programs reimburse doulas at rates around $1500 for a full birth package—prenatal visits, on-call time, 24/7 availability, labor support (which can last over 24 hours), and postpartum follow-up.

These rates are unsustainable. They lead to burnout, especially for solo doulas or those from the very communities most in need of care. I’ve chosen not to engage with a system that doesn’t adequately value the care I provide, especially when that system has historically undervalued the labor of birth workers, birthing people, and especially people of color.

Time Spent on Billing Is Time Away from Clients

As a solo doula practitioner my time is best spent serving my clients. Managing insurance billing and credentialing is a full-time job in itself. From navigating ever-changing codes and submitting claims, to chasing down denials and resubmitting paperwork; it’s a bureaucratic maze that takes energy away from where it’s most needed, with the families I support.

I want to spend my time preparing you for birth, holding space during labor, checking in during your postpartum days, not on hold with insurance companies or struggling with online portals. The more I simplify the back-end of my practice, the more present and available I can be to my clients.

What I Can Offer

I will always (and have always) worked on a sliding scale. Which means that anyone who requests services with me also has access to lower payment options as needed. I believe that access matters. I offer flexible payment plans, and I’m actively involved in community initiatives and mutual aid networks that support those who may not be able to afford care otherwise.

Though I don’t bill insurance directly, I’m happy to provide itemized receipts that you can submit to your insurance for possible reimbursement. I also accept HSA & FSA cards as payment and I am a CARROT approved provider. 

I will always refer out to doulas who DO take insurance too! I’m not the right doula for everyone, and cost is part of that.

Reclaiming the Heart of Doula Work

By remaining outside the insurance system, I’m choosing to protect the integrity, depth, and relational nature of this work. I’m creating a practice that is sustainable for me and nourishing for the families I serve. I believe there’s power in reclaiming this work as community care—not just healthcare.

I of COURSE respect the choice of the many birth workers who’ve credentialed with insurance (autonomy always!) who have been able to expand access in this way. It is just not the right decision for me.

Thank you for understanding and for trusting me and the decisions that work best for my practice.