Doula Support for Healthy Births Pilot Program

HB 515 2026

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A bill to be entitled 1
An act relating to the Doula Support for Healthy 2
Births pilot program; creating s. 383.295, F.S.; 3
defining terms; establishing the pilot program in 4
Broward, Miami-Dade, and Palm Beach Counties for a 5
specified purpose; providing the purpose of the pilot 6
program; requiring the Department of Health, in 7
collaboration with its maternal and child health 8
section, to implement and oversee the pilot program; 9
specifying the duration of the pilot program, subject 10
to funding; requiring the pilot program to target 11
specified populations for enrollment; specifying 12
services that must be provided under the pilot 13
program; requiring the department to collaborate with 14
specified entities to integrate doula services into 15
existing maternal health programs and facilitate 16
outreach and service delivery; authorizing the 17
department to integrate doula services into existing 18
maternal and child health programs as an expansion of 19
the pilot program, subject to certain requirements; 20
providing for funding of the pilot program; creating 21
the Doula Certification Task Force within the 22
department for a specified purpose; requiring the 23
department to oversee and provide administrative 24
support to the task force; providing for membership 25

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and meetings of the task force; specifying duties of 26
the task force; requiring the task force to submit a 27
final report of its findings and recommendations to 28
the Governor and the Legislature by a specified date; 29
providing for expiration of the task force; providing 30
an effective date. 31
32
WHEREAS, preterm birth is defined as a live birth before 37 33
completed weeks of gestation and is associated with increased 34
morbidities or ailments, such as cerebral palsy, breathing 35
difficulties, feeding problems, developmental delay, and vision 36
and hearing problems, and 37
WHEREAS, preterm labor occurs when regular contractions 38
cause the cervix to open between 20 and 37 weeks of gestation, 39
which can result in a baby being born before 37 weeks of 40
gestation, and the earlier the delivery, the greater the health 41
risks for the baby, requiring special care in a neonatal 42
intensive care unit and potentially causing long-term mental and 43
physical health concerns, and 44
WHEREAS, Florida's preterm birth rate has risen annually 45
since 2014 to its current average rate of 10.9 percent, higher 46
than the national average of 10.5 percent, and 47
WHEREAS, Florida ranks among the highest in the nation for 48
infant mortality, with a rate of 5.9 deaths per 1,000 births, 49
higher than the national average of 5.4 deaths per 1,000 births, 50

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and 51
WHEREAS, Florida also has one of the highest cesarean 52
delivery rates in the nation at 37.4 percent, compared to the 53
national average of 31.8 percent, with cesarean delivery being 54
associated with increased risks to infants, including 55
respiratory distress, infection, and long-term health 56
complications, and 57
WHEREAS, maternal mortality is defined as the annual number 58
of female deaths from any cause related to or aggravated by 59
pregnancy or its management, excluding accidental or incidental 60
causes, during pregnancy and childbirth or within 42 days after 61
termination of a pregnancy, irrespective of the duration and 62
site of the pregnancy, and 63
WHEREAS, Florida ranks 17th in the nation with a maternal 64
mortality rate of 26.3 deaths per 100,000 births, compared to a 65
national rate of 23.2 deaths per 100,000 births, and 66
WHEREAS, Broward County has a maternal mortality rate of 67
24.8 deaths per 100,000 live births, and an infant mortality 68
rate of 5 deaths per 1,000 live births, and 69
WHEREAS, Miami-Dade County has a maternal mortality rate of 70
20.3 deaths per 100,000 live births, and an infant mortality 71
rate of 4.8 deaths per 1,000 live births, and 72
WHEREAS, Palm Beach County has a maternal mortality rate of 73
33.2 deaths per 100,000 live births, and an infant mortality 74
rate of 5.4 deaths per 1,000 live births, and 75

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WHEREAS, continued perinatal support, including the 76
services provided by trained doulas, is associated with reduced 77
rates of cesarean delivery and improved birth outcomes, and 78
WHEREAS, Florida has ongoing challenges related to child 79
safety and welfare, with statistics showing disparities in 80
health and safety outcomes for children across racial and 81
socioeconomic groups, and 82
WHEREAS, doula care is the continuous, one-to-one 83
emotional, informational, and physical support provided by a 84
trained nonmedical professional to pregnant women and their 85
families during pregnancy, labor, and the postpartum period, and 86
WHEREAS, while doulas do not perform medical tasks, they 87
provide an array of educational and support services throughout 88
the birthing process to ensure that the mother has a positive 89
and empowering experience, including, but not limited to, 90
educational resources and information about pregnancy, 91
childbirth, and postpartum care; assistance in creating a birth 92
plan; continuous emotional support during labor and delivery; 93
assistance with breathing techniques, relaxation, and 94
positioning during labor; massage and counterpressure measures; 95
facilitation of communication with medical staff; advocacy in 96
and navigation of the medical setting; and postpartum support 97
with newborn care and feeding, and 98
WHEREAS, evidence-based support provided by trained doulas 99
has been shown to enhance birth experiences, reduce cesarean 100

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deliveries, and improve overall health outcomes for mothers and 101
infants, and 102
WHEREAS, the state has a compelling interest in improving 103
maternal and infant outcomes through increased access to high-104
quality doula services, NOW, THEREFORE, 105
106
Be It Enacted by the Legislature of the State of Florida: 107
108
Section 1. Section 383.295, Florida Statutes, is created 109
to read: 110
383.295 Doulas.— 111
(1) DEFINITIONS.—As used in this section, the term: 112
(a) "Department" means the Department of Health. 113
(b) "Doula" means a nonmedical professional who provides 114
health education, advocacy, and physical, emotional, and 115
nonmedical support for pregnant and postpartum women before, 116
during, and after childbirth, including support during 117
miscarriage and stillbirth. Doulas are not clinical providers 118
and are not licensed. 119
(c) "Doula services" means the provision of physical, 120
emotional, and informational support by a nonmedical 121
professional to a pregnant woman during the prenatal, 122
intrapartum, and postpartum periods. Activities may include 123
childbirth education, labor support, postpartum recovery 124
support, assistance with infant care, lactation support, and 125

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connection to community resources. 126
(d) "Evidence-based" means a process in which decisions 127
are made and actions or activities are carried out, based on the 128
best evidence available, with the goal of removing subjective 129
opinion, unfounded beliefs, or bias from decisions and actions. 130
Such evidence may include practitioner experience and expertise 131
as well as feedback from other practitioners and beneficiaries. 132
(2) PILOT PROGRAM ESTABLISHED.— 133
(a) The Doula Support for Healthy Births pilot program is 134
established in Broward, Miami-Dade, and Palm Beach Counties to 135
integrate doula services into existing maternal health 136
initiatives, targeting pregnant and postpartum women who have 137
overcome or are overcoming substance use disorders. 138
(b) The purpose of the pilot program is to improve birth 139
outcomes by decreasing preterm birth rates and cesarean 140
deliveries, enhancing access to care, and supporting maternal 141
well-being throughout the pregnancy, labor, and postpartum 142
periods using evidence-based methods. 143
(c) The Department of Health, through its maternal and 144
child health section, shall implement and oversee the pilot 145
program. 146
(3) PROGRAM STRUCTURE.— 147
(a) The pilot program may operate for 12 to 24 months, 148
subject to funding. 149
(b) The pilot program shall target the enrollment of 150

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pregnant and postpartum women who have overcome or are 151
overcoming substance use disorders. 152
(c) The following support services must be offered under 153
the pilot program: 154
1. Prenatal support, such as educational resources, 155
personalized birth plans, and emotional support. 156
2. Labor support, such as continuous emotional support, 157
comfort measures, and communication facilitation. 158
3. Postpartum support, such as assistance with newborn 159
care, postpartum resources, and household tasks. 160
4. Advocacy support, such as assistance with preferences 161
and needs within medical settings and health care navigation. 162
5. Comprehensive emotional support during the pregnancy 163
and postpartum periods. 164
(4) COLLABORATION; INTEGRATION.— 165
(a) The department shall collaborate with: 166
1. Health care providers, community organizations, 167
community coalitions, and advocacy groups to integrate doulas 168
and doula services into existing maternal health programs, 169
ensuring that such doulas are trained and meet all of the 170
following criteria: 171
a. Demonstrate a strong understanding of the reproductive 172
system, labor process, and postpartum recovery. 173
b. Are proficient in hands-on techniques, such as massage, 174
counterpressure, breathing exercises, and nonmedicated pain 175

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management. 176
c. Support a client's birth plan, communicate effectively 177
with medical staff, and advocate for informed consent. 178
d. Provide guidance on breastfeeding, basic newborn care, 179
and both the physical and emotional aspects of postpartum 180
recovery. 181
e. Use active listening, clear communication, and conflict 182
resolution skills in interactions with clients and health care 183
providers. 184
f. Understand common medical complications and provide 185
emotional and physical support to clients in challenging 186
situations. 187
g. Uphold professionalism, ethical decisionmaking, and 188
legal responsibilities in doula practice. 189
2. Local WIC programs, hospitals, birth centers, and 190
community health centers to facilitate outreach and service 191
delivery. 192
(b) The department may integrate doula services into 193
existing maternal and child health programs as an expansion of 194
the pilot program, focusing on pregnant and postpartum women who 195
have overcome or are overcoming substance use disorders. Any 196
such expansion of the pilot program must include annual 197
reporting requirements for the department to evaluate 198
effectiveness, equity, and quality of integrating doula services 199
into the existing maternal and child health programs. 200

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(5) FUNDING.—The pilot program shall be funded using 201
appropriations for the Closing the Gap grant program established 202
under ss. 381.7351-381.7356. The department shall coordinate 203
with its Division of Community Health Promotion and Office of 204
Minority Health and Health Equity to seek additional federal 205
funds to support implementation. 206
Section 2. Doula Certification Task Force.— 207
(1) ESTABLISHMENT.—There is created within the Department 208
of Health the Doula Certification Task Force, a task force as 209
defined in s. 20.03(5), Florida Statutes, for the purpose of 210
reviewing the scope of doula services and ensuring competency, 211
quality, and consistency in the delivery of doula services to 212
pregnant and postpartum women. 213
(2) OVERSIGHT.—The Department of Health shall oversee and 214
provide administrative support to the task force. 215
(3) MEMBERSHIP; MEETINGS.— 216
(a) The task force shall be composed of nine members. 217
Three members shall be appointed by the Governor, three members 218
shall be appointed by the Senate President, and three members 219
shall be appointed by the Speaker of the House of 220
Representatives. Of the nine members, two members must be health 221
care practitioners as defined in s. 456.001, Florida Statutes, 222
experienced in caring for pregnant or postpartum women, and at 223
least one member must be a doula or otherwise have experience 224
providing nonmedical support services to pregnant or postpartum 225

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women. A vacancy on the task force must be filled in the same 226
manner as the original appointment. The task force shall elect a 227
chair from among its members. 228
(b) The task force shall meet as often as necessary to 229
complete its work, but at least quarterly, at the call of the 230
chair. The task force may conduct its meetings through 231
teleconference or other similar electronic means. 232
(4) DUTIES.—The task force shall do all of the following: 233
(a) Review the scope of practice for doulas in this state, 234
as well as in other states. 235
(b) Establish core competencies for the provision of doula 236
services. 237
(c) Recommend minimum certification standards for doulas, 238
which must include, but need not be limited to, all of the 239
following: 240
1. Possession of a high school diploma or its equivalent. 241
2. Completion of a department-approved, evidence-based 242
training program. 243
3. A minimum number of supervised practice hours. 244
4. Completion of a background screening. 245
5. Education in professional ethics. 246
(5) REPORT.—By January 1, 2028, the task force shall 247
submit a final report of its findings and recommendations to the 248
Governor, the President of the Senate, and the Speaker of the 249
House of Representatives. 250

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(6) SUNSET.—The task force shall operate on a temporary 251
basis in conjunction with the Doula Support for Healthy Births 252
pilot program established under s. 383.295, Florida Statutes, as 253
created by this act, and shall expire on October 2, 2029, in 254
accordance with s. 20.052(8), Florida Statutes. 255
Section 3. This act shall take effect upon becoming a law. 256
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