Luca and Sofia, a New Jersey couple in their 30s, were experiencing a lot of fear and anxiety during Sofia’s pregnancy after a previous stillbirth. Without any family in the United States, they were worried stress would affect their ability to bond with their new baby.
Becky Ofrane, a doula and an assistant professor of public health at College for Community Health at Montclair State University in Montclair, New Jersey, was the couple’s postpartum doula.
“I provided them with education and skills but mostly reinforced their own innate abilities,” she says. “They took on parenting with so much love. I was there to gently acknowledge their sadness and fear and cheer them on.”
After having nine months to develop a birth plan and envision the arrival of a baby, many pregnant women enter the delivery room with a particular vision in mind: A momentous occasion with cheerleading and coaching at the bedside and a blissful postpartum bonding experience.
But reality may not always match the fantasy. And while patients expect and deserve ample support during their birth experience, medical emergencies, emotions and hospital culture can sometimes get in the way. For this reason, many women turn to doulas for an ongoing support system.
Read on to learn the meaning of a doula, what a doula does, how doulas support families and the range of doula services available to you.
What Is a Doula?
A doula is a nonmedical professional who provides emotional and physical support throughout the pregnancy journey.
For example, during labor and delivery, doulas support the pregnant individual’s emotional needs, while the nurses and doctors are focused on the health of the patient and baby,
“Doulas are focused on our client’s emotional needs,” says Kristin Revere, owner and founder of Gold Coast Doulas in Grand Rapids, Michigan, and co-host of the Ask the Doulas podcast. “We also work with nurses on position changes and offer physical support during the pushing stage (of labor).”
Doulas may offer additional services, including:
— Text, email and phone support on-demand
— Pregnancy and postpartum home visits
— Lactation support
— Help with developing a birth plan
Types of doulas
There are several types of doulas, including:
— Birth doulas. These doulas prepare pregnant individuals for labor and delivery. During labor, birth doulas also provide emotional support and pain interventions, such as massage or counterpressure, which can relieve lower back pain.
— Postpartum doulas. Postpartum doulas assist after childbirth, often during the lesser-known “fourth trimester.” Their areas of support include facilitating breastfeeding, helping with newborn tasks and offering emotional guidance.
— Bereavement doulas. For those who suffer from grief after an expected or unexpected loss, a bereavement doula provides comfort or spiritual guidance. Bereavement doulas also help parents through grief after a miscarriage.
— Death or end-of-life doulas. Death doulas give guidance to the dying and their family members about what to expect during the death process and how to cope with dying.
— Abortion doulas. An abortion doula provides emotional, physical and informational support through trauma-informed care before, during and after an abortion.
— Full-spectrum doula. A full-spectrum doula can provide support across the full range of the reproductive experience.
Doulas are also referred to as “support specialists,” “transition companions,” “support people,” “consultants” or “coaches.”
[READ: Delivery and Labor: What to Expect at the Hospital]
Benefits of Doulas
There are several pros and cons of having a doula to consider, including: “Moms who feel empowered as a caregiver have an easier time bonding with their baby and, therefore, lower chances of depression and anxiety,” Ofrane says.
In fact, research shows that working with doulas is associated with lower odds of C-sections and reduced the incidence of postpartum depression and anxiety.
However, doulas do not replace the need for an attending birth provider over your birth, delivery and postpartum care.
“Professional doulas do not speak for our clients if medical decisions need to be made,” Revere says. “We can offer our clients evidence-based information to make nonemergent decisions if an intervention is recommended.”
[READ: Checklist for Choosing a Maternity Hospital.]
How Doulas Work With Other Birth Providers
During labor and delivery, the primary health care professional overseeing the birth and recovery process is the attending provider.
There are three main options for attending providers, all of whom can collaborate with a doula:
| Attending provider type | Definition | Considerations | Collaboration with doulas |
| Midwives | A professional trained to support physiologic birth and low- to moderate-risk pregnancies. They include certified nurse-midwives, or CNMs, certified midwives, certified professional midwives, direct-entry midwives and lay midwives. | Each state has different regulations that dictate which services each type of midwife can perform. CNMs are graduate-level nurses, so they often work in hospital systems as labor providers. | Doulas reinforce natural birthing techniques alongside midwives and offer continuous support to minimize unnecessary medical interventions. |
| OB-GYNs | A medical doctor specialized in managing high-risk pregnancies, emergencies and cesarean births | OB-GYNs may be an ideal choice for those with prenatal complications or a complicated health history. | Doulas provide emotional support during high-risk interventions or procedures. Doulas help patients feel empowered as OB-GYNs manage complicated medical decisions. |
| Family medicine OB providers | A primary care provider, who is a physician, with special prenatal, labor and delivery privileges | A family medicine OB doctor is a great option for anyone with a relatively uncomplicated pregnancy who already has a strong rapport with their family doctor. | Doulas offer continuous support across the birth and postpartum spectrum in tandem with a family medicine OB. |
[READ: 7 Ways to Make Your Childbirth Easier]
What Are the Qualifications of a Doula?
Being a doula doesn’t require licensure. Therefore, anyone can call themselves a doula. However, many doulas have certifications and liability insurance, and participate in annual continuing education.
The following organizations certify doulas:
— ProDoula
— DONA International
— The Childbirth and Postpartum Professional Association
— Bebo Mia
“None of these organizations support attending unassisted (home) births,” Revere adds. “If a doula attends a home birth, it would be with a midwife, as we play a nonmedical role.”
How Much Does a Doula Cost?
Doulas are often contractors, so they can set their own prices for highly customized services.
| Payment type | Notes |
| Out-of-pocket | Prices can vary. In the Midwest, for instance, out-of-pocket costs range from $1,000 to $1,600 or more. In larger markets, the cost can be $3,000 to $5,000. |
| Medicaid | Some states, such as Michigan, have coverage for doula services if the doula is certified and insured. |
| Fertility benefits | Some benefit programs, such as Carrot, Progyny or Maven, cover all or part of the fee for birth and postpartum doulas. Some employer benefit plans also cover birth and postpartum doula services, Revere says. |
| Tricare military benefits | May cover birth doula costs |
| HSA and FSA plans | May cover birth and postpartum doula costs, depending on the plan specifics |
Where you live, how many visits you want and how accessible you need your doula to be are all going to factor into your all-in cost.
Visit DoulaMatch for average rates in your area or the International Doula Institute for general price ranges.
How to Find a Doula Near You
A great place to start if you are looking for a doula is your attending birth provider. Chances are, they’ve worked with one before and already have a professional relationship built.
There are also many online doula directories you can search from to filter doulas by experience, location and specialty.
Once you have a potential doula, schedule an interview to learn more about their approach to doula services to make sure it’s a good match.
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What Is a Doula? originally appeared on usnews.com
Update 12/05/25: This story was previously published at an earlier date and has been updated with new information.
