MBRNPC Official Statement on the TRICARE CBSD Extension

FOR IMMEDIATE RELEASE

Military Birth Resource Network and Postpartum Coalition Statement on the Extension of the TRICARE Childbirth and Breastfeeding Support Demonstration

The Military Birth Resource Network and Postpartum Coalition welcomes the Department of Defense's decision to extend the TRICARE Childbirth and Breastfeeding Support Demonstration (CBSD) through December 31, 2031. This five-year extension ensures that eligible military families will continue to have access to certified labor doulas, lactation consultants, and lactation counselors - support that is essential to improving maternal and infant health outcomes across our community.

Since its launch in January 2022, the CBSD has represented meaningful progress in recognizing the role that non-medical perinatal support providers play in reducing complications, improving birth experiences, and promoting breastfeeding success. We are encouraged that the Department is also soliciting public comments on the demonstration's potential integration into the permanent TRICARE basic benefit, and we urge all stakeholders to participate in that process before the May 11, 2026 comment period closes.

At the same time, we believe the extension presents a critical opportunity to address longstanding gaps in the program's reach. Most significantly, the CBSD currently excludes beneficiaries who give birth at Military Treatment Facilities (MTFs), leaving some of the most underserved members of our community - including active duty servicemembers - without access to doula support at the very institutions meant to serve them. Expanding CBSD coverage to MTF births must be a priority in any evaluation of the program's effectiveness and equity.

The personal cost of this gap is real. Active-duty Marine Ashley Parker paid out of pocket for a doula during her birth at an MTF, an experience that underscores both the value of this support and the urgent need for coverage where military families are actually giving birth.

"As an active-duty service member, paying out of pocket for a doula for my daughter’s birth at US Naval Hospital was the best decision I made. She provided focused, one-on-one support that improved my experience and lessened the information burden on the hospital staff. Her familiarity with the military healthcare system was invaluable. It truly underscores how vital doula support is for women’s healthcare. This essential service should not be a personal expense, it should be optional support covered by Tricare," said Parker.

Additional program improvements we are calling for include:

Fair and stable reimbursement rates. Adequate reimbursement is essential to sustaining a robust network of both doulas and lactation professionals willing to serve military families. Rates must reflect the true value of perinatal support and remain stable enough to ensure provider participation is not eroded over time.

Expansion of accepted certifications. The current list of recognized certifying bodies for both labor doulas and lactation professionals must be broadened to reflect the full landscape of qualified providers. Limiting accepted certifications restricts the diversity and cultural competency of the provider force - directly impacting the military families, particularly families of color, who most need access to providers who reflect their backgrounds and experiences.

"The extension of the CBSD is a recognition that military families deserve the same quality of perinatal support that civilian families are increasingly able to access," said Gaby Cavins, Executive Director of the Military Birth Resource Network and Postpartum Coalition. "But continuation alone is not enough. Until doula and lactation services are available to every military family, including those giving birth at Military Treatment Facilities, and until providers are fairly compensated and reflect the diversity of the communities they serve, we will continue to advocate for the changes needed to make this demonstration live up to its full potential."

We look forward to engaging with the Defense Health Agency throughout this extended evaluation period and will be submitting formal comments ahead of the May 11, 2026 deadline.