A recent Seattle Times article discusses the state of maternal and child health in Washington state, and explores potential solutions. The use of doulas may help to reduce racial gaps in maternal mortality rates, yet the role of doulas are not well understood. Building on CHWS research on the use of doulas in underserved communities and the challenges in building a sustainable doula workforce, in this article Dr. Paula Kett, CHWS Research Scientist discusses the added burdens that health insurance create in accessing high quality maternal care.