How Doulas Work

Becoming a Doula
Jessica Thomas provides postpartum doula care for new parents through her business Ballast & Buoy in Portland, Maine. Gregory Rec/Portland Press Herald via Getty Images

Like many careers, life as a doula can be rewarding and challenging. "Long hours and the general stress of the hospital environment are two of the biggest challenges," Bennett explains, which makes sense since laboring mothers can take many hours to deliver, and typically a doula sticks around for most, or all, of the process. However, "Seeing new life come into the world and watching the expressions on the new parents' faces never gets old!" she adds.

Now for the nitty-gritty details. Doulas do not have to have a high school or college degree. In fact, Childbirth Professionals International hold that being a doula is a great way for someone to work their way through school. Although doulas do not have to be certified or licensed, it's definitely a professional boon to go through a training course. Reputable organizations include DONA International, Doula Trainings International and CAPPA. Many organizations offer both online and in-person classes, and require a certain number of hours and births be completed as a student before certification is achieved (requirements vary by program). Training time also varies. Childbirth Professionals International's program includes 16 hours of class time, self-paced study, a childbirth class and a breastfeeding class, as well as attending two births before a certificate is given.

The doula pay rate varies widely and is usually based on where the services are being provided. Some geographic areas are more expensive to live and work in, and thus rates in those places will be higher. According to DONA International, the world's first doula certifying organization, a DONA-certified doula's fee was on average $653-$844 for a birth in 2016. A non-certified doula's fee was $494-$708 [source: James].

Doulas can be salaried or freelance professionals. Some hospitals and community groups keep doulas on staff, or a doula can get clients by working with community groups, public health agencies, referral agencies, doctor's offices or word of mouth.

There are several types of doulas. Most are labor doulas, who are present during labor and delivery. However, there are also antepartum doulas who are skilled at providing support to mothers having high-risk pregnancies, or who have been put on bed rest. By contrast, postpartum doulas are helpful in the first weeks post-birth. They provide direction about caring for the baby and feeding him, and also give emotional backup to overwhelmed mothers. Some even complete physical tasks, like cooking meals, and cleaning and caring for the infant [source: American Pregnancy Association]. And some doulas offer special support for women experiencing abortion, miscarriage or adoption [source: The Radical Doula].