How To Become A Birth Doula
By Kasey Erin Phifer-Byrne
Birth is beautiful, messy, wonderful, intense, unpredictable, and life-changing. In a matter of hours or days, women and their families experience what is arguably the most intense physical phenomenon known to us: transitioning a watermelon-sized human from the inside of the mother's body to the wild and bright outside world.
The work is the mother's, really—supported by her loved ones and usually by nurses, doctors, midwives, or all three. Sometimes, too, by that special soul known as a doula.
What is a birth doula?
Birth doulas are paraprofessionals who provide physical, emotional, and mental non-medical support to women and their families through childbirth. But if you're reading this, you probably know that already. If you're reading this, I'm thinking that you're thinking you might want to become a doula. Being a doula is difficult but rewarding work, and with the right kind of support, it's a career that can offer enough flexibility to be compatible with family life, too.
When I decided to become a birth doula, I was overwhelmed by the amount of information out there—mostly internet-based—on how to make it happen. Do you have to get certified? How do you find clients? How do you even become a doula? Let's break it down.
Certification and Training
If you're ready to get started becoming a doula, you'll need to first decide if you plan to certify, and through which organization. There are many organizations through which you can become a certified doula, including DONA International (formerly Doulas of North America), CAPPA (Childbirth and Postpartum Professional Association), Birth Arts International, and others. You can also choose not to become certified at all, because there isn't a licensing requirement for doulas to practice.
That said, I highly recommend becoming a certified doula through a respected doula organization such as one of the ones I listed. Certifying not only gives you access to specially-designed, comprehensive educational training programs for doulas, but also gives you a standard of care and scope of practice to adhere to, which helps earn you the respect of doctors, midwives, nurses, and other medical care professionals you'll be interacting with and working alongside. In full disclosure, my organization of choice is DONA International, so a few of my tips may be specific to that organization.
No matter which path you choose, you'll be headed for doula-specific education surrounding pregnancy and birth, labor support, postpartum care, and other essentials like breastfeeding and newborn care. My training included a childbirth education course; a weekend-long doula training session exploring labor support techniques, postpartum care, and professional conduct; and a class on supporting breastfeeding mothers.
And yes, it all costs money! Training costs can vary depending on your organization and geographic location. Between my training course, materials, and a certification packet, I had paid about $400 by the time I was ready to start attending births as a student doula. The education I received and the personal support from my doula trainer was well worth the cost, and when I started attending births, I couldn't have imagined being there without my prior training.
Going to a Birth as a Student Doula
Most organizations require student doulas to attend a certain number of births (as a doula, not an observer) as part of their certification. My organization requires three, and because there are a few rules that each of those births must meet, most doulas end up attending a few more than that before reaching three that can be submitted as part of the certification packet. And when I say "submitted," I'm referring to your notes about the labor and delivery as well as short surveys on the quality of your care, completed by the mother and one of the medical professionals in attendance. Lots of paperwork!
So how does a student doula find births to attend? Don't most mamas want a doula with more experience?
Well, here's the thing: doulas aren't generally covered by medical insurance, and the out of pocket costs of hiring an experienced doula can top $1000 or more in some parts of the US. Student doulas charge reduced fees (or sometimes no fee at all), which makes this kind of support accessible to more families. You'd be surprised how many families are happy to have the support of a student doula, and some for reasons other than cost. The second birth I attended was for a mother who did have the budget for a more experienced doula, but remembered the difficulty of being a student dietician before she became registered, and really wanted to offer a birth opportunity to a student doula.
About those fees: what do student doulas charge?
As I mentioned, sometimes nothing. When I completed my training, my doula trainer recommended charging at least a small fee for the purpose of creating a binding contract between the doula and the family. They'll call you when labor begins, and you'll show up. And even as a student, your time is still valuable. Ultimately, though, the choice is yours.
How do I find clients?
I found my first clients through word-of-mouth, and by asking to leave a few business cards at the birth center in my area. If you talk to enough people, you will always find someone with a pregnant friend or relative who might be interested in affordable doula support. Don't be shy!
What else do I need to know?
You can take your first few births as an opportunity to check in with yourself about how to build your doula "business." You don't have to think of yourself as a business if you only plan to attend a birth occasionally, but doulas that want this as their primary career might want to think about forming an LLC, and will definitely want to consider how many births they can handle. Being a doula isn't only supporting a mother through labor—which, by the way, can last awhile. My first birth as a student doula was over 60 hours long, and between my doula partner and myself, we were with the mother nearly the entire time. You'll also spend time in short initial consultations (where you and the mother or family decide if you're a good fit for each other), longer prenatal visits, and postpartum visits. I offer two prenatal visits, each lasting 2-3 hours, and one shorter postpartum visit in addition to in-person labor support for as long as the mother needs it. Some doulas put a limit on the number of hours they'll stay with a mother, or they don't join her until she begins active labor. This is your choice. Remember that babies don't come on a schedule, so you'll want to space your clients out with that in mind. You may also want to block out time in your schedule for vacations or other special days, and avoid taking clients with due dates near those times.
Also consider transportation costs, childcare costs if you have little ones who will need to be cared for on short notice when labor calls (sometimes at 3am!), and other operational costs like doula supplies, educational materials, and professional membership costs. And if you have other employment, think about how you'll manage the need to leave at a moment's notice.
Being a doula is hard work, but I can say without a doubt that it's some of the most rewarding work there is. You'll share intimate, life-altering hours with a mother and her family, supporting her through what might be the most intense moment of her entire life.
Here's to your doula journey. It's a path marked by the joy and love of those who have walked it before you, and I hope you'll add to it with your own.
Kasey Phifer-Byrne is an English professor, poetry-writer, lactation consultant in training, and mom to one cat and one soon-to-be-born human. She teaches from home while balancing clinical hours for lactation support, preparing for new parenthood, and enjoying a good hike near her home outside of Philadelphia. Kasey is passionate about supporting breastfeeding mamas and advocating for family leave and work-life balance despite today's challenges to working parents.