Last Updated on May 26, 2022

The information presented on these pages is for informational purposes only. Links to official documentation and information is provided where and when possible. Please consult local government authorities for current and accurate information.

Oregon has been actively reimbursing doula services through Medicaid since 2014. A doula does have to be enrolled in the state registry as a “traditional health worker.”

Current Legislation

In 2011, the Oregon Legislature passed House Bill 3311 (HB 3311) requiring Oregon Health Authority to explore doula benefits. The benefit began in 2014. Initially the reimbursement rate was $75 for presence at labor and delivery. In 2015, following a proposal from Oregon Doula Association, the state implemented a $350 global payment. This includes 2 prenatal and 2 postpartum visits, $50 each, as well as labor and delivery services at $150. There are some coordinated care organizations that pay more ($700-900) and some doulas have successfully negotiated higher rates.

From 2016-2020 almost 19,000 people per year gave birth while enrolled in Medicaid. Despite this, only 204 births were reimbursed for doula services over the four year period. There were still doulas who provided services for free and others who were paid through grant programs.

Becoming a Traditional Health Worker – Doula

  1. Become a Certified and Registered Traditional Health Worker (THW)
  2. Become an ORegon Medicaid Provider
  3. Bill for Doula services

First and foremost, a doula must be certified and registered as a Traditional Health Worker. The Oregon Health Authority has established certification and recertification requirements including:

  • 40 contact hours:
    • 28 in-person contact hours of core curriculum.
      • This must be provided by a birth doula certification program.*
      • These include fifteen categories such as anatomy and physiology of labor, labor coping strategies, communication skills, and professional conduct.
    • 6 hours in cultural competency training.
    • 6 hours in one or more of the following:
      • Inter-professional collaboration.
      • HIPPA compliance
      • Trauma-informed care.
  • Community Resource List
  • Attend and document 3 births and 3 postpartum visits
  • Background Check

*A “Birth doula certification organization” means an entity nationally or internationally recognized for training and certifying birth doulas whose educational requirements includes the core curriculum topics described in these rules.

Oregon does require in-person training and does not accept midwifery education, nursing training, or online childbirth and doula training courses.

The certification is good for three years and a doula must complete 20 hours of continuing education during that three year period to renew their certification. Up to 10 hours of the continuing education may be done online.

Once a doula is certified and registered with the state, they must become an Oregon Medicaid Provider. First a doula should obtain a National Provider Identification. Then, a doula must enroll as a medicaid provider. The steps for enrollment depend on whether the doula intends to (a) work through a doula billing organization or clinic that will bill on their behalf or (b) bill directly themself. Doula should research their options and determine which billing method is best for them.

Finally, a doula may use the professional claim form to bill for services to Medicaid members. This can be done through the global fee–4 maternity visits/2 prenatal and 2 postpartum and labor and delivery support or separately if the doula is able to provide some but not all of the global services.

The Oregon Health Plan (OHP) provides several resources to assist doulas including billing tips and service program guidelines.

Oregon Doula Association

Doulas may find the Oregon Doula Association (ODA) helpful in clarifying processes, procedures, or requirements. ODA is a statewide representative doula organization which originated following HB 3311 and has relationships with the Oregon Health Authority and Division of Medicaid Assistance Programs. They also provide information for about doula services for Medicaid recipients, doulas already providing services to Medicaid recipients, and continuing education opportunities.


Oregon covers doula work, but progress is moving at a ‘glacial pace’, The Lily (Mar. 1, 2021)

Midwives, doulas take center stage as Providence develops team approach to pregnancy care, Oregon Live (Feb. 13, 2015)

Links to official documentation and information is provided where and when possible. Please consult local government authorities for current and accurate information.

Last Updated on May 26, 2022