Doula

The famous African proverb “It takes a village” rings true for many community-supported endeavors—and childbirth is no exception.

Becoming a doula is an ideal career choice for those who feel compelled to provide emotional and physical support to women during childbirth. The care provided by birth doulas to laboring paretns and their families has lasting positive impacts on the physical and emotional health of parents and babies, as well as improved societal and financial outcomes.

The doula profession has existed for centuries, and emerging research reveals that expectant parents who have the continuous support of a doula during labor and delivery have more positive birth experiences.

The Cochrane Review, published in 2017, evaluated 26 medical studies and concluded that parents who had a doula present during their birth experiences were more likely to have shorter labor times, spontaneous vaginal births, decreased cesarean deliveries, and less likely to use pain medication. Furthermore, public awareness of the benefits that doulas provide is on the rise. A 2012 survey titled “Listening to Mothers III” reports that while only 6 percent of parents surveyed in 2011 and 2012 received supportive care from a doula during childbirth, 27 percent of women understood the scope of care provided by a trained labor assistant and expressed retroactive interest in having a doula present at their birthing experiences. 

Having more support during childbirth goes beyond a desire for better access to healthcare; it’s also an issue of social and financial equality. Data from the Commonwealth Fund shows that the United States has the highest rate of maternal death compared to other developing nations and that the maternal mortality rate in the U.S. is higher for women of color. In fact, according to the report, African American parents in the US experience a maternal mortality rate of 49.5 per 100,000 live births versus 22.3 for all Americans on average.

The Doula Medicaid Project has responded to these statistical inequities through legal advocacy and education in support of the expansion of doula services for low-income women in the United States. Further support for doulas comes from cost-effectiveness studies published in the Journal of Midwifery & Women’s Health and Birth: Issues in Prenatal Care, which calculate that families and health insurance companies can save anywhere from $929 to $1,360 per birth due to the drastic reduction in complications when a doula is present during childbirth.

As Dr. Neel Shah—an MD and an assistant professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School—told the New York Times, “It is important to remember that people have goals other than simply emerging from childbirth unscathed. Safety during labor is the floor of what people deserve. What we should all really be aiming for is the ceiling: care that is not just safe, but also supportive and empowering.” 

The community-oriented care provided by doulas in tandem with other birth medical personnel increases the likelihood that all parents and newborns can have the healthy birth experiences they deserve. 

Read on to learn more about how to become a birth doula.

Doulas are non-medical birthing and postpartum professionals who are primarily dedicated to the physical and emotional well-being of a birthing parent and their newborn baby. Professional doula responsibilities include:

• Meeting with a parent and her birth team during the third trimester prior to labor and delivery
• Providing one-on-one supportive care for the parent during labor and delivery
• Creating a calm birthing environment
• Providing pain management and breathing techniques
• Giving light massage 
• Preparing a birthing tub
• Offering positioning and movement techniques during labor
• Supporting birth partners
• Advocating for the parent’s birth preferences (i.e., whether they wants a medicated or non-medicated birth)
• Facilitating communication between parents, partners, and medical care providers
• Helping families process their birth experiences 
• Teaching newborn care techniques
• Empowering parents and birth support teams to ask questions

There are two main types of doulas: birth doulas and postpartum doulas. These specializations are designated by DONA International—the leading organization for doula training, certification, and continuing education.

A birth doula is present during labor and delivery and gives emotional and physical support to parents in labor through pain management and breastfeeding techniques. Birth doulas perform their work wherever babies are born, typically in hospitals, birthing centers, midwifery clinics, or in client’s private homes for home births.

A postpartum doula supports the emotional and physical needs of parents in the weeks following childbirth. Postpartum doulas make house calls or assist parents who are experiencing extended stays in the hospital. They support families by providing emotional support during the fourth trimester (the three months following childbirth) and teaching techniques in lactation and newborn care.

In cases of miscarriage, stillbirth, abortion, or postpartum depression, they provide specialized emotional and physical support to grieving paretns and families.

Doulas with certification from DONA International are represented by the following credentials:

• CD (DONA) – Certified birth doula
• PCD (DONA) – Postpartum certified doula
• AdvCD (DONA) – Advanced birth doula distinction
• AdvPCD (DONA) – Advanced postpartum doula distinction
• BDT (DONA) – Birth doula trainer
• PDT (DONA) – Postpartum doula trainer
• CD/PCD (DONA) – Certified birth and postpartum doula

While there are no specific prerequisite requirements for admission to DONA International doula training workshops, individual trainers may require workshop participants to complete an application stating why they are interested in the profession and listing any specific skills or certifications they have. They may also assign reading or listening from books or audio lectures so aspiring doulas can prepare themselves with a base-level understanding of the profession.

DONA International requires doulas seeking certification to enroll in a training program and become members of the organization before they can become eligible to pursue certification as doulas.

While there are currently no accreditation organizations for doula programs, some organizations provide training, certification, professional support, and advocacy for the profession. Here’s a list of some of the leading doula certification programs:

• DONA International: a certification and professional organization for doulas worldwide
• Childbirth and Postpartum Professional Association (CAPPA): an international certification organization for doulas, childbirth, and lactation educators
• International Childbirth Education Association (ICEA): an organization that supports maternity and newborn care educators and healthcare professionals
• NAPS Doulas: an organization that certifies postpartum doulas
• Pacific Association of Labor Support (PALS): a doula certification association offering four pathways for aspiring doulas

DONA International Birth Doula Training Workshops

In-person birth doula training programs are offered by 165 DONA-approved doula trainers worldwide. In these evidence-based training workshops, participants typically attend a two- or four-day workshop and sometimes complete additional required coursework in doula training.

Topics covered can include the significance of labor in a woman’s life, doulas and partner care, cesarean births, the role of a doula in medicated births, vaginal birth after cesarean (VBAC), and doula business seminars. Longer training programs often include additional childbirth education and breastfeeding education components which are required for doulas who want to pursue certification.

The cost of birth doula training workshops ranges from $400 to $700 US dollars and may or may not include required textbooks.

• Location: Locations vary worldwide
• Duration: 16 or more hours
• Accreditation: DONA International

DONA International Postpartum Doula Training Workshops

In-person postpartum doula training programs present current best practices to support postpartum parents and their families process their birth experiences. The workshops can last anywhere from two to four days with the longer workshops typically offering classes required for DONA International certification.

Topics included in postpartum doula training workshops include effective listening, emotional issues from birth, physical changes, breastfeeding, postpartum mood disorders, integrating a baby into a family, and loss and grief.

Costs for DONA International-approved postpartum training workshops range from $400 to $700 US dollars and typically include DONA International training materials. Additional reading materials may be required.

• Location: Locations vary worldwide
• Duration: 16 or more hours
• Accreditation: DONA International

Carriage House Birth

Carriage House Birth offers in-person Postpartum Doula Training in Brooklyn, New York. This comprehensive training program covers the essential skills and knowledge required for postpartum doula practice. It includes hands-on experience, practical support techniques, and business development guidance and emphasizes providing compassionate care to families during the postpartum period.

Participants in this training will engage in interactive learning sessions, role-playing scenarios, and discussions to deepen their understanding of postpartum care practices. Additionally, students will have networking opportunities with experienced doulas and educators, fostering a supportive community for aspiring postpartum doulas to grow and thrive in their careers.

• Location: Brooklyn, NY
• Duration: Nine weeks
• Accreditation: N/A

North Star Doulas

North Star Doula offers a comprehensive training program for individuals aspiring to become certified doulas. They require all applicant’s first step to be attending a DONA-certified doula training to acquire skills in educating and supporting birthing families, grounding oneself in compassionate business practices, and enhancing personal development. After completing the training, participants engage in shadowing senior doulas, completing additional certifications such as lactation and CPR/First Aid, and serving as the primary doula for at least three births to gain practical experience and mentorship. The North Star Certification also includes benefits like OHP THW Registration, induction into the North Star Doula Service collective, monthly skill-enhancing meetings, ongoing mentorship, access to childbirth education courses, and involvement in innovative doula care practices, and collaborations with hospitals and insurance providers

• Location: Astoria, Oregon
• Duration: Varies
• Accreditation: DONA International

Sharon Muza

Sharon Muza’s Birth Doula Training prepares individuals for DONA International Birth Doula Certification. The training offers interactive learning activities, a custom workbook, access to an online platform, and a required book for attendees. It covers essential topics such as labor and birth, client care, doula business, and provides bonus resources like a doula bag starter kit. The training emphasizes diversity, equity, evidence-based practices, and ongoing support for trainees, with mentoring, private community group access, and alumni discounts available. The cost is comparable to other programs, but they have payment plans and scholarships, reflecting Sharon Muza’s commitment to creating a safe and inclusive learning environment for all participants.

• Location: Seattle, WA
• Duration: Four days to four weeks
• Accreditation: DONA International

International Childbirth Education Association (ICEA)

The ICEA offers online birth doula workshops to aspiring birth doulas who choose to pursue certification via their traditional pathway. This certification pathway is designed for those who have little to no previous experience as a birth doula or birth professionals who want to formally expand their knowledge and services.

Applicants must first enroll in an ICEA doula certification program to be eligible to register for the online workshop. Additional fees are required for the online option. The curriculum is divided into six parts: introduction, labor overview, labor process, comfort measures, family integration, and coping with the unusual.

• Location: Raleigh, NC
• Duration: Two to three days or more
• Accreditation: International Childbirth Education Association (ICEA)

International Doula Institute (IDI)

The IDI offers an online doula training program to become a certified doula (CD) and earn professional credentials to help parents and babies from an online learning platform.

Students in this program can expect daily and weekly lessons taught by childbirth experts such as doctors, nurses, midwives, dietitians, and doulas as well as assignments and assessments in multimedia format. Aspiring doulas have access to a doula trainer via phone and email for one year after signing up for the certification course. Doulas with previous training or certification get a discount of $150 when they register for this program and can begin seeing clients and using their professional credentials within 14 to 30 days of completion.

• Location: Locations vary worldwide
• Duration: One to 12 months
• Accreditation: International Doula Institute

BEST Doula Training

BEST Doula Training offers comprehensive and modern doula training to individuals interested in becoming certified doulas. The training covers hands-on skills, business development, supporting various types of births, community building, postpartum care, and infant feeding support. Courses are offered in person or online across the country. With a focus on personalized guidance and a supportive community, BEST Doula Training prepares individuals to excel in their doula practice and make a positive impact on the lives of parents, babies, and families.

• Location: Locations vary across the US
• Duration: Two days
• Accreditation: N/A

Doula Trainings International 

Doula Trainings International (DTI) offers a comprehensive Full Spectrum Doula Training program that includes certifications in birth doula, postpartum doula, and reproductive health doula within a 12-month timeframe. The training is available both online and in person, with online modules covering essential reproductive health knowledge and support for various reproductive health events. 

DTI’s curriculum encompasses key topics such as birth equity, core concepts for DTI doulas, birth anatomy and physiology, business building, and more, providing a well-rounded education for aspiring doulas. Additionally, DTI emphasizes personalized attention by keeping cohorts small, with a maximum of 10 students per cohort, ensuring individualized support and guidance throughout the training journey.

• Location: Locations vary across the US
• Duration: Varies
• Accreditation: N/A

CAPPA

CAPPA’s Certified Postpartum Doula (CPD) training equips individuals with the necessary skills and knowledge to become postpartum doulas. The training offers in-person, virtual, and hybrid options, along with online distance learning courses. Students undergo practical experience by working with three families postpartum, completing at least 15 hours of in-person support and five hours of virtual support per family within the first four months. 

Certification requirements include passing exams, obtaining recommendations, creating a resource List, and adhering to CAPPA’s Code of Conduct and Scope of Practice. The emphasis is on non-clinical support, communication, informed decision-making, and resource provision within CAPPA’s standards, excluding medical diagnosis or treatment.

• Location: Locations vary across the US
• Duration: Varies
• Accreditation: N/A

The short answer is four days to four years. Most doula training programs last two to four days, with the longer programs typically including additional courses required for future certification, such as childbirth education and breastfeeding basics.

DONA International training workshops remain valid for four years from the date of completion, allowing aspiring doulas time to complete the requirements for certification, including supervised birth experiences and doula business webinars.

Step One: Enroll in a DONA International-approved Birth Doula Training (16 Hours or More)

DONA International (formerly Doula Organization of North America) provides in-person training workshops for birth and postpartum doulas, which last 16 hours or longer. This training is valid for four years from the date of completion.

Step Two: Invest in DONA International Membership

Becoming a member of DONA International costs $100 and gives doulas who have completed a training workshop two benefits: professional affiliation and the ability to purchase a doula certification packet at a discounted rate.

Step Three: Purchase a DONA International Birth Doula or Postpartum Doula Certification Packet (Up to Two Years)

The doula certification process begins with the purchase of the DONA International doula certification packet for $110 within four years of completing a doula training workshop (see step one).

Certified doulas have two years from the time of packet purchase to submit their application to DONA International for birth or postpartum doula certification.

Step Four: Get Professional Experience (45 Hours or More)

To apply for birth doula certification, a doula must serve as the primary doula at three separate births and spend a minimum of 15 hours on each birth experience. Documentation in the form of a service contract with the family and evaluations by other birthing professionals are required; pre-labor meetings with the family can also count towards the 15 hours required for each birth experience.

Step Five: Fulfill Coursework and Home Study Requirements (Two Months or More)

In addition to gaining three supervised birth experiences, additional coursework and home study tasks are required for certification. A complete list of the requirements for birth doula certification is available from DONA International.

Once all of the required certification materials have been received by DONA International, applicants can expect to learn about their doula certification status within one month.

Step Six: Become a DONA International Certified Doula (Two Months to Two Years)

Congratulations on becoming a certified doula! Certified doulas are eligible to practice their craft and use the following professional credentials:

• CD (DONA) – Certified birth doula
• PCD (DONA) – Postpartum certified doula
• CD/PCD (DONA) – Certified birth and postpartum doula

Step Seven: Apply for Recertification (Every Three Years)

DONA International certified doulas are required to apply for recertification every three years and pay an $80 fee. Continuing education requirements vary for each certification:

• Certified birth doulas: at least 15 contact hours of continuing education in birth or a parenting-related field.
• Postpartum doulas: a minimum of 18 contact hours in areas related to the perinatal or postpartum period, including birth, breastfeeding, postpartum mood disorders, or early parenting.

There are no state licensure requirements to practice as a doula in the United States. Doula certification is required for employment by many healthcare organizations and is highly recommended by professional organizations to ensure that best practices of doula care are provided to parents and babies. This is also done to support the future development and legitimacy of the doula profession. 

Some states have require doulas to obtain certification in order to be reimbursed by insurance for their services. In Oregon professionals in this field can obtain a Birth Doula Certification that permits them to provide services to Oregon Health Plan members and receive payment. 

Ziprecruiter.com (July 2024) reports the average annual salary for certified birth doulas in the United States as $49,220. This career is not tracked by the Burea of Labor Statistics. Percentiles according to ZipRecruiter are:

• 10th percentile: $38,500
• 25th percentile: $43,500
• 50th percentile: $49,220
• 75th percentile: $51,000
• 90th percentile: more than $53,000

Here are a few alternatives to a career as a doula. 

Become a Lactation Consultant

Lactation consultants specialize in providing guidance and support to breastfeeding parents to ensure successful breastfeeding experiences. They assist with addressing common breastfeeding challenges such as latching issues, low milk supply, and nipple pain. They also offer personalized strategies, education, and encouragement to help nursing parents establish and maintain a comfortable and effective breastfeeding relationship with their infants.

• Typical Education: Certification
• Licensing or Certifying Organization: International Board of Lactation Consultant Examiners (IBLCE)

Become a Certified Nurse Midwife

Certified nurse midwives provide personalized care to birthing parents throughout their pregnancy, childbirth, and postpartum period. They offer a range of services, including prenatal care, labor and delivery support, and gynecological care.

• Typical Education: Master’s or doctorate
• Licensing or Certifying Organization: American Midwifery Certification Board (ACMB)

Become a Neonatal Nurse

Neonatal nurses care for newborn infants, particularly those who are premature, ill, or require specialized medical attention. They monitor vital signs, administer medications, and provide essential care to ensure the well-being of neonates in the neonatal intensive care unit (NICU). They also offer support to parents, educate them on infant care, and assist in the transition as their newborn progresses toward health and stability.

• Typical Education: Bachelor’s, although it is possible to enter this field with an associate’s
• Licensing or Certifying Organization: American Association of Critical-Care Nurses (ACCN) or National Certification Corporation (NCC)

Kimmy Gustafson

Writer

At HealthcareDegree.com, Kimmy Gustafson has delivered in-depth and insightful articles since 2019, aiding prospective students to navigate the complexities of choosing the right healthcare degree. Her recent work includes topics such as the ethics of gene editing and physician assistant’s fight for autonomy.

Kimmy has been a freelance writer for more than a decade, writing hundreds of articles on a wide variety of topics such as startups, nonprofits, healthcare, kiteboarding, the outdoors, and higher education. She is passionate about seeing the world and has traveled to over 27 countries. She holds a bachelor’s degree in journalism from the University of Oregon. When not working, she can be found outdoors, parenting, kiteboarding, or cooking.

Rachel Drummond, MEd

Writer

Rachel Drummond has written about integrating contemplative movement practices such as yoga into healthcare professions since 2019, promoting the idea that mental and physical well-being are critical components of effective patient care and self-care in the high-stress world of healthcare.

Rachel is a writer, educator, and coach from Oregon. She has a master’s degree in education (MEd) and has over 15 years of experience teaching English, public speaking, and mindfulness to international audiences in the United States, Japan, and Spain. She writes about the mind-body benefits of contemplative movement practices like yoga on her blog, inviting people to prioritize their unique version of well-being and empowering everyone to live healthier and more balanced lives.