I
119THCONGRESS
1
STSESSION H. R. 2469
To direct the Secretary of Health and Human Services to evaluate the
benefits of abortion doula care and coverage.
IN THE HOUSE OF REPRESENTATIVES
MARCH27, 2025
Ms. S
TRICKLAND(for herself and Ms. MOOREof Wisconsin) introduced the
following bill; which was referred to the Committee on Energy and Commerce
A BILL
To direct the Secretary of Health and Human Services to
evaluate the benefits of abortion doula care and coverage.
Be it enacted by the Senate and House of Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE. 3
This Act may be cited as the ‘‘Abortion Data and 4
Outreach to Unlock and Leverage Abortion Support Act’’ 5
or the ‘‘Abortion DOULAS Act’’. 6
SEC. 2. DEFINITIONS. 7
In this Act: 8
(1) A
BORTION DOULA CARE .—The term ‘‘abor-9
tion doula care’’ means the provision of emotional, 10
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social, informational, and physical support by non- 1
clinical, trained professionals (commonly known as 2
‘‘abortion doulas’’) to individuals before, during, and 3
after medication and procedural abortions, including 4
such provision of practical support, patient naviga-5
tion support, patient advocacy, and postabortion 6
care. 7
(2) S
ECRETARY.—The term ‘‘Secretary’’ means 8
the Secretary of Health and Human Services. 9
SEC. 3. FINDINGS. 10
Congress finds the following: 11
(1) Abortion doulas provide critical support to 12
patients and families before, during, and after medi-13
cation and procedural abortions. Abortion doula care 14
can encompass physical, social, and emotional sup-15
port; information sharing, advocacy, and education; 16
and personal care, such as planning meals or pro-17
viding childcare. Abortion doula care may be individ-18
ualized, culturally and linguistically congruent, and 19
trauma-informed. 20
(2) Abortion doulas work in a variety of envi-21
ronments, including hospitals, clinics, clients’ homes, 22
and community spaces, and in both telehealth and 23
in-person care settings. They may work independ-24
ently, through a collective or community-based orga-25
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nization, as part of a local health department, or 1
through or in close partnership with a health care 2
system or health plan. 3
(3) While research has shown that doula sup-4
port to parents during labor, birth, and the 5
postpartum period is associated with better birthing 6
experiences and healthier outcomes for both parents 7
and infants, existing evidence on doula support dur-8
ing other reproductive health care events, such as 9
abortion, miscarriage, or stillbirth, is more limited. 10
(4) A 2015 National Institutes of Health study 11
found that nearly all the women who had doulas 12
present during first-trimester procedural abortions 13
reported satisfaction with the doula care they re-14
ceived, with many expressing support for greater in-15
volvement of abortion doulas in abortion care. 16
(5) In a randomized controlled trial of doula 17
support during first-trimester procedural abortions, 18
96 percent of women who received doula support 19
recommended that it be incorporated into routine 20
abortion care, and 72 percent of women who had not 21
received doula support wished they had received it. 22
(6) The Supreme Court’s decision in Dobbs v. 23
Jackson Women’s Health Organization and its im-24
pact on communities across our nation have made 25
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access to abortion doula care more important than 1
ever. 2
(7) The Dobbs decision has had an outsized im-3
pact on people who already face barriers to health 4
care access, particularly Black people, Indigenous 5
people, people of color, disabled people, undocu-6
mented immigrants, low-income individuals and fam-7
ilies, young people, people in rural communities, and 8
people with limited English proficiency. The care 9
that doulas provide, which often includes culturally 10
competent patient advocacy and coordination with 11
health care providers, can help medically 12
marginalized patients confront heightened challenges 13
to accessing appropriate medical care. Abortion 14
doulas with a lived understanding of the commu-15
nities in which they work can leverage local social 16
support and connect clients and their families with 17
community resources that best meet their needs. 18
(8) Additionally, in the confusing legal land-19
scape of abortion access after the Dobbs decision, 20
abortion doulas help people navigate misinformation 21
and combat the shame and stigma around abortion 22
that restrictions may have exacerbated. 23
(9) There are several barriers to accessing 24
doula care. 25
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(10) Barriers include limited awareness of 1
doula services among pregnant patients and their 2
families, members of the perinatal care workforce, 3
and other health care professionals. 4
(11) The cost of doula care is another barrier 5
to access, particularly for Black people, Indigenous 6
people, people of color, people in rural communities, 7
and low-income individuals and families. 8
(12) Doulas themselves face challenges such as 9
barriers to entering the field, insufficient support 10
during the Medicaid credentialing process, and low 11
Medicaid reimbursement rates. As a result, abortion 12
doulas are often unpaid and operate within a volun-13
teer infrastructure. 14
(13) Many State Medicaid programs still do not 15
cover doula services despite growing interest in ex-16
panding State Medicaid coverage to include doula 17
care. Private insurance coverage of doula care is 18
more limited. State Medicaid and private insurance 19
plans that do include doula care often do not include 20
support for abortion doula care. 21
SEC. 4. STUDY ON THE BENEFITS OF ABORTION DOULA 22
CARE AND COVERAGE. 23
(a) S
TUDY.—The Secretary of Health and Human 24
Services, in coordination, as appropriate, with the Director 25
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of the Office of Minority Health and the Director of the 1
Office on Women’s Health, shall conduct and complete a 2
study on the benefits of abortion doula care and coverage. 3
Such study shall include an assessment of the following: 4
(1) The impact of abortion doula care on the 5
well-being of individuals seeking abortions, including 6
patient experience before, during, and after seeking 7
care. 8
(2) The potential of abortion doula care to en-9
hance the quality of care provided before, during, 10
and after abortions. 11
(3) The role of abortion doulas in providing in-12
formational, logistical, and practical support to indi-13
viduals in the process of seeking abortion care. 14
(4) The availability and accessibility of abortion 15
doula care in all States of the United States. 16
(b) D
ATACOLLECTION.—The Secretary shall collect 17
data from a representative sample of individuals who have 18
received abortion doula care, including the following: 19
(1) Surveys of and interviews with individuals 20
and their family members who have utilized abortion 21
doula care, including those in States in which doula 22
care for all pregnancy outcomes, including abortion, 23
is covered under State plans (or waivers of such 24
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plans) under title XIX of the Social Security Act (42 1
U.S.C. 1396 et seq.). 2
(2) Surveys of and interviews with practicing 3
abortion doulas and health care providers who work 4
with abortion doulas, including those in States in 5
which doula care for all pregnancy outcomes, includ-6
ing abortion, is covered under such plans or waivers. 7
(3) Review of academic literature on the subject 8
of abortion doula care. 9
(c) E
XPERTINPUT.—The Secretary shall consult 10
with experts in the fields of reproductive health, maternal 11
health, mental health, and social work. The Secretary shall 12
also consult with community-based doulas and organiza-13
tions that provide abortion doula care to individuals in un-14
derserved or rural communities. 15
(d) P
ATIENTPRIVACYPROTECTIONS.—The data col-16
lected under subsection (b) shall be anonymized to prevent 17
the release and misuse of sensitive personal information. 18
SEC. 5. REPORT ON STATE MEDICAID APPROACHES TO 19
ABORTION DOULA CARE BENEFITS AND AC-20
CESS. 21
(a) R
EPORT.—Not later than 18 months after the 22
date of enactment of this Act, the Secretary shall complete 23
the study under section 4 and submit to the Committee 24
on Energy and Commerce of the House of Representatives 25
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and the Committee on Health, Education, Labor, and 1
Pensions of the Senate a report on the results of such 2
study. 3
(b) T
OPICS.—The report under subsection (a) shall 4
include the following: 5
(1) An assessment of the potential benefits and 6
challenges of integrating abortion doula care into 7
abortion care and services. 8
(2) Suggestions on how to increase access to 9
abortion doula care, especially in underserved or 10
rural areas where access to comprehensive health 11
care may be limited. 12
(3) Policy considerations and recommendations 13
to States regarding the incorporation of abortion 14
doula care into State plans (or waivers of such 15
plans) under title XIX of the Social Security Act (42 16
U.S.C. 1396 et seq.), with attention to Federal and 17
State regulations, eligibility criteria for program 18
participation, covered services, payment models and 19
levels, and other programs features, through changes 20
to such plans or waivers. 21
(b) P
UBLICACCESSIBILITY.—The report under sub-22
section (a) shall be made publicly available on the website 23
of the Department of Health and Human Services. 24
Æ
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