For Policy Makers and Legislators

Dear Policy Maker or Legislator,

Here are some answers to typical questions as well as links to useful information on this site.

How is the doula profession organized?  

The birth doula profession can sometimes seem confusing to outsiders. For the first decades of my career, it was not seen as a legitimate profession with any practical purpose, or it was seen as some activity inherent to being a woman. Birth doulas don't do any kinds of intimate or medical touch and don't do any diagnosing or care that requires a state license.  Because of this, it has just grown organically, with some regions and states having highly developed networks of doulas and local certification requirements.  Other areas have only informal networks or loosely connected social media groups with very little organizing. Like all businesses and professions, unless there is the financial incentive to grow into more complex systems, it doesn't happen.  

What is doula licensing or certification?

There is no such thing as licensing in the birth or postpartum doula professions. Licensing is a credential or standard set by a state approval body.  Instead, organizations that train doulas also offer certification.  True legitimate certification is when the doula has completed a list of requirements and has also been vetted for their personal character by the organization.  In turn, if anyone complains about this doula, the organization offers a grievance process and ombudsperson to represent the doula in this matter if needed.  Of the almost one hundred organizations that are now training doulas in North America, less than ten offer true certification.  Instead they "certify" someone who has only completed a list of requirements.  This makes it more important for the consumer to discern what level of certification the person has.  Some organizations certify people for life.  Others require recertification based on continuing education hours every number of years (like more traditional medical professions).  

For more about certification issues, download my free short pdf file of essays.  

How much are doulas usually reimbursed?

The cost of birth doulas vary widely depending on their service package and regional location.  However, the question we should be asking is how can we reimburse doulas at a living wage for the work duties they perform?  If we value the vital connection and service that the birth doula brings to the family, why would we want to pay that person as little as possible?  Consider what a middle class income is in your state for a two earner family.  That's what a birth doula should be earning, especially since it is physically and emotionally impossible to do a second job.  

I was the co-author of the WMJ study on reimbursable doula program costs. Here are my comments.

How are doulas classified in the US Labor Code?

I have a whole blog post about that!  

Are you looking for something else and can't find it?  Is there an issue I should address but haven't yet?  

Send me an email and let me know!

Thank you for visiting my web site and good luck on crafting your legislation!

Amy L. Gilliland, Ph.D. 

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