Mary's Hands Network · for the Louisiana Health Care Quality Forum
Doula Care,
On the Record
Louisiana now pays for doula care. Nobody can see it yet. Here is what three years of tracked births show, and how we can measure it together.
Madeline Harris LeBlanc, MHA, RNC-OB, IBCLC, IAT-BD/PD
Founder & Executive Director, Mary's Hands Network · September 24, 2026
Louisiana's reality
58.1
maternal deaths per 100,000 live births
More than twice the national rate. A March of Dimes grade of F. And Black mothers face three to four times the pregnancy-related death rate of white mothers.
March of Dimes · CDC Pregnancy Mortality Surveillance System
Louisiana's reality, continued
It does not stop with mothers.
7,454 Louisiana babies were born preterm in 2024. Behind every maternal death are far more mothers and newborns who got sick, went to the NICU, or had surgery they might not have needed.
14.0%
Preterm birth
US 10.4%. Louisiana ranks 51st of 52. March of Dimes grade: F
7.1
Infant deaths per 1,000 births
US 5.6. Louisiana ranks 46th of 52
12%
NICU admission
US 9%. One in eight Louisiana newborns starts life in intensive care
37%
Cesarean birth
US 32%. Major surgery for more than one in three Louisiana mothers
Who we are
Every birth deserves a doula.
Mary's Hands Network is a Louisiana 501(c)(3) founded in 2023. We recruit, train and match community doulas with families across Southeast Louisiana at no cost to the family, and we track every birth under an IRB protocol.
276
Doulas trained
Across 19 ICEA-approved cohorts
9,504
Volunteer hours
Given to families in need
202
Births attended
IRB-tracked outcomes, Protocol #2025-001
206
Babies loved
Including four sets of twins
Birth outcomes, May 2023 to May 2026
Better than Louisiana. Better than the nation.
Cesarean rate
Roughly half the state rate
Preterm birth
71% fewer than Louisiana
NICU admission
67% fewer than Louisiana
Sources: MHN IRB Protocol #2025-001 · Louisiana Department of Health · March of Dimes · CDC.
The payer's view
A Medicaid plan ran its own numbers.
Louisiana Healthcare Connections compared members who received Mary's Hands doula care with members referred but never seen. Same plan, same referral pool.
| Metric | With doula (44 deliveries) | No doula (64 deliveries) | Difference |
|---|
| Preterm birth | 4.5% | 10.9% | 6.4 points lower |
| Low birth weight | 18.2% | 25.0% | 6.8 points lower |
| NICU admission | 18.2% | 25.0% | 6.8 points lower |
| NICU length of stay | 10.4 days | 23.6 days | 13.2 days shorter |
| Postpartum follow-up visits | 9 | 0 | 9 more |
~176
NICU days avoided
across 44 doula-supported deliveries vs. the no-doula rates
$3,000
average cost of one NICU day
conservative national estimate
~$529K
estimated NICU savings
about $12,000 per doula-supported birth, from NICU care alone
What it is worth
Fewer cesareans. Fewer NICU days. Real dollars.
$988K
Louisiana health care costs avoided
Three years of Mary's Hands care. About 25 avoided cesareans at $13,000 and about 9 avoided NICU admissions at $73,700.
$336.6M
Annual savings potential, statewide
Roughly 59,000 Louisiana births a year at MHN's demonstrated cesarean and NICU differentials.
The gap
The benefit exists. The evidence base does not.
Louisiana Medicaid began enrolling doulas as providers in December 2025 under Act 228. For the first time the state is paying for doula care at scale, and it has no way to see it.
No field in the chart
No Louisiana hospital EHR records whether a doula was at the bedside. The doula is invisible in the delivery record.
No record in the exchange
Nothing about doula care flows through LaHIE, so hospitals, plans and LDH cannot link it to outcomes.
No statewide comparison
Nobody can compare doula-supported births to all other Louisiana births. Small programs like ours are the only evidence.
Opportunity one
"Doula at bedside" in every Louisiana EHR
One discrete field in the delivery record: was a doula present at this birth? Captured at every Louisiana birthing hospital and carried through LaHIE. Small to build. Statewide in reach.
What it unlocks
- Doula-supported births compared against every other birth in the state, not just our 202
- An evaluation of the Medicaid doula benefit built on the state's own data
- A doula outcomes registry alongside the registries the Forum already runs
Opportunity two
Review how we collect and store our data
Three years of IRB-tracked outcomes, built by a small nonprofit. We want your team's eyes on how we collect it, where we store it, and how to make it registry-ready before it grows.
What it unlocks
- A dataset that stands up to the scrutiny of a health plan, a hospital or a journal
- A data model that can plug into LaHIE or a Forum registry later
- A template other Louisiana doula programs can adopt as the Medicaid benefit grows
Opportunity three
Bring the impact of doula care to the full Forum
A presentation to the Forum's members and the Employer Coalition on the cost savings from cesarean and NICU prevention: the payer's perspective from Louisiana Healthcare Connections, and what those same savings mean for a self-insured employer.
What it unlocks
- Health plans and hospitals see doula care as a quality and cost lever, not a nicety
- Employers learn that maternity is often their largest claims category and doulas move it
- New partners and funders for statewide doula access
Working together
Three ways to start
1
Doula at bedside
A single EHR field, statewide, so Louisiana can finally compare doula-supported births to all others.
2
Review our data
Your team's assessment of how we collect and store three years of tracked outcomes.
3
Share the impact
Cost savings from cesarean and NICU prevention, presented to the Forum and its employers.
Thank you.
Doulas don't replace medical care. They make sure no family goes through birth without a hand to hold. Let's make sure Louisiana can see it.