Pregnancy The Role of the Doula in Pregnancy By Angelica Bottaro Published on June 22, 2023 Medically reviewed by Monique Rainford, MD Print Table of Contents View All Table of Contents Doula vs. Midwife Why Hire a Doula Services and Cost Finding a Doula Professional Background A doula is a trained professional that assists pregnant people and their families through the pregnancy and birthing process. They are not medical professionals and cannot offer medical care during childbirth. Their primary purpose is to provide physical and emotional support to pregnant people, as well as information regarding giving and preparing for birth. People typically hire doulas to provide care if they need extra help during pregnancy, birthing, or after their child's birth. This article discusses what a doula does, why they are hired, and where to find a good doula. AndreyPopov / Getty Images If Not a Midwife, Then What Is a Doula? A midwife and a doula may often be confused with one another, but the two are not the same. A midwife is a healthcare provider that offers medical assistance to pregnant people, such as: Maternity care and examsDelivery of the babyKeeping track of vitals during childbirthPost-birth repair Doulas, on the other hand, act as more of an emotional and physical support. They can provide the following: Emotional supportResources and guidance to help new parentsEducation regarding pregnancy, the birthing process, and after childbirthActing as a birthing coach or cheerleader during the birth processPostpartum assistance to new parents Midwife vs. Doula Definitions According to the Oxford Dictionary, a midwife is “a person, especially a woman, who is trained to help women give birth to babies." In contrast, the dictionary states that a doula is “a person, usually a woman, whose role is to give support, help and advice to a woman who is having a baby." Doula vs. Midwife: How to Choose the One That's Right for You Why Would You Hire a Doula? Many people hire doulas because they want an extra level of care and support during pregnancy, childbirth, and during the postpartum period. Given the disparities in Black maternal health and care, many Black parents-to-be are now seeking doulas to help improve their birthing experience and outcomes. According to research, hiring a doula can: Improve maternal and infant outcomes Decrease the chances of preterm birth Increase the chances of having a good breastfeeding schedule Higher levels of satisfaction among new parents Lower the risk of low birth weight in newborns Lower the risk of complications during birth Reduction of risk of c-section (cesarean section) Hiring a doula is a personal choice, but evidence suggests it could help the entire birthing process run smoothly. Why Would Someone Choose Not to Hire a Doula? While hiring a doula can be beneficial, it’s not for everyone. Some people may choose to forgo a doula because of the following:Number of visitors in the birthing room may be limited, and opting for a partner may be preferredCostLack of medical training vs. a certified midwifeConcern over how much a doula may help What Is Home Birth? Doula Services and Insurance Doulas can be costly and aren’t always covered by insurance. Currently, only 10 states cover doulas through Medicaid, and the plans vary by state: State Reimbursable Fees Billing California Initial visit: $126.31; perinatal visits: $60.48/visit; abortion/miscarriage support: $250.85; postpartum visits: $180/visit Can bill directly as an independent doula or through a part of a doula group; must receive written recommendations from a physician Maryland 8 prenatal and postnatal visits: $930; flat rate of $350 for assistance during labor and delivery Can practice and bill independently or with a Medicaid-enrolled organization that handles billing Michigan Six prenatal and postpartum visits: $75/visit; labor and delivery assistance: $750 flat rate Can practice and bill independently or with a Medicaid-enrolled organization that handles billing Minnesota Prenatal or postpartum visits: $47/visit; labor and delivery assistance: $488 Can practice and bill independently or through a supervising healthcare provider that bills for doula services Nevada Prenatal and postpartum visits: $50/ visit (for a maximum of four visits); labor and delivery assistance: $150 Can practice and bill independently or through a supervising healthcare provider that bills for doula services New Jersey Prenatal or postpartum visits (total of 8): $1,065; labor and delivery assistance: $500 Can practice and bill independently or through a supervising healthcare provider that bills for doula services Oregon Two prenatal visits, care during delivery, two postpartum visits: $1,500 flat rate Can practice and bill independently or through a supervising healthcare provider that bills for doula services Rhode Island Three prenatal visits, labor and delivery assistance, three postpartum visits: $1,500 flat rate Can practice and bill independently or through a practicing doula group or through a supervising healthcare provider that bills for doula services Virginia Up to 8 visits: $859 Can practice and bill independently or through a supervising healthcare provider that bills for doula services Washington, D.C. Maximum of 12 visits: $97.04 per perinatal visits, $12.13 per postpartum visit, billed every 15 minutes; labor and delivery assistance: $686.23 Can practice and bill independently or through a supervising healthcare provider that bills for doula services; enroll with Medicaid managed care organization In many cases, private insurance plans do not offer the same level of coverage (if at all) for doulas. Because of that, people without Medicaid or coverage for doulas may have to pay out of pocket. The average cost depends on your location, the market, and the cost of living. Doulas with higher levels of experience will also cost more. People can expect to pay anywhere from $800 to $2,500 for the total cost of a doula. Doula services usually include: Prenatal visits and supportBirthing supportPostpartum visits and support Do Doulas Get in the Way of Partner Duties? When considering the costs, you may wonder if hiring a doula and spending the money is worth it, especially if you have a partner to provide support. While some people may feel the doula overshadows their partner's duties, others may not. It’s important to speak with your doula about your expectations and boundaries before choosing one that’s right for you. Where to Find a Doula The best way to find a doula is to ask a healthcare provider for recommendations. They may know doulas and give you the names of some who have helped other pregnant people and their partners during pregnancy and birthing. If you wish to find one independently, you can search for accredited doulas through organizations like DONA (Doulas of North America) International or the National Black Doulas Association (NBDA). Using these types of organizations will ensure you're getting a doula who is trained, certified, experienced, and effective at providing you with the benefits of having a doula by your side before, during, and after you give birth. A Doula's Professional Background DONA International is a great place to start when learning about doulas, as well as searching for a doula to help you throughout your pregnancy. The organization can connect you with other organizations and doulas in your area that have gone through the certification process and are recognized professionally. The NBDA provides information for birthing people who are specifically seeking Black doulas or trainers. People who want to be doulas must undergo professional training and certification. This can also be done through the DONA website, but it doesn’t have to be. These training workshops and certification programs are designed to equip people with the knowledge and skills they need to be doulas effectively and within the parameters of the law. Summary A doula is a support person that helps expecting families through the pregnancy and birthing process. They aid in mental and physical support but cannot be utilized for medical support as they are not considered medical professionals. Hiring a doula is a personal choice, and while research shows that they can help improve the entire process, affordability and personal comfort with an individual during a sensitive time may keep people from going the doula route. Doulas are trained in their field and must be registered with their respective states' health authorities to perform doula duties legally. Because of a doula's training, people who opt in for the service can benefit from having someone available to provide answers and support, which partners may not be equipped for. Talk to your healthcare provider about doulas in your area if you want to add one to your pregnancy support team. They will be able to point you in the direction of one that's right for you. 10 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Ramey-Collier K, Jackson M, Malloy A, McMillan C, Scraders-Pyatt A, Wheeler SM. Doula care: A review of outcomes and impact on birth experience. Obstet Gynecol Surv. 2023 Feb;78(2):124-127. doi:10.1097/OGX.0000000000001103 Oxford English Disctionary. Midwife, noun. Oxford English Dictionary. Doula, noun. National Heart, Lung, and Blood Institute. National Black Doulas Association: Helping to fight Black maternal mortality. Falconi AM, Bromfield SG, Tang T, Malloy D, Blanco D, Disciglio RS, Chi RW. Doula care across the maternity care continuum and impact on maternal health: Evaluation of doula programs across three states using propensity score matching. EClinicalMedicine. 2022 Jul 1;50:101531. doi:10.1016/j.eclinm.2022.101531 Gruber KJ, Cupito SH, Dobson CF. Impact of doulas on healthy birth outcomes. J Perinat Educ. 2013 Winter;22(1):49-58. doi:10.1891/1058-1243.22.1.49 National Academy for State Health Policy. State Medicaid approached to doula service benefits. Strauss N, Sakala C, Corry MP. Overdue: Medicaid and private insurance coverage of doula care to strengthen maternal and infant health. J Perinat Educ. 2016;25(3):145-149. doi:10.1891/1058-1243.25.3.145 National Heart, Lung, and Blood Institute. National Black Doulas Association: Helping to fight Black maternal mortality. DONA International. Birth doula certification. By Angelica Bottaro Bottaro has a Bachelor of Science in Psychology and an Advanced Diploma in Journalism. She is based in Canada. 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