THE BILL ITSELF
CS/SB 514
Doula Support for Healthy Births Pilot Program
Florida Senate - 2026 CS for SB 514 By the Committee on Health Policy; and Senator Osgood 588-02412-26 2026514c1
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, subject to a specific appropriation
7
in the General Appropriations Act; providing the
8
purpose of the pilot program; requiring the Department
9
of Health, in collaboration with its maternal and
10
child health section, to implement and oversee the
11
pilot program; specifying the duration of the pilot
12
program, based on appropriated funds; requiring the
13
pilot program to target specified populations for
14
enrollment; specifying services that must be provided
15
under the pilot program; requiring the department to
16
collaborate with specified entities to integrate doula
17
services into existing maternal health programs and
18
facilitate outreach and service delivery; authorizing
19
the department to integrate doula services into
20
existing maternal and child health programs as an
21
expansion of the pilot program, subject to certain
22
requirements; creating the Doula Certification Task
23
Force within the department for a specified purpose;
24
requiring the department to oversee and provide
25
administrative support to the task force; providing
26
for membership and meetings of the task force;
27
specifying duties of the task force; requiring the
28
task force to submit a final report of its findings
29
and recommendations to the Governor and the
30
Legislature by a specified date; providing for
31
expiration of the task force; providing an effective
32
date.
34
WHEREAS, preterm birth is defined as a live birth before 37
35
completed weeks of gestation and is associated with increased
36
morbidities or ailments, such as cerebral palsy, breathing
37
difficulties, feeding problems, developmental delay, and vision
38
and hearing problems, and
39
WHEREAS, preterm labor occurs when regular contractions
40
cause the cervix to open between 20 and 37 weeks of gestation,
41
which can result in a baby being born before 37 weeks of
42
gestation, and the earlier the delivery, the greater the health
43
risks for the baby, requiring special care in a neonatal
44
intensive care unit and potentially causing long-term mental and
45
physical health concerns, and
46
WHEREAS, Florida’s preterm birth rate has risen annually
47
since 2014 to its current average rate of 10.9 percent, higher
48
than the national average of 10.5 percent, and
49
WHEREAS, Florida ranks among the highest in the nation for
50
infant mortality, with a rate of 5.9 deaths per 1,000 births,
51
higher than the national average of 5.4 deaths per 1,000 births,
52
and
53
WHEREAS, Florida also has one of the highest cesarean
54
delivery rates in the nation at 37.4 percent, compared to the
55
national average of 31.8 percent, with cesarean delivery being
56
associated with increased risks to infants, including
57
respiratory distress, infection, and long-term health
58
complications, and
59
WHEREAS, maternal mortality is defined as the annual number
60
of female deaths from any cause related to or aggravated by
61
pregnancy or its management, excluding accidental or incidental
62
causes, during pregnancy and childbirth or within 42 days after
63
termination of a pregnancy, irrespective of the duration and
64
site of the pregnancy, and
65
WHEREAS, Florida ranks 17th in the nation with a maternal
66
mortality rate of 26.3 deaths per 100,000 births, compared to a
67
national rate of 23.2 deaths per 100,000 births, and
68
WHEREAS, Broward County has a maternal mortality rate of
69
24.8 deaths per 100,000 live births, and an infant mortality
70
rate of 5 deaths per 1,000 live births, and
71
WHEREAS, Miami-Dade County has a maternal mortality rate of
72
20.3 deaths per 100,000 live births, and an infant mortality
73
rate of 4.8 deaths per 1,000 live births, and
74
WHEREAS, Palm Beach County has a maternal mortality rate of
75
33.2 deaths per 100,000 live births, and an infant mortality
76
rate of 5.4 deaths per 1,000 live births, and
77
WHEREAS, continued perinatal support, including the
78
services provided by trained doulas, is associated with reduced
79
rates of cesarean delivery and improved birth outcomes, and
80
WHEREAS, Florida has ongoing challenges related to child
81
safety and welfare, with statistics showing disparities in
82
health and safety outcomes for children across racial and
83
socioeconomic groups, and
84
WHEREAS, doula care is the continuous, one-to-one
85
emotional, informational, and physical support provided by a
86
trained nonmedical professional to pregnant women and their
87
families during pregnancy, labor, and the postpartum period, and
88
WHEREAS, while doulas do not perform medical tasks, they
89
provide an array of educational and support services throughout
90
the birthing process to ensure that the mother has a positive
91
and empowering experience, including, but not limited to,
92
educational resources and information about pregnancy,
93
childbirth, and postpartum care; assistance in creating a birth
94
plan; continuous emotional support during labor and delivery;
95
assistance with breathing techniques, relaxation, and
96
positioning during labor; massage and counterpressure measures;
97
facilitation of communication with medical staff; advocacy in
98
and navigation of the medical setting; and postpartum support
99
with newborn care and feeding, and
100
WHEREAS, evidence-based support provided by trained doulas
101
has been shown to enhance birth experiences, reduce cesarean
102
deliveries, and improve overall health outcomes for mothers and
103
infants, and
104
WHEREAS, the state has a compelling interest in improving
105
maternal and infant outcomes through increased access to high
106
quality doula services, NOW, THEREFORE,
108
Be It Enacted by the Legislature of the State of Florida:
110
Section 1. Section 383.295, Florida Statutes, is created to
111
read:
112
383.295 Doulas.—
113
(1) DEFINITIONS.—As used in this section, the term:
114
(a) “Department” means the Department of Health.
115
(b) “Doula” means a nonmedical professional who provides
116
health education, advocacy, and physical, emotional, and
117
nonmedical support for pregnant and postpartum women before,
118
during, and after childbirth, including support during
119
miscarriage and stillbirth. Doulas are not clinical providers
120
and are not licensed.
121
(c) “Doula services” means the provision of physical,
122
emotional, and informational support by a nonmedical
123
professional to a pregnant woman during the prenatal,
124
intrapartum, and postpartum periods. Activities may include
125
childbirth education, labor support, postpartum recovery
126
support, assistance with infant care, lactation support, and
127
connection to community resources.
128
(d) “Evidence-based” means a process in which decisions are
129
made and actions or activities are carried out, based on the
130
best evidence available, with the goal of removing subjective
131
opinion, unfounded beliefs, or bias from decisions and actions.
132
Such evidence may include practitioner experience and expertise
133
as well as feedback from other practitioners and beneficiaries.
134
(2) PILOT PROGRAM ESTABLISHED.—
135
(a) Subject to a specific appropriation of funds in the
136
General Appropriations Act, the Doula Support for Healthy Births
137
pilot program is established in Broward, Miami-Dade, and Palm
138
Beach Counties to integrate doula services into existing
139
maternal health initiatives, targeting pregnant and postpartum
140
women who have overcome or are overcoming substance use
141
disorders.
142
(b) The purpose of the pilot program is to improve birth
143
outcomes by decreasing preterm birth rates and cesarean
144
deliveries, enhancing access to care, and supporting maternal
145
well-being throughout the pregnancy, labor, and postpartum
146
periods using evidence-based methods.
147
(c) The department, through its maternal and child health
148
section, shall implement and oversee the pilot program.
149
(3) PROGRAM STRUCTURE.—
150
(a) The pilot program may operate for 12 to 24 months,
151
based on appropriated funds.
152
(b) The pilot program shall target the enrollment of
153
pregnant and postpartum women who have overcome or are
154
overcoming substance use disorders.
155
(c) The following support services must be offered under
156
the pilot program:
157
1. Prenatal support, such as educational resources,
158
personalized birth plans, and emotional support.
159
2. Labor support, such as continuous emotional support,
160
comfort measures, and communication facilitation.
161
3. Postpartum support, such as assistance with newborn
162
care, postpartum resources, and household tasks.
163
4. Advocacy support, such as assistance with preferences
164
and needs within medical settings and health care navigation.
165
5. Comprehensive emotional support during the pregnancy and
166
postpartum periods.
167
(4) COLLABORATION; INTEGRATION.—
168
(a) The department shall collaborate with:
169
1. Health care providers, community organizations,
170
community coalitions, and advocacy groups to integrate doulas
171
and doula services into existing maternal health programs,
172
ensuring that such doulas are trained and meet all of the
173
following criteria:
174
a. Demonstrate a strong understanding of the reproductive
175
system, labor process, and postpartum recovery.
176
b. Are proficient in hands-on techniques, such as massage,
177
counterpressure, breathing exercises, and nonmedicated pain
178
management.
179
c. Support a client’s birth plan, communicate effectively
180
with medical staff, and advocate for informed consent.
181
d. Provide guidance on breastfeeding, basic newborn care,
182
and both the physical and emotional aspects of postpartum
183
recovery.
184
e. Use active listening, clear communication, and conflict
185
resolution skills in interactions with clients and health care
186
providers.
187
f. Understand common medical complications and provide
188
emotional and physical support to clients in challenging
189
situations.
190
g. Uphold professionalism, ethical decisionmaking, and
191
legal responsibilities in doula practice.
192
2. Local WIC programs, hospitals, birth centers, and
193
community health centers to facilitate outreach and service
194
delivery.
195
(b) If appropriated funding is sufficient, the department
196
may integrate doula services into existing maternal and child
197
health programs as an expansion of the pilot program, focusing
198
on pregnant and postpartum women who have overcome or are
199
overcoming substance use disorders. Any such expansion of the
200
pilot program must include annual reporting requirements for the
201
department to evaluate effectiveness, equity, and quality of
202
integrating doula services into the existing maternal and child
203
health programs.
204
Section 2. Doula Certification Task Force.—
205
(1) ESTABLISHMENT.—There is created within the Department
206
of Health the Doula Certification Task Force, a task force as
207
defined in s. 20.03(5), Florida Statutes, for the purpose of
208
reviewing the scope of doula services and ensuring competency,
209
quality, and consistency in the delivery of doula services to
210
pregnant and postpartum women.
211
(2) OVERSIGHT.—The Department of Health shall oversee and
212
provide administrative support to the task force.
213
(3) MEMBERSHIP; MEETINGS.—
214
(a) The task force shall be composed of nine members. Three
215
members shall be appointed by the Governor, three members shall
216
be appointed by the Senate President, and three members shall be
217
appointed by the Speaker of the House of Representatives. Of the
218
nine members, two members must be health care practitioners as
219
defined in s. 456.001, Florida Statutes, experienced in caring
220
for pregnant or postpartum women, and at least one member must
221
be a doula or otherwise have experience providing nonmedical
222
support services to pregnant or postpartum women. A vacancy on
223
the task force must be filled in the same manner as the original
224
appointment. The task force shall elect a chair from among its
225
members.
226
(b) The task force shall meet as often as necessary to
227
complete its work, but at least quarterly, at the call of the
228
chair. The task force may conduct its meetings through
229
teleconference or other similar electronic means.
230
(4) DUTIES.—The task force shall do all of the following:
231
(a) Review the scope of practice for doulas in this state,
232
as well as in other states.
233
(b) Establish core competencies for the provision of doula
234
services.
235
(c) Recommend minimum certification standards for doulas,
236
which must include, but need not be limited to, all of the
237
following:
238
1. Possession of a high school diploma or its equivalent.
239
2. Completion of a department-approved, evidence-based
240
training program.
241
3. A minimum number of supervised practice hours.
242
4. Completion of a background screening.
243
5. Education in professional ethics.
244
(5) REPORT.—By January 1, 2028, the task force shall submit
245
a final report of its findings and recommendations to the
246
Governor, the President of the Senate, and the Speaker of the
247
House of Representatives.
248
(6) SUNSET.—The task force shall operate on a temporary
249
basis in conjunction with the Doula Support for Healthy Births
250
pilot program established under s. 383.295, Florida Statutes, as
251
created by this act, and shall expire on October 2, 2029, in
252
accordance with s. 20.052(8), Florida Statutes.
253
Section 3. This act shall take effect upon becoming a law.