As abortion bans sweep the U.S., clinics shutter and gender-affirming care is criminalized, New Mexico accomplished something radical: It passed a law to pay doulas—because doulas save lives.
In 2025, the state unanimously enacted HB 214, the Doula Credentialing and Access Act, creating the nation’s most comprehensive Medicaid coverage for full-spectrum doula care, including for abortion, miscarriage, pregnancy, birth, postpartum and loss.
This victory was decades in the making, a fight led by Black, Indigenous, Latinx, LGBTQ+, immigrant, disabled and community-based doulas. These care workers have long provided essential, unpaid labor in a healthcare system that overlooked them. Now, for the first time, their labor is recognized as essential health infrastructure.
Still, as this vision takes root under HB 214, federal funding threats loom, including cuts to Medicaid, SNAP and reproductive health access—all part of a national strategy to defund care and increase control. Believe in this future? Help protect it. Urge your state to follow New Mexico’s lead. Support local doula collectives. Push for policies that center care over control. The path forward is here—let’s walk it together.
(This essay is part of a collection presented by Ms. and the Groundswell Fund highlighting the work of Groundswell partners advancing inclusive democracy.)