When Sylvia Halliburton became the first person to complete Arkansas’ new community-based doula certification process, it marked more than a professional achievement. It marked the beginning of a long-overdue shift in how Arkansas recognizes maternal support, especially in rural communities that have been underserved for generations.
For years, doulas across Arkansas have done essential work largely without formal recognition, sustainable funding, or reimbursement pathways. They have shown up for women in labor, sat beside mothers navigating high-risk pregnancies, connected families to transportation and resources, and helped women advocate for themselves inside complex health-care systems. Most have done it for free, or at a very low rate, because the need was too urgent not to.
Now, for the first time, Arkansas is creating a framework that could allow community-based doulas to receive Medicaid and insurance reimbursement for their work.
Act 965 of 2025 established a certification process through the Arkansas Department of Health. The new certification standards, developed alongside the Doula Alliance of Arkansas, create an official pathway for doulas to be recognized as trained providers supporting women during pregnancy and postpartum. While reimbursement structures are still being finalized, certification is the critical first step. Without standardized certification, there is no system for Medicaid or insurers to reimburse services.
Maternal health challenges in rural Arkansas are well-documented. Many women face long drives to hospitals, limited access to OB-GYN providers, transportation barriers, child-care challenges, and increasing rates of pregnancy-related complications. In some communities, women are navigating pregnancy while also managing housing instability, food insecurity, untreated trauma, or the absence of reliable support systems.
That is where community-based doulas often step in. Sylvia, who serves families across the Arkansas Delta, describes doula work as “more than birthing plans and hip squeezes.” In practice, it often means helping mothers build support systems, navigate appointments, understand warning signs, access community resources, and feel less alone during one of the most vulnerable periods of their lives.
In many rural communities, that support can be transformative. Community-based doulas are uniquely positioned because they often understand the cultural, geographic, and economic realities families face. They are trusted neighbors, advocates, educators, and connectors. They know what it means when a mother lives two hours from the nearest hospital. They understand the stress of finding child care before labor begins. They recognize when a woman may need emotional support just as much as medical support.
Research nationally has shown that doula support can improve birth outcomes, reduce unnecessary interventions, and strengthen postpartum support.
Act 965 signals that the state is beginning to recognize doulas as part of the maternal health ecosystem, especially in communities where health-care shortages continue to grow. Still, certification alone will not solve Arkansas’ maternal health challenges. Sustainable reimbursement rates, continuing education opportunities, workforce development, and broader community investment will all be necessary to make the system work long-term.
But every system starts somewhere. And in Arkansas, that beginning now has a face.
It is a doula from Brinkley who has spent years serving mothers across the Delta, often without compensation, and who now represents the first official step toward building a stronger maternal support system for families across the state.
Liyah Wasson is the co-founder and executive director of the Doula Alliance of Arkansas.
