Congratulations on taking the first step toward becoming a birth doula! This is an exciting career path and an incredibly rewarding role where you’ll support your clients as they transition into parenthood and family life. This guide will walk you through the steps you can take if you want to become a birth doula!
Stepping into a new career is thrilling but can also be intimidating. If you’re just starting your journey or haven’t yet decided if being a birth doula is right for you, you might have lots of questions. This guide is designed to try and answer as many of them for you as possible. If you’re not sure whether being a birth doula is your dream job, take a look at our interviews with seven awesome doulas to read how they feel about their work: Read Our Doula Interviews
While we’d love to see you choose Childbirth International for your birth doula training, this is not a sales pitch. We’ll tell you honestly the different options for becoming a doula, cover some of the more common questions, and hopefully give you the information you need to take the next step in choosing a training organization.
Prefer to download the guide and read it later? No problem! You can download the guide (no credit card, no obligation, no email address required) or you can just read on…
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What is a Birth Doula?
This section will address some of the common questions about the role and responsibilities of a birth doula. If you already understand this well, you might want to skip to the next section.
What exactly does a birth doula do?
You might already have read that a birth doula supports families through pregnancy, birth, and the early postpartum period, but that’s a bit vague. A birth doula’s client determines the doula’s role based on the client’s needs, and every client will have different needs. A birth doula might help clients explore their options during pregnancy and labor, provide some basic education on labor and birth or lactation, offer emotional support and comfort techniques to a person during labor, or help a client with latching their baby for a feed in the first few hours after their birth.
A doula can be beneficial in helping a client navigate the choices available to them and in learning how to communicate and negotiate with their care provider to have the birth experience they want. For some people that means using comfort techniques to manage their birth without medical intervention, while for others it means planning the right time to have an epidural or planning a cesarean birth. A doula can also support the client’s partner, family, and friends, helping them to identify their needs and take as active a role as they want.
What’s the difference between a doula and a midwife?
A midwife is a healthcare provider trained, usually over 3-4 years, to provide clinical care for the pregnant individual and their baby. A doula is a non-clinical professional who understands the process of pregnancy and birth but is there to support clients in their choices, help them understand those choices, and make decisions that are right for them. A doula also provides emotional support. Depending on the work setting, the midwife’s role might include the emotional aspects of doula support. In most cases, doulas and midwives work alongside each other, offering different but complementary skills.
Is it “doula” or “dula” or “doulah” and where did the word come from?
It’s “doula” and is pronounced “doo-lah”. The word was first used in the 1970s by Dana Raphael to describe a person who supported a new parent in the first weeks after birth. After describing the role, Dana said that an elderly Greek woman she met told her that this person (usually the grandmother) was called a doula in Greece.
What types of doulas are there?
Many doulas provide support during different life transitions: birth doulas, postpartum, full spectrum, and death doulas. Doulas can also specialize in other areas, such as infertility, working with adolescents, or supporting individuals who have disabilities.
- Birth doulas typically work with clients during pregnancy, labor, birth, and the first few days after birth.
- Postpartum doulas support families from birth for about the first six weeks.
- A full-spectrum doula works with clients experiencing all pregnancies, including those that end in miscarriage and termination.
- Death doulas work with families who have recently had a loved one die or where a death is anticipated, either the death of a baby or an older family member.
Is a doula just a fad or a growing trend?
While the term doula has only been used in English-speaking countries since the 1970s, people have always supported new families through pregnancy and into the postpartum period. In the 1970s, doulas mostly trained through an apprenticeship model, with formal training programs being introduced in the late 1980s. Back in the 1990s, there were just three training organizations worldwide. There are now hundreds of training organizations offering training in different formats. Doulas are now more widely recognized by the general public and medical care providers.
Extensive research has now been carried out consistently showing a doula’s benefits. Health departments recognize how much a doula’s presence influences positive outcomes, and insurance companies often cover the cost of a doula in their healthcare plans. We believe the number of doulas and doula training options will continue to grow, especially while birth is medicalized and more people are giving birth far away from their families. Clients wanting an empowering birth where they are active participants and decision-makers are increasingly looking to doula support to help them achieve that.
Do I need to train to work as a birth doula?
Completing a training course is not essential to working as a doula. People have supported others in pregnancy, labor, birth, and postpartum since time began. However, choosing a training organization that provides a solid foundation and excellent support as you develop your knowledge and skills can make all the difference to your confidence and ultimately allow you to provide the very best support to your clients. It’s also common for hospitals to require training and certification for any doula working there even if they’re employed by the client and not by the hospital.
If you’re not ready to commit to a training program just yet, you can gain experience by supporting friends and family, apprenticing with an experienced doula, and joining groups that offer mentorship to new doulas.
Training as a Birth Doula
Are doula training courses accredited?
Accreditation can be awarded to training providers to recognize the quality and robustness of a training program. There is no accreditation specifically for doula training, but there are organizations that review training programs and assess how well-designed the curriculum is and how professional the training provider is in their approach to education.
The accreditation process should be independent of the training provider to be legitimate. An independent accreditation review is comprehensive and typically takes a long time to complete. Gaining independent accreditation from organizations like the ANCC or LEAARC indicates that training providers’ courses are well-designed and meet the standards expected for high-quality adult education.
Who regulates the doula profession?
The doula profession is currently unregulated worldwide. This means that anybody can become a doula and any organization can provide doula training. The lack of regulation can make it difficult to compare one doula training organization with another since they all include different topics, take different amounts of time to complete their courses, and have different restrictions or requirements. Given this inconsistency, it’s important to identify what’s essential to you in a training program and then research each one thoroughly to know whether they’ll meet your needs.
In some locations, we’re increasingly seeing government health departments regulating doulas who want to be paid through state-funded programs like Medicaid. Usually, they’re just looking for proof that a person has completed a training program and met the requirements for certification set out by their training organization. While regulation o birth doulas has not happened yet, it’s likely to arrive sooner or later. Choosing an accredited training organization with a quality curriculum could be a wise decision for any future requirements imposed on doulas.
What’s included in birth doula training?
There’s a lot to learn as a birth doula, and it can be difficult to find all the information you need in textbooks when you’re just starting. A good training program will cover the anatomy and physiology of pregnancy and birth, communication techniques for navigating client and healthcare provider relationships, complications that can arise in pregnancy and birth, infant feeding and sleep in the first few weeks, comfort measures for labor, cesarean and vaginal birth after cesarean (VBAC), and establishing your business as a birth professional. Some of the better training programs also cover grief and loss, research skills, mental health conditions, health, and nutrition, and walk you through what you can do as a birth doula when complications or unexpected events arise.
As important as the knowledge you build through training, a comprehensive training program helps you understand how that knowledge can be applied in the real world. For example, it’s useful to learn about the diameters of the pelvis and how different positions during labor will affect the space available for a baby to move through the pelvis. It’s even more useful to be able to use case studies and scenarios to explore what barriers might exist that prevent a client from being upright, how they can anticipate whether they’ll be supported in their choice of positions during labor, and what you can do to help them overcome or minimize barriers if they do exist. It’s also helpful to have opportunities to discuss with your peers when you come across challenges with clients, so finding a training program that enables you to connect with your fellow students and more experienced doulas can be a real bonus in your early days of working as a doula.
How long does it take to become a doula?
Every training program is different; how long it will take depends on how the course is delivered, how in-depth the training is, and what requirements you must complete to certify.
Some programs issue a certificate of completion after a three-day workshop without any requirements for you to attend a birth or support a client. Choosing a program that promises quick certification may be tempting, but this is likely to leave you feeling unprepared and lacking in confidence. It might be better to think of these sorts of programs as a nice introduction to doula work, giving you a chance to practice a few hands-on skills rather than comprehensive training.
Other training organizations are more robust where you have to complete the course work and meet additional requirements in working with clients, surveying services in your local community, and submitting assignments or completing online exams. When you look at each training organization’s website, you can usually see the estimated time to complete the course. A rough estimate of how long your training would typically take is 4-5 months if you had ten hours a week to study. It may take longer if you have other commitments, need a break, or don’t start looking for clients to work with until you finish the coursework. Remember that you can work as a birth doula while still studying. Some programs have deadlines that you have to complete all the requirements, such as completing them within 12 months of initially registering. Or you might prefer a program that offers you the flexibility to take as little or as much time as you need to complete your training in your specific circumstances without any time limits.
Are there any prerequisites or restrictions?
Some training organizations have different prerequisites or restrictions. They may have minimum age restrictions, for example, or require you to charge a specific amount of money to your first few clients (or not charge at all). They might require you to finish your training and apply for certification within a set timeframe (most do) or sign codes of conduct that prevent you from working with clients in certain circumstances (e.g., unassisted birth without a medical care provider present).
When deciding on a training organization, it’s really important to find out about any restrictions or prerequisites they have rather than finding out after you have paid for the course.
How can I compare training organizations?
It can be confusing trying to compare training organizations. They all have different ways of teaching, different pricing structures, different topics they cover, and different certification requirements. Here’s a simple comparison chart for you to choose from several organizations and see how they compare on different metrics: Training organization comparison chart.
Once you have found a few training organizations that you’re interested in, look at their website or social media presence. See if you can determine the organization’s values and whether they’re meaningful to you.
How much does training cost?
This varies significantly from one organization to the next and can start as low as US$200 or be as high as US$2,000. Many of the courses priced at the lower end are very basic, and the training organization may not be run by experienced doulas. When looking for support from them, you may only be answered by a general administration person who has never worked as a birth doula or worse yet, a chatbot.
The average cost of doula training is US$650-US$1,000. Some organizations quote the cost of the training component of the course but have additional fees that will be required to certify. When calculating the cost, check if training and certification are charged separately or if additional purchases are needed, like required reading.
Some organizations offer refunds if you change your mind, while others don’t. Likewise, some organizations have payment plan options, while others require full payment. Paying for your training over time might make it more affordable for you.
Look at any discounts the training organization offers as they can make training more affordable. Some organizations offer discounts if you purchase multiple courses at once or if you previously bought a course from them. Others may offer payment plans so you can budget your training costs and pay over several months. Scholarships may also be available from the organization you’re interested in.
Is it better to do additional courses simultaneously, like lactation counseling?
Some doulas will start multiple courses together, like training to be childbirth educators, lactation counselors, or postpartum doula. This can enhance your services and bring cost savings if the training organization gives a discount for multiple courses. On the downside, it might feel overwhelming to start with multiple courses. You can ask the training organization if they offer discounts for a subsequent course once you complete your doula training.
How is online learning different from face-to-face?
Apart from the obvious difference between online and face-to-face, there are a few fundamental differences between the two options.
When the doula profession was first introduced, face-to-face workshops were the only way to train as we didn’t have the internet back then. However, online training was quickly established to make training more accessible and to provide more in-depth training. CBI first introduced online training in 1998, and it has been our focus ever since with more than 10,000 students worldwide choosing to train in this way.
Face-to-face training has some benefits and suits some people more than others. It can be a great way to top up, refresh your skills, or introduce you to doula work. Each trainer who provides a workshop will have their own way of teaching, and they’ll decide which topics are important for you to cover, so one workshop can be very different from another, even under the same umbrella training organization. After a workshop, you are typically given reading materials and a list of requirements to meet. Without trainer and peer support, some people who completed a workshop feel overwhelmed and confused when they realize just how much they still have to learn.
Online learning makes birth doula training more accessible to people wherever they live and eliminates many barriers to training. Because you’re not restricted to training on specific dates, your learning can start when you want it to, can happen over time, and has the flexibility to fit in with your schedule and commitments. Good training organizations have a written curriculum that’s provided to every student, so you know you’re all getting the same quality of education, and trainer support continues for as long as you take to complete your training and certification.
Online learning allows you to learn gradually, exploring many more topics in a lot more depth, and gives you the time to absorb everything you’re learning. Most doulas want to feel confident and informed before working with clients; a good training program will provide that reassurance. Online learning also allows greater flexibility where you can study at a time and place that works for you.
When looking at training organizations that provide online learning, you might want to consider how long they have been operating and whether their program was specifically designed for an online learning environment and online adult education. Some face-to-face organizations simply adapted their workshop to be delivered online, often because of Covid, but may not be engaging or rigorous enough to meet adult education standards for online learning.
Certifying as a Birth Doula
Do I need to be certified?
Certification is a separate process from training. Sometimes, the training organization charges these two things separately, with a fee for the training component and then a separate fee/s for applying for certification once you have met all requirements. Other organizations include everything at one price, so you don’t have to worry about additional costs.
You might choose to train with an organization and not certify with them. If, for example, they have a code you’re required to sign for certification that you don’t entirely agree with, you might want to train with them and skip the certification process. Or, they might require you to pay for recertification every few years to maintain your certified status. Other organizations don’t require recertification and instead give you lifetime certification, much like a college diploma, where you’re not required to reprove your doula status every few years.
What do I have to do to be certified?
Each training organization that offers certification has different requirements. Typically, you would expect to support a couple of clients through pregnancy and birth, complete some assignments, and pass exams. In most cases where a training organization has exams, these are open-book and multiple-choice. Some training organizations have time limits on when you have to complete certification, while others have no time limits. Some training organizations charge additional fees for the certification process. It should be clear from the organization’s website what the certification requirements are, whether there are any restrictions or limitations, whether there’s an additional cost for the certification, and whether your certification is lifetime or if there’s a recertification process you have to go through every few years.
When can I start charging for births?
Unless restricted by your training organization or are specifically supporting a client on a volunteer basis, you can charge whatever price you like whether you are certified or not. Even while you’re training, you’ll have costs like travel and childcare and spend many hours supporting your clients. Some doulas charge a lower fee when they are still training, while others set a higher price so they still make a profit for their certification births.
Can I shadow another doula instead of doing births on my own?
Shadowing a more experienced doula can be a good way of seeing what a doula does during a birth. It is worth considering how having an extra doula might affect the person in labor if you are just there to observe, as your presence might slow or stall their labor. As an alternative to shadowing another doula, you can gain a lot by watching videos of doulas working and connecting with other doulas to ask how they approach different situations.
In most cases, you’ll already have established a relationship with your client throughout their pregnancy, so it won’t feel uncomfortable being their primary doula once they go into labor. Your training organization might require you to be the primary doula for your certification births.
Are there time limits or restrictions for certification requirements?
Some training organizations have time limits on when you have to meet their certification requirements. For example, they might require you to submit all your certification documentation within 12 months of completing their training. Other organizations have restrictions about which births you can use for certification. When looking at the certification requirements, find out whether you can use a cesarean birth for certification or have to be with the client for a minimum number of hours.
What can I call myself once I’m certified?
Each training organization uses different designations for certified doulas. Most will have something similar to a Certified Labor Doula (CLD). Training programs might provide training in multiple areas and use a different designation, like a Certified Full Spectrum Doula or a Certified Maternal Support Practitioner.
Will I get a certificate once I’m certified?
Once you have met all the certification requirements, you should receive a certificate stating your name, the designation used for a certified doula, and the date you were certified.
How long does it take to get a certificate once I’ve applied for certification?
Some training organizations will make a certificate available to you within a few days of meeting the certification requirements, while others can take several weeks.
Working as a Doula
How does a doula find work?
Most doulas are self-employed, but there are increasing opportunities to work within a clinic or hospital-based program. Doulas also can set up doula agencies or cooperatives to share the workload and centralize tasks like marketing and administration.
Having a social media presence is a great way to get your name out there. You can also look at community marketing opportunities like community noticeboards and school or church newsletters. Local businesses and community groups serving the same kind of customer as you might be willing to display a poster or leaflets promoting your services. Word of mouth is one of the most valuable ways to get new clients – make sure you leave your clients with cards or other marketing materials so they can pass your contact details on to their friends! A good training program will include lessons on marketing yourself and finding clients.
How much can a doula earn?
This depends on your community, the clients you’re working with, and how you manage your finances. It’s certainly possible that doula work can be a full-time job, especially when you add in additional services like lactation counseling, childbirth education, and postpartum support. While doulas’ fees vary, a doula typically charges between US$500 and US$2,000 for each birth in the US. The main expenses in doula work are fuel, internet, and telephone fees. You might also have to pay for childcare, or you might pay someone to do the administrative tasks of your business, like keeping your accounts and submitting taxes or managing your website.
Taking on 3-5 clients a month is reasonable if you only offer birth doula services. While some doulas schedule more than 3-5 births a month, they would likely need a good backup in case two clients go into labor at the same time.
What are the challenges of working as a birth doula?
If you live in an area where doulas are not common, your first challenge might be educating people on your role and the benefits of having a doula at their birth. If, on the other hand, there are many doulas in your local community, you might have to think about how you can differentiate your services from theirs. It’s a good idea to look at whatever situation you have locally and think about how, what can first seem a challenge, can be turned into an opportunity. For example, having lots of doulas in the community means it is more likely that people have heard of doulas. Experienced doulas might be very busy and will often refer clients to you when they are fully booked if you build relationships with them.
Once you’re working as a doula, it can be challenging to be on call. Typically, a birth doula is on call from about four weeks before a client’s due date and up to two weeks after. During a birth, you can be with a client for many hours, so it’s important to keep yourself well-nourished and hydrated. If you’ve got young children, you might need to set up reliable childcare that allows you to be away for many hours and is available at short notice. Some clients want to have lots of regular contact with their doula. It is important during your training to build skills to make sure this doesn’t become unmanageable.
What equipment do I need to work as a doula?
There is really no equipment that is essential to working as a birth doula. Some people like to have a bag with tools they can use with clients, like heat packs or massage tools. Others encourage their clients to purchase whatever they want and just carry items for their own care like a change of shirt and snacks.
Do I have to get insurance to work as a doula?
Insurance for doula work is not a requirement but it might give you peace of mind. If you have clients come to your home or workspace, you might want to look at professional liability insurance. Some training organizations have agreements with insurance companies where their members can get reduced premiums.
Can doulas work at a homebirth or only in the hospital?
Doulas can work within any setting. Their role doesn’t change much whether they are at a client’s house, in a birth center, or working in a hospital. The midwife or obstetrician is still providing clinical care to your client, and you still provide emotional support and help with decision-making.
Do doulas only support people planning to birth without medication?
Doulas can benefit all clients, regardless of whether they are having pain relief, an induction, or any other intervention. The doula can provide information on the intervention, helping a client to understand the risks and benefits and ways to minimize risks if they choose the intervention. They can also help clients identify alternatives if they want that information and help guide them through communicating with their care provider to discuss their preferences and make the right decisions for them.
What does a doula do at a cesarean birth?
A doula can provide vital support to a client having either an unplanned or a planned cesarean. Clients can benefit from understanding the procedure of a cesarean and an opportunity to talk about their fears or concerns beforehand. The doula can remind the client about the things important to them during the procedure of a cesarean, like the environment in the theater, and can help them in the first few hours after a cesarean with breast/chestfeeding when the client is less mobile. After their birth, some clients want to talk through the circumstances that led to their cesarean and a doula can help them debrief and reflect on that experience.
How does a doula help partners?
Some clients are worried that their partner will be excluded if they have a doula present. In most cases though, the presence of a doula helps partners. The doula can take pressure off the partner to have to remember everything and let them focus instead on supporting the person they love in whatever way feels comfortable for them. During long labors, partners and doulas can take the opportunity to rest and have breaks, making sure they both have the energy to support the person in labor confidently.
Can I volunteer as a doula?
Many doulas volunteer either for all the births they do or only for some, while others never offer volunteer services. They might volunteer for other organizations like doula programs run in domestic violence shelters or prisons. They might offer to be a volunteer for clients experiencing financial hardship. There can be downsides to volunteering though so it is important to really think about whether volunteer doula work is for you. For example, without a financial commitment, a client may decide not to call you when they’re in labor which can be disappointing and frustrating. It may be difficult for you, your family, or your clients, to view your role as a professional one if you’re not being paid for the work you do. You can quickly burn out if you’re not making a living wage at doula work. As an alternative to volunteering, you could establish a sliding scale for clients who can’t afford your full fee or offer clients who can afford your services the opportunity to contribute towards a fund for others who are having financial difficulties.
How do I set up my business?
If you’ve never been self-employed before, you might be worried about setting up a business. When you’re looking at training organizations, see what kind of focus they have on the business side of being a doula. While you’ll have local and regional requirements for setting up your business and tax obligations, a good training organization should teach you some of the fundamentals of marketing, financial management, and professional development.
Do your research
It can be confusing and a little scary when trying to make a decision about which organization you choose to train with. You are about to make a significant financial commitment and want to be sure that you are getting the best value in your decision and that the organization’s philosophy and values align with yours. It’s worth investing the time to research each training organization to enable you to understand the differences between them and feel confident about the decision you make.
Ask other doulas
If you have other doulas in your local community, ask them who they trained with and what they liked or didn’t like about their training. Understanding what was important to them in a training program is helpful. A doula in your town who says they loved their training program, but the most important thing to them was finishing their course as quickly as possible, is not going to have the same priorities if what is important to you is a comprehensive, evidence-based training program that you complete over a longer period.
There are many groups on social media that bring doulas together and allow you to find out from people who have finished their training what they thought about the program they chose. CBI’s Becoming a Doula Facebook group is a great place to start. The group is open to all doulas, regardless of their training and experience, and is moderated so is a kind, respectful environment. While the group is hosted by us, we encourage everyone to share their training experiences, regardless of who they trained with. Any questions you have about getting started as a birth doula can be asked in the group, and hundreds of experienced doulas can tell you what has worked for them.
Compare your top choices
Once you’ve identified your top choices for doula training, it can be helpful to contact each of the organizations and ask them for more information on the things that are important to you. You might do a standard email that has 3-4 questions on things that you feel are the most significant in a training program. Send the same email to your top training organizations and see how they each respond. If they don’t respond at all or take a long time to respond, this might be an indication that their communication while you’re training with them might be lacking. Look at how welcoming and friendly they are and how well they answered your questions. How an organization responds before you’ve purchased their service is a good indication of what kind of relationship they have with their customers after they’ve paid.
We hope that after reading through this guide, you’re feeling more confident about taking the next steps in researching training organizations and many of your questions have been answered. If there was something we missed, send us an email to email@example.com, or contact us through our Facebook page or the contact form on our website and let us know your questions. Our Facebook group Becoming a Doula is also a great place to ask questions of other doulas who have been through exactly the same process you’re in, trying to identify the right doula training program for them. We’re always here to help, and our team is happy to answer any questions you have that aren’t answered in this guide. Or maybe they are answered, but you just want the reassurance of speaking to a real person!
Of course, we’d love it if you chose Childbirth International for your training! If you do, you’ll be choosing a training organization with 25 years of experience specializing in online learning, which we sincerely believe is the best way to learn everything you need as a birth doula. CBI is run by a team who work as doulas all around the world, have established successful doula practices themselves, and attended hundreds of births and seen every possible outcome. Our trainers are all experts in facilitating adult education and love walking alongside their students as they grow and develop their skills, however long that takes. Everything we’ve outlined in this guide that indicates a good training organization is something that we provide. You’ll also be choosing the only doula training organization that has been accredited with distinction by the American Nurses Credentialing Center (ANCC). More than 10,000 students have trusted us to deliver excellence in training and support and believe in our goal to make birth better. We hope you will too!
Whoever you choose to train with, we wish you all the very best in your path toward becoming a birth doula. It’s an incredibly rewarding career and you are about to start on an exciting and fulfilling journey. Thank you for making a difference to birthing families across the world!