[The following final update was written by the organization and then sent to us for further sharing.]

As a recipient of the LA2050 Grants Challenge, Birthworkers of Color Collective is proud to share the measurable progress and deep community impact achieved through this year’s funding. With the support of LA2050 and the Goldhirsh Foundation, we expanded access to culturally rooted doula care in Los Angeles County, empowered new birthworkers through training and professional support, and removed critical barriers preventing Black, Indigenous, and other doulas of Color from entering and sustaining careers in birthwork.

Our project centered on three primary objectives:

1. Provide full-spectrum doula training scholarships to increase the number of culturally relevant doulas serving Los Angeles County families.

2. Host PAVE Support Workshops to guide doulas through the Medi-Cal Provider onboarding and credentialing process.

3. Reduce financial barriers for BIPOC doulas by supporting PAVE-related expenses including business licenses, HIPAA training, and liability insurance.

Through this initiative, we aimed to strengthen the local doula workforce, ensure doulas could access Medi-Cal reimbursement, and ultimately improve perinatal outcomes for marginalized birthing people across LA County.

Doula Training Scholarships

During the grant period, we hosted three full-spectrum doula trainings serving participants from across Los Angeles County and surrounding communities. Thanks to LA2050 support, we were able to award 27 full and partial scholarships awarded to new and emerging birthworkers.

These trainings equipped participants with the skills to provide compassionate, culturally congruent support across the full reproductive spectrum including pregnancy, birth, postpartum, abortion, and pregnancy loss. Many graduates have already begun offering services to families both in person and virtually, expanding community access to trusted care providers who reflect and understand their lived experiences.

Our training includes four full days of live training followed by six months of additional learning through our online learning platform. Our live training and online learning center also include videos and resources on getting started as a Medi-Cal provider. Training participants are also

invited to attend optional doula trainings sessions that are hosted once per month where we cover business basics such as creating your doula brand, setting your rates and packages, and contracts.

PAVE Support Workshops

Recognizing that training alone does not ensure sustainability, we expanded our PAVE Support Workshops to address the next major barrier for birthworkers hoping to increase access to doula support for low-income communities: navigating the complex Medi-Cal Doula Provider enrollment system.

In total, 45 doulas registered for our PAVE Support workshops, with consistent attendance from new and experienced birthworkers seeking clarity on Medi-Cal participation. Our Medi-Cal Doula Program Coordinator hosted 14 individualized support sessions. Through these sessions, the participants learned to identify and overcome common obstacles such as technical issues in the PAVE application portal, potential delays in credentialing, resources for complying with credentialing requirements, and managed care contracting and billing inconsistencies.

PAVE Stipends

We awarded eleven Medi-Cal Provider support stipends to BIPOC doulas, covering essential costs such as business licensing fees, HIPAA training costs, liability insurance, and CPR training/recertifying fees. For many recipients, this financial support was the difference between delaying or moving forward with their Medi-Cal enrollment.

Our evaluation process combined quantitative tracking with qualitative feedback. Participants in our doula trainings and PAVE workshops consistently expressed high satisfaction with the depth, accessibility, and cultural grounding of the sessions. Many noted that our organization is one of the few spaces providing practical, affirming, and community-centered guidance through the bureaucratic realities of the Medi-Cal benefit.

Recurring themes in participant feedback included:

● A strong desire for clarity on billing procedures and Medi-Cal-approved services.

● Appreciation for peer support and mentorship within the workshops.

● Frustration with inconsistent information across Managed Care Plans, which often created confusion even after PAVE approval.

Despite these systemic challenges, participants overwhelmingly reported increased confidence and readiness to engage as Doula providers. Here are some quotes from our training participants,

“I found everything so helpful. I like how things were broken down and helped me get a better understanding. I found the resources to be very helpful. As I am currently working with a family who have just gone through a miscarriage and being able to use some of the things I have learned through the training has been a great support and being able to help the family connect to resources.”

“I was inspired the most by the shared experiences of why many of us want to become doulas and knowing that we deserve payment as many people don’t really put emphasis on that.”

“What I found most helpful were the varied, nuanced perspectives and approaches we were introduced to. We looked at birthwork from western medical perspectives, indigenous and holistic perspectives, and birthwork as activism and liberation. I also LOVED that it was full-spectrum, covering fertility, pre-conception, perinatal, postnatal, abortion, loss and so much more. I felt affirmed in many aspects, challenged in some, but overall my knowledge, confidence, and passion was deepened.”

“What most inspired me most was to be open to being your TRUE self. This training inspired me to show my face more on social media platforms, to be me and do what I love most and share with families so that they can have healthier and safer births.”

Lessons Learned and Ongoing Challenges

While the program met and exceeded our primary objectives, several challenges remain. Chief among them is the lack of consistency and transparency across Medi-Cal Managed Care Plans. Even doulas who successfully completed the PAVE process encountered confusion about billing codes, reimbursement timelines, and plan-specific policies.

Additionally, technical literacy varied among doulas, with some participants needing more intensive support to complete digital applications or troubleshoot system errors. This revealed the need for a more tiered support model, including optional tech navigation sessions and peer mentorship opportunities.

These insights will shape our next phase of programming as we continue to build an infrastructure that helps doulas not just enter, but thrive within Medi-Cal.

The shifting political landscape also presents a major challenge for our staff, doulas, and community members. One Big Beautiful Bill has detrimental effects on the most vulnerable in our communities. The intensification of ICE immigration and enforcement activities also has many clients skipping important perinatal care appointments for fear of family separation and deportation. Our team has hosted multiple community calls to keep our collective network informed of any potential impacts to the Medi-Cal doula program and advocacy opportunities.

Partnerships and Collaboration

One exciting development during the grant period was our growing relationship with the Los Angeles County Department of Children and Family Services (DCFS). After engaging with our outreach team at a community event, DCFS invited us to present to their Home Visiting Network and Program Administrators. This presentation sparked discussions about integrating doula services into their support offerings for families, potentially creating new paid opportunities for our graduates.

We also received recognition and promotion through the National Health Law Program (NHeLP) Medicaid Newsletter, which featured our PAVE Support Workshops as a trusted source of support promoting equitable provider enrollment across California.

Our organization is committed to continuing this work beyond the LA2050 grant period. Building on our success, we plan to:

• Continue hosting monthly PAVE Support Workshops, including 1:1 technical assistance and expand session times to accommodate participant preferences and availability.
• Develop an advanced Medi-Cal Billing and Reimbursement Training to address persistent challenges doulas face post-enrollment.
• Strengthen partnerships with local agencies and hospitals to create employment pipelines for newly trained doulas.
• Seek additional funding to scale the PAVE Stipend Program to reach at least 25 doulas in 2026.

The LA2050 grant catalyzed a year of meaningful progress toward equity in perinatal care. Through training, mentorship, and structural support, we empowered 27 new doulas, supported 14 doulas through Medi-Cal Provider enrollment, and removed systemic financial barriers for 11 doulas that have historically excluded BIPOC birthworkers.

While challenges persist in navigating new systems, the progress made this year underscores what’s possible when community-based solutions are adequately funded. Together, we are transforming the birth landscape in Los Angeles County.

Everyone deserves a doula!