Florida Senate - 2025 SB 780
By Senator Osgood
32-01255A-25 2025780__
1 A bill to be entitled
2 An act relating to the Doula Support for Healthy
3 Births pilot program; creating s. 383.295, F.S.;
4 defining terms; establishing the pilot program in
5 Broward, Miami-Dade, and Palm Beach Counties for a
6 specified purpose; providing aims of the pilot
7 program; requiring the Department of Health, in
8 collaboration with its maternal and child health
9 section, to implement and oversee the pilot program;
10 specifying the duration of the pilot program, subject
11 to funding; requiring the pilot program to target
12 specified populations for enrollment; specifying
13 services that will be provided under the pilot
14 program; requiring the department to collaborate with
15 specified entities to integrate doula services into
16 existing maternal health programs and facilitate
17 outreach and service delivery; authorizing the
18 department to integrate doula services into existing
19 maternal and child health programs as an expansion of
20 the pilot program, subject to certain requirements;
21 providing for funding of the pilot program; providing
22 an effective date.
23
24 WHEREAS, preterm birth is defined as a live birth before 37
25 completed weeks of gestation and is associated with increased
26 morbidities or ailments, such as cerebral palsy, breathing
27 difficulties, feeding problems, developmental delay, and vision
28 and hearing problems, and
29 WHEREAS, preterm labor occurs when regular contractions
30 cause the cervix to open between 20 and 37 weeks of gestation,
31 which can result in a baby being born before 37 weeks of
32 gestation, and the earlier the delivery, the greater the health
33 risks for the baby, requiring special care in a neonatal
34 intensive care unit and potentially causing long-term mental and
35 physical health concerns, and
36 WHEREAS, Florida’s preterm birth rate has risen annually
37 since 2014 to its current average rate of 10.9 percent, higher
38 than the national average of 10.5 percent, and
39 WHEREAS, Florida ranks among the highest in the nation for
40 infant mortality, with a rate of 5.9 deaths per 1,000 births,
41 higher than the national average of 5.4 deaths per 1,000 births,
42 and
43 WHEREAS, Florida also has one of the highest cesarean
44 delivery rates in the nation at 37.4 percent, compared to the
45 national average of 31.8 percent, with cesarean delivery being
46 associated with increased risks to infants, including
47 respiratory distress, infection, and long-term health
48 complications, and
49 WHEREAS, maternal mortality is defined as the annual number
50 of female deaths from any cause related to or aggravated by
51 pregnancy or its management, excluding accidental or incidental
52 causes, during pregnancy and childbirth or within 42 days after
53 termination of a pregnancy, irrespective of the duration and
54 site of the pregnancy, and
55 WHEREAS, Florida ranks 17th in the nation with a maternal
56 mortality rate of 26.3 deaths per 100,000 births, compared to a
57 national rate of 23.2 deaths per 100,000 births, and
58 WHEREAS, Broward County has a maternal mortality rate of
59 24.8 deaths per 100,000 live births, and an infant mortality
60 rate of 5 deaths per 1,000 live births, and
61 WHEREAS, Miami-Dade County has a maternal mortality rate of
62 20.3 deaths per 100,000 live births, and an infant mortality
63 rate of 4.8 deaths per 1,000 live births, and
64 WHEREAS, Palm Beach County has a maternal mortality rate of
65 33.2 deaths per 100,000 live births, and an infant mortality
66 rate of 5.4 deaths per 1,000 live births, and
67 WHEREAS, continued perinatal support, including the
68 services provided by trained doulas, is associated with reduced
69 rates of cesarean delivery and improved birth outcomes, and
70 WHEREAS, Florida has ongoing challenges related to child
71 safety and welfare, with statistics showing disparities in
72 health and safety outcomes for children across racial and
73 socioeconomic groups, and
74 WHEREAS, doula care is the continuous, one-to-one
75 emotional, informational, and physical support provided by a
76 trained nonmedical professional to pregnant women and their
77 families during pregnancy, labor, and the postpartum period, and
78 WHEREAS, while doulas do not perform medical tasks, they
79 provide an array of educational and support services throughout
80 the birthing process to ensure that the mother has a positive
81 and empowering experience, including, but not limited to,
82 educational resources and information about pregnancy,
83 childbirth, and postpartum care; assistance in creating a birth
84 plan; continuous emotional support during labor and delivery;
85 assistance with breathing techniques, relaxation, and
86 positioning during labor; massage and counterpressure measures;
87 facilitation of communication with medical staff; advocacy in
88 and navigation of the medical setting; and postpartum support
89 with newborn care and feeding, and
90 WHEREAS, evidence-based support provided by trained doulas
91 has been shown to enhance birth experiences, reduce cesarean
92 deliveries, and improve overall health outcomes for mothers and
93 infants, and
94 WHEREAS, the state has a compelling interest in improving
95 maternal and infant outcomes through increased access to high
96 quality doula services, NOW, THEREFORE,
97
98 Be It Enacted by the Legislature of the State of Florida:
99
100 Section 1. Section 383.295, Florida Statutes, is created to
101 read:
102 383.295 Doulas.—
103 (1) DEFINITIONS.—As used in this section, the term:
104 (a) “Department” means the Department of Health.
105 (b) “Doula” means a nonmedical professional who provides
106 health education, advocacy, and physical, emotional, and
107 nonmedical support for pregnant and postpartum women before,
108 during, and after childbirth, including support during
109 miscarriage and stillbirth. Doulas are not licensed or clinical
110 providers, and they do not require supervision.
111 (c) “Doula services” means the provision of physical,
112 emotional, and informational support by a nonmedical
113 professional to a pregnant woman during the prenatal,
114 intrapartum, and postpartum periods. Activities may include
115 childbirth education, labor support, postpartum recovery
116 support, assistance with infant care, lactation support, and
117 connection to community resources.
118 (d) “Evidence-based” means a process in which decisions are
119 made and actions or activities are carried out, based on the
120 best evidence available, with the goal of removing subjective
121 opinion, unfounded beliefs, or bias from decisions and actions.
122 Such evidence may include practitioner experience and expertise
123 as well as feedback from other practitioners and beneficiaries.
124 (2) PILOT PROGRAM ESTABLISHED.—
125 (a) The Doula Support for Healthy Births pilot program is
126 established in Broward, Miami-Dade, and Palm Beach Counties to
127 integrate doula services into existing maternal health
128 initiatives, targeting parents who are uninsured, underinsured,
129 or eligible for Medicaid or the Special Supplemental Nutrition
130 Program for Women, Infants, and Children (WIC).
131 (b) The purpose of the pilot program is to improve birth
132 outcomes by decreasing preterm birth rates and cesarean
133 deliveries, enhancing access to care, and supporting maternal
134 well-being throughout the pregnancy, labor, and postpartum
135 periods using evidence-based methods.
136 (c) The Department of Health shall work in collaboration
137 with its maternal and child health section to implement and
138 oversee the pilot program.
139 (3) PROGRAM STRUCTURE.—
140 (a) The pilot program may operate for 12 to 24 months,
141 subject to funding.
142 (b) The pilot program shall target the enrollment of
143 uninsured and underinsured pregnant women, WIC participants, and
144 Medicaid-eligible parents.
145 (c) The following support services must be offered under
146 the pilot program:
147 1. Prenatal support.—Educational resources, personalized
148 birth plans, and emotional support.
149 2. Labor support.—Continuous emotional support, comfort
150 measures, and communication facilitation.
151 3. Postpartum support.—Assistance with newborn care,
152 postpartum resources, and household tasks.
153 4. Advocacy support.—Assistance with preferences and needs
154 within medical settings and health care navigation.
155 5. Emotional support.—Comprehensive emotional support
156 during the pregnancy and postpartum periods.
157 (4) COLLABORATION; INTEGRATION.—
158 (a) The department shall collaborate with:
159 1. Health care providers, community organizations,
160 community coalitions, and advocacy groups to integrate doulas
161 and doula services into existing maternal health programs,
162 ensuring that such doulas are trained and meet all of the
163 following criteria:
164 a. Demonstrate a strong understanding of the reproductive
165 system, labor process, and postpartum recovery.
166 b. Are proficient in hands-on techniques such as massage,
167 counterpressure, breathing exercises, and nonmedicated pain
168 management.
169 c. Support a client’s birth plan, communicate effectively
170 with medical staff, and advocate for informed consent.
171 d. Provide guidance on breastfeeding, basic newborn care,
172 and both the physical and emotional aspects of postpartum
173 recovery.
174 e. Use active listening, clear communication, and conflict
175 resolution skills in interactions with clients and health care
176 providers.
177 f. Understand common medical complications and provide
178 emotional and physical support to clients in challenging
179 situations.
180 g. Uphold professionalism, ethical decisionmaking, and
181 legal responsibilities in doula practice.
182 2. Local WIC programs, hospitals, birth centers, and
183 community health centers to facilitate outreach and service
184 delivery.
185 (b) The department may integrate doula services into
186 existing maternal and child health programs as an expansion of
187 the pilot program, focusing on uninsured, underinsured, and
188 Medicaid populations. Any such expansion of the pilot program
189 must include annual reporting requirements for the department to
190 evaluate effectiveness, equity, and quality of integrating doula
191 services into the existing maternal and child health programs.
192 (5) FUNDING.—The pilot program shall be funded using
193 appropriations for the Closing the Gap grant program established
194 under ss. 381.7351-381.7356. The department shall collaborate
195 with its Division of Community Health Promotion and Office of
196 Minority Health and Health Equity to seek additional federal
197 funds to support implementation.
198 Section 2. This act shall take effect upon becoming a law.