Florida Senate - 2026                                     SB 514
       
       
        
       By Senator Osgood
       
       
       
       
       
       32-00380C-26                                           2026514__
    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 the purpose 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 must 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; creating
   22         the Doula Certification Task Force within the
   23         department for a specified purpose; requiring the
   24         department to oversee and provide administrative
   25         support to the task force; providing for membership
   26         and meetings of the task force; specifying duties of
   27         the task force; requiring the task force to submit a
   28         final report of its findings and recommendations to
   29         the Governor and the Legislature by a specified date;
   30         providing for expiration of the task force; providing
   31         an effective date.
   32  
   33         WHEREAS, preterm birth is defined as a live birth before 37
   34  completed weeks of gestation and is associated with increased
   35  morbidities or ailments, such as cerebral palsy, breathing
   36  difficulties, feeding problems, developmental delay, and vision
   37  and hearing problems, and
   38         WHEREAS, preterm labor occurs when regular contractions
   39  cause the cervix to open between 20 and 37 weeks of gestation,
   40  which can result in a baby being born before 37 weeks of
   41  gestation, and the earlier the delivery, the greater the health
   42  risks for the baby, requiring special care in a neonatal
   43  intensive care unit and potentially causing long-term mental and
   44  physical health concerns, and
   45         WHEREAS, Florida’s preterm birth rate has risen annually
   46  since 2014 to its current average rate of 10.9 percent, higher
   47  than the national average of 10.5 percent, and
   48         WHEREAS, Florida ranks among the highest in the nation for
   49  infant mortality, with a rate of 5.9 deaths per 1,000 births,
   50  higher than the national average of 5.4 deaths per 1,000 births,
   51  and
   52         WHEREAS, Florida also has one of the highest cesarean
   53  delivery rates in the nation at 37.4 percent, compared to the
   54  national average of 31.8 percent, with cesarean delivery being
   55  associated with increased risks to infants, including
   56  respiratory distress, infection, and long-term health
   57  complications, and
   58         WHEREAS, maternal mortality is defined as the annual number
   59  of female deaths from any cause related to or aggravated by
   60  pregnancy or its management, excluding accidental or incidental
   61  causes, during pregnancy and childbirth or within 42 days after
   62  termination of a pregnancy, irrespective of the duration and
   63  site of the pregnancy, and
   64         WHEREAS, Florida ranks 17th in the nation with a maternal
   65  mortality rate of 26.3 deaths per 100,000 births, compared to a
   66  national rate of 23.2 deaths per 100,000 births, and
   67         WHEREAS, Broward County has a maternal mortality rate of
   68  24.8 deaths per 100,000 live births, and an infant mortality
   69  rate of 5 deaths per 1,000 live births, and
   70         WHEREAS, Miami-Dade County has a maternal mortality rate of
   71  20.3 deaths per 100,000 live births, and an infant mortality
   72  rate of 4.8 deaths per 1,000 live births, and
   73         WHEREAS, Palm Beach County has a maternal mortality rate of
   74  33.2 deaths per 100,000 live births, and an infant mortality
   75  rate of 5.4 deaths per 1,000 live births, and
   76         WHEREAS, continued perinatal support, including the
   77  services provided by trained doulas, is associated with reduced
   78  rates of cesarean delivery and improved birth outcomes, and
   79         WHEREAS, Florida has ongoing challenges related to child
   80  safety and welfare, with statistics showing disparities in
   81  health and safety outcomes for children across racial and
   82  socioeconomic groups, and
   83         WHEREAS, doula care is the continuous, one-to-one
   84  emotional, informational, and physical support provided by a
   85  trained nonmedical professional to pregnant women and their
   86  families during pregnancy, labor, and the postpartum period, and
   87         WHEREAS, while doulas do not perform medical tasks, they
   88  provide an array of educational and support services throughout
   89  the birthing process to ensure that the mother has a positive
   90  and empowering experience, including, but not limited to,
   91  educational resources and information about pregnancy,
   92  childbirth, and postpartum care; assistance in creating a birth
   93  plan; continuous emotional support during labor and delivery;
   94  assistance with breathing techniques, relaxation, and
   95  positioning during labor; massage and counterpressure measures;
   96  facilitation of communication with medical staff; advocacy in
   97  and navigation of the medical setting; and postpartum support
   98  with newborn care and feeding, and
   99         WHEREAS, evidence-based support provided by trained doulas
  100  has been shown to enhance birth experiences, reduce cesarean
  101  deliveries, and improve overall health outcomes for mothers and
  102  infants, and
  103         WHEREAS, the state has a compelling interest in improving
  104  maternal and infant outcomes through increased access to high
  105  quality doula services, NOW, THEREFORE,
  106  
  107  Be It Enacted by the Legislature of the State of Florida:
  108  
  109         Section 1. Section 383.295, Florida Statutes, is created to
  110  read:
  111         383.295 Doulas.—
  112         (1)DEFINITIONS.—As used in this section, the term:
  113         (a) “Department” means the Department of Health.
  114         (b) “Doula” means a nonmedical professional who provides
  115  health education, advocacy, and physical, emotional, and
  116  nonmedical support for pregnant and postpartum women before,
  117  during, and after childbirth, including support during
  118  miscarriage and stillbirth. Doulas are not clinical providers
  119  and are not licensed.
  120         (c) “Doula services” means the provision of physical,
  121  emotional, and informational support by a nonmedical
  122  professional to a pregnant woman during the prenatal,
  123  intrapartum, and postpartum periods. Activities may include
  124  childbirth education, labor support, postpartum recovery
  125  support, assistance with infant care, lactation support, and
  126  connection to community resources.
  127         (d) “Evidence-based” means a process in which decisions are
  128  made and actions or activities are carried out, based on the
  129  best evidence available, with the goal of removing subjective
  130  opinion, unfounded beliefs, or bias from decisions and actions.
  131  Such evidence may include practitioner experience and expertise
  132  as well as feedback from other practitioners and beneficiaries.
  133         (2) PILOT PROGRAM ESTABLISHED.—
  134         (a) The Doula Support for Healthy Births pilot program is
  135  established in Broward, Miami-Dade, and Palm Beach Counties to
  136  integrate doula services into existing maternal health
  137  initiatives, targeting pregnant and postpartum women who have
  138  overcome or are overcoming substance use disorders.
  139         (b) The purpose of the pilot program is to improve birth
  140  outcomes by decreasing preterm birth rates and cesarean
  141  deliveries, enhancing access to care, and supporting maternal
  142  well-being throughout the pregnancy, labor, and postpartum
  143  periods using evidence-based methods.
  144         (c) The Department of Health, through its maternal and
  145  child health section, shall implement and oversee the pilot
  146  program.
  147         (3) PROGRAM STRUCTURE.—
  148         (a) The pilot program may operate for 12 to 24 months,
  149  subject to funding.
  150         (b) The pilot program shall target the enrollment of
  151  pregnant and postpartum women who have overcome or are
  152  overcoming substance use disorders.
  153         (c) The following support services must be offered under
  154  the pilot program:
  155         1.Prenatal support, such as educational resources,
  156  personalized birth plans, and emotional support.
  157         2.Labor support, such as continuous emotional support,
  158  comfort measures, and communication facilitation.
  159         3.Postpartum support, such as assistance with newborn
  160  care, postpartum resources, and household tasks.
  161         4.Advocacy support, such as assistance with preferences
  162  and needs within medical settings and health care navigation.
  163         5.Comprehensive emotional support during the pregnancy and
  164  postpartum periods.
  165         (4) COLLABORATION; INTEGRATION.—
  166         (a)The department shall collaborate with:
  167         1.Health care providers, community organizations,
  168  community coalitions, and advocacy groups to integrate doulas
  169  and doula services into existing maternal health programs,
  170  ensuring that such doulas are trained and meet all of the
  171  following criteria:
  172         a.Demonstrate a strong understanding of the reproductive
  173  system, labor process, and postpartum recovery.
  174         b.Are proficient in hands-on techniques, such as massage,
  175  counterpressure, breathing exercises, and nonmedicated pain
  176  management.
  177         c.Support a client’s birth plan, communicate effectively
  178  with medical staff, and advocate for informed consent.
  179         d.Provide guidance on breastfeeding, basic newborn care,
  180  and both the physical and emotional aspects of postpartum
  181  recovery.
  182         e.Use active listening, clear communication, and conflict
  183  resolution skills in interactions with clients and health care
  184  providers.
  185         f.Understand common medical complications and provide
  186  emotional and physical support to clients in challenging
  187  situations.
  188         g.Uphold professionalism, ethical decisionmaking, and
  189  legal responsibilities in doula practice.
  190         2.Local WIC programs, hospitals, birth centers, and
  191  community health centers to facilitate outreach and service
  192  delivery.
  193         (b) The department may integrate doula services into
  194  existing maternal and child health programs as an expansion of
  195  the pilot program, focusing on pregnant and postpartum women who
  196  have overcome or are overcoming substance use disorders. Any
  197  such expansion of the pilot program must include annual
  198  reporting requirements for the department to evaluate
  199  effectiveness, equity, and quality of integrating doula services
  200  into the existing maternal and child health programs.
  201         (5) FUNDING.—The pilot program shall be funded using
  202  appropriations for the Closing the Gap grant program established
  203  under ss. 381.7351-381.7356. The department shall coordinate
  204  with its Division of Community Health Promotion and Office of
  205  Minority Health and Health Equity to seek additional federal
  206  funds to support implementation.
  207         Section 2. Doula Certification Task Force.
  208         (1)ESTABLISHMENT.—There is created within the Department
  209  of Health the Doula Certification Task Force, a task force as
  210  defined in s. 20.03(5), Florida Statutes, for the purpose of
  211  reviewing the scope of doula services and ensuring competency,
  212  quality, and consistency in the delivery of doula services to
  213  pregnant and postpartum women.
  214         (2)OVERSIGHT.—The Department of Health shall oversee and
  215  provide administrative support to the task force.
  216         (3)MEMBERSHIP; MEETINGS.—
  217         (a)The task force shall be composed of nine members. Three
  218  members shall be appointed by the Governor, three members shall
  219  be appointed by the Senate President, and three members shall be
  220  appointed by the Speaker of the House of Representatives. Of the
  221  nine members, two members must be health care practitioners as
  222  defined in s. 456.001, Florida Statutes, experienced in caring
  223  for pregnant or postpartum women, and at least one member must
  224  be a doula or otherwise have experience providing nonmedical
  225  support services to pregnant or postpartum women. A vacancy on
  226  the task force must be filled in the same manner as the original
  227  appointment. The task force shall elect a chair from among its
  228  members.
  229         (b) The task force shall meet as often as necessary to
  230  complete its work, but at least quarterly, at the call of the
  231  chair. The task force may conduct its meetings through
  232  teleconference or other similar electronic means.
  233         (4)DUTIES.—The task force shall do all of the following:
  234         (a)Review the scope of practice for doulas in this state,
  235  as well as in other states.
  236         (b)Establish core competencies for the provision of doula
  237  services.
  238         (c)Recommend minimum certification standards for doulas,
  239  which must include, but need not be limited to, all of the
  240  following:
  241         1.Possession of a high school diploma or its equivalent.
  242         2.Completion of a department-approved, evidence-based
  243  training program.
  244         3.A minimum number of supervised practice hours.
  245         4.Completion of a background screening.
  246         5.Education in professional ethics.
  247         (5)REPORT.—By January 1, 2028, the task force shall submit
  248  a final report of its findings and recommendations to the
  249  Governor, the President of the Senate, and the Speaker of the
  250  House of Representatives.
  251         (6)SUNSET.—The task force shall operate on a temporary
  252  basis in conjunction with the Doula Support for Healthy Births
  253  pilot program established under s. 383.295, Florida Statutes, as
  254  created by this act, and shall expire on October 2, 2029, in
  255  accordance with s. 20.052(8), Florida Statutes.
  256         Section 3. This act shall take effect upon becoming a law.