Let's Talk Medicaid Doula Support!

Our doula Renee discussed doula support options for SD Medicaid recipients. Watch the replay at the bottom (or read on) and learn what's covered, how to qualify, and why doula support makes such a difference!

Doula Support Covered by South Dakota Medicaid: What You Need to Know

By Renee Forred, Co-Owner of Transitions: Doula & Life Services

We are thrilled to share a truly exciting development for pregnant and postpartum families in South Dakota — doula support is now covered by South Dakota Medicaid! This is a game-changer for so many families who might not have been able to access this kind of care before, and I want to walk you through what it means, who qualifies, and how to get started.

What Is a Doula?

Let’s start with the basics. A doula is a professional who provides physical, emotional, and informational support throughout pregnancy, birth, and the postpartum period. At Transitions: Doula & Life Services, our doulas are trained in birth and postpartum, and show up with evidence-based resources, encouragement, and hands-on help.

There are different types of doulas, but when we talk about Medicaid coverage, we’re focused on birth and postpartum doulas. These are the doulas who:

• Support you in pregnancy with preparation, resources, and birth planning

• Are present at your labor and delivery to help you feel confident and supported

• Visit you at home after birth to nurture your recovery and transition to parenthood

What Changed? Medicaid Coverage in South Dakota

Before January 1, 2025, doula care in South Dakota was typically an out-of-pocket expense. A few private insurance companies offered partial reimbursement, but it wasn’t guaranteed and often required families to pay up front and file paperwork themselves.

Now, that’s changed.

Thanks to ongoing collaboration between doulas, advocates, and state officials, South Dakota Medicaid will now cover up to $1,800 in doula services for eligible recipients. The state recognized what doulas have known all along: continuous, compassionate, culturally informed support makes a real difference in outcomes — from maternal mental health to reduced birth trauma to better breastfeeding success.

What Does $1,800 in Doula Support Look Like?

At Transitions, we’ve created a comprehensive Birth + Postpartum Package that is Medicaid-approved and available to everyone — whether you're Medicaid-eligible, paying privately, or using insurance. It includes:

✅ Two Prenatal Visits
To get to know you and your birth team, plan for your birth experience, and help prepare for postpartum. This may also include customized childbirth or breastfeeding education.

✅ Birth Support
Your doula will be on-call and physically present during your labor and birth, offering continuous emotional and physical support — massage, comfort measures, advocacy, and more.

✅ One Postpartum Visit
Once you're home, your doula visits to check in, talk through your birth experience, and help troubleshoot early feeding or newborn care.

✅ 20 Hours of Daytime Postpartum Support
A postpartum doula comes to your home to care for you while you heal. That might look like helping with newborn care, feeding support, meal prep, light chores, or simply giving you space to rest while knowing your baby is in capable hands.

This is real, hands-on, practical support — and Medicaid is covering it!

How to Get Started

If you're pregnant and have South Dakota Medicaid — or if you’ve recently delivered and need postpartum help — the process is simple:

1. Contact your provider (OB, midwife, or primary care) and ask them to complete a Medicaid doula referral.

2. Choose your doula. Not every doula is enrolled in Medicaid, but we have several Medicaid-approved doulas on our team ready to support you.

3. We take it from there. Once the referral is processed, we handle the paperwork and get started with your care!

Let’s Talk

If you have questions about Medicaid doula support or want to learn more about how this could help you or someone you know, reach out!

📩 DM us on Instagram @transitionsdoula
🌐 Visit www.transitionsdoulaservices.com
📧 Email us through our website contact form

We are here to serve, support, and celebrate you during this incredible life transition. Doula care shouldn’t be a luxury — and now, in South Dakota, it doesn’t have to be.

Thank you for being part of this growing movement toward compassionate, equitable care. Let’s keep the conversation going.

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7 Benefits of Working for a Doula Agency (and 1 Con)

1. Supportive community

Doula work can be lonely. If you’ve worked as a solo doula at all, you know that you are a one-person show. Even in Sioux Falls, which has a vibrant birth community, being a solo doula can feel like being on an island when you have wins to celebrate or feel defeated.

Doula agencies offer the comradery of being part of a team. Our agency has monthly meetings where we get together in person to discuss our work, and an active text thread where we work together to take care of our clients. Everyone cheers for each other in our wins and surrounds each other with support.

2. Built in backup

Very few other careers require a person to commit to putting their life on hold for a month at a time, 10 months into the future. That’s what solo doula work is like… someone will contact you in October to ask if you have availability in May or June of the next year!

When clients hire a doula from a doula agency, they understand that teamwork is a perk for the doula AND the client. If something comes up during the time that you are on call for someone, you simply ask someone from the team to cover you. Clients have the peace of mind of knowing the back up doula is already vetted by the agency, and can get to know the back up ahead of time. You can take the time off that you deserve, knowing your client will be well-cared for in your absence.

3. Room for growth

Our agency is very excited about growing doulas! Part of our mission is to make our community the best place to be a doula. We support our doulas in their interests and help them pursue growth in whatever way that looks for them. Burned out doulas don’t last long… we want to help our doulas make this a career, not just a blip in their work history. We aim to nurture our doulas in furthering their experience, helping them through obstacles, and cheering them on! This should be a goal of all agencies, not just ours.

4. IC’s can take their own clients

Did you know that an independent contractor can run their own business as well as work for an agency? If you’ve got your own clients, you are welcome to bring them to the agency in order to utilize all the perks of the agency, or you can take them on 100% independently.

5. No backend work

Marketing, tax IDs, nurturing local resource relationships, maintaining a social media presence, building a website, SEO, taking inquiries, courting potential clients, onboarding, handling contracts, payments, taxes, offboarding…. if this sounds overwhelming to you, you are a good candidate to be an agency doula.

Solo doulas are a one-person show. You wear all the hats! As an agency doula, you get to show up for the client and do the work.. The agency handles the rest.

6 Clients come to you

Building off of the previous reason… as an agency doula, the clients come to you. A big hurdle as a solo doula is finding clients, especially if they are a newer doula. The agency has a steady flow of clients looking for support.

7. The value of agency

Clients get excited about the prospect of working with an agency. It makes it so easy for them. They can get all of their needs met in one place, rather than seeking out all of the roles separately. It’s a smooth experience, from start to finish. There is value to this! And agencies are just as valuable to the clients as they are to the doula.

… And 1 con…

By working with an agency, you pay for what you get. Running a business costs money (even if you’re doing it solo), so most agencies take a portion of what the client pays. This is called the agency fee.

Agency fees vary from business to business. The range is usually between 25% and 40% of the client fee. This money goes to all pay for all of those benefits listed. To doulas who see the value of all of those benefits, it’s a no brainer. But if you are very business-minded and enjoy the challenge of wearing all the hats, agency doula life might not be for you.

Renee is co-owner of Transitions: Doula & Life Services in Sioux Falls, SD. Renee’s goal is that every person has their very best birth and postpartum. Renee helps birthing persons and their partners accomplish this goal by connecting them with Transitions Doulas who provide loving physical and emotional support throughout pregnancy, birth, and beyond. In addition to running the agency, Renee also provides postpartum doula support, lactation support, and childbirth education.