The Ultimate Guide To Doula Certifications
Navigating doula certifications can be confusing, often leading to more questions than answers. I remember when I first became interested in becoming a doula, I was asking myself:
Am I legally required to be a nurse or midwife to be a Doula?
Do I need to be certified?
What does it mean to be DONA certified? Do I need that?
Why are the differences in the certifications, and how do I choose one?
Our team wrote this article to help you navigate your options to build a beautiful foundation as a practicing Doula. Hopefully it should clear up all these primary questions so you can be more empowered as you search for the right program for you.
First, about me.
My name is Sarah-Denise Elolaimi, I am a certified Doula in Portland, OR and have been in professional practice since 2021. I run both my own private doula business and also work within the OHSU hospital network. I have gone through the process of being approved to bill Oregon State Health Insurance plans as a doula (we’ll talk about that more later on, as it’s an exciting new possibility for Doula in many states).
There’s a lot I’ve learned that I wish I knew when I was first making my career transition. Before working as a Doula, I was a corporate trainer, and I knew little about the entire process, so I had to learn it all from scratch myself. I originally received my Doula training in 2020. When I was first searching for a training, it took me about a month just to wrap my head around all the certifications options and the legal requirements.
After reading this, I hope you feel a lot more clear about your major questions.
The 2 Primary Different Types of Doulas
The first thing that’s helpful to know is there are primarily two different types of doulas.
Birthing Doula
Post-Partum Doula
There are many, many different types of doulas. In this article, we will be focusing on the main two Doula types as within the industry. These two different types present very different types of work and a different work context. While many doulas do both birthing, and postpartum work, it’s more common for doulas to choose one or the other. Postpartum work also has many different sub-categories which are generally recognized as specialists within the industry. However, most doula’s mix and match these skillsets together, doing more training to be able to offer more services to their clients.
Birthing Doula:
A traditional birth doula is the most common types of Doula. Birthing doulas are now covered in many states by state health insurance. Six states (Oregon, Minnesota, New Jersey, Florida, Maryland, and Virginia) have Medicaid plans that reimburse patients for doula services.
Six states (California, Washington D.C., Illinois, Indiana, Nevada, & Rhode Island) plan to get CMS approval to implement doula coverage in Medicaid in 2022 and 2023. If you’re interested in getting reimbursement from your state for birth doulaing, we’ll talk about that process more later on. I went through it myself, so I can overview what was required. I do highly recommend it as it opens up a larger stream of new clients.
A Birth Doula is someone who typically begins working with the mother a few months before delivery. The birth doula is a trained professional who supports the mother with the emotional, spiritual and physical components of birth. A good doula will develop a strong relationship with the mother, apply the Doula training to uniquely support the mother in front of her with navigating overwhelm, offering physical postures to ease pain and support the birthing process, and be a gentle guide for the partner and family involved. A Doula in the birthing space creates an empowered, transformative space with reduced anxiety and stress, which greatly impacts the baby coming into the world.
A Doula offers a continuous presence, unlike medical staff, that can be invaluable to a mother experiencing the most powerful and painful moment of her life. Doulas stay with the birthing person during labor and delivery, offering consistent support and reassurance throughout the process. Doulas help with advocacy and communication and can act as a vessel while facilitating communication between the birthing person and their healthcare providers, ensuring that their preferences and concerns are understood and respected.
Birth doulas offer a wide variety of pain management techniques and are trained in various comfort measures and pain relief techniques, such as breathing exercises, massage, and positioning, which can help manage pain and discomfort during labor. They provide information and resources about pregnancy, childbirth, and postpartum care, enabling the birthing person to make informed decisions about their healthcare. Doulas support both the birthing person and their partner, helping the partner feel more included and confident in supporting their loved one during labor and delivery. Studies have shown that having a Doula present during childbirth can lead to lower rates of medical interventions such as cesarean sections and epidurals.
Postpartum Doula
The other most popular type of Doula to choose from is a Postpartum Doula. Postpartum Doulas come in after the birth to support the transition in caring for a newborn. Postpartum Doulas provide the mother and family with essential newborn care to ease the transition of integrating a new human into the family! This includes crucial pieces like breastfeeding, newborn care, and emotional well-being. Some postpartum Doulas even design their business where they come live with the Mother to cook and care for her during this time.
There are many advantages of going the route of a postpartum doula, primarily that postpartum doulas typically make a higher hourly rate, and have more consistent work.
There are disadvantages as well. Many of the roles of a postpartum doula can bleed into being a babysitter, caretaker, nanny, and even maid all wrapped into one. As a postpartum doula, you’ll have to decide and be clear on what services you will/will not offer to clients and what your boundaries will be. It’s crucial to be upfront with those so your clients aren’t asking you to mop their floors!
Typically only the financial elite can afford a postpartum doula. As of June 2023, postpartum doulas are not yet recognized by any health insurance plans, so you’ll be receiving exclusively direct-pay clients.
What I Wish I Knew When I Started:
Treat every client situation individually.
The doula industry is much more fluid and organic than it originally sounds when you read about it online. The way it really works is expecting mothers will contact you at various points of their process, and that always happens at a different time. Some mothers want help earlier on in their pregnancy process, while others don’t think to hire a doula until a couple of days before their birth process.
As a doula, the most important thing is to treat every situation individually and really listen to the client’s needs. The best advice I can give you is to be like water, filling in whatever needs and gaps are there. You won’t be working alone, you’ll likely be working with a team of people including the family, the midwife, doctor, and hospital staff (if you’re doing a hospital birth).
2. Make relationships earlier in the process so you can become the pointgaurd.
You’ll have a much better relationship (and be able to bill clients more) by creating a relationship earlier in the birthing process. The time right around birth is hectic and is where you’ll have the most intensive work. It’s much better to create relationships earlier on in the process so you can act as a point guard for your family. This is exactly why we train our practitioners with hormonal knowledge during pregnancy, and even fertility knowledge, so you can create relationships with mothers earlier on in their process.
2. People find Doulas on Google.
Getting your first clients is perhaps the hardest challenge all doulas face. I didn’t realize when I first started that there’s a LOT of people that search for a doula online.
There are over 30,000 people every month that search for a doula online. If you know how to position yourself online and show up in search results for your area, it’s a steady, reliable source of new clients.
When I started my career, I didn’t really have a plan for getting new clients. Once I joined a doula agency, I started seeing my first clients. In hindsight, what my agency was really offering was just a website that showed me at the top of google!
In our business program our founder walks you through this process so you can do it all yourself, skipping the middle men.
Legal Requirements as a Doula, and Which Certifications To Choose
When I first started searching for doula training, I kept going in circles trying to understand what types of certifications I need to practice. Why were there SO many different options?
The most helpful thing to understand right away is that Doula is that it is an unregulated field. That means you do not need a doula certification in order to legally practice. All the doula certification options out there are professional certifications, regulated not by the state or government, but by these professional organizations.
This is why there are seemingly endless certification options, because each professional organization (including DONA International) set their own professional standards to be certified by their company or organization.
I am certainly not suggesting that you start practicing as a doula without any education. Quite the opposite. In fact, because it is an unregulated field and it’s hard to properly vet professionals, what’s happening in the doula market currently is that most of the work is going to the doulas with the most extensive training. That’s why later on we’ll talk about why the Pregnancy & Fertility Practitioner training truly sets doula’s apart.
There are good parts and bad parts about unregulated industries. The good parts is they typically are easier to get started, because you don’t have to go through extended schooling to begin. The downside, however, is these fields quickly become flooded with increasingly discounted education, which inevitably degrades the quality of practitioners. This, essentially, is what has happened in the doula educational space, and you can now become a “certified doula” for just a few hundred dollars.
What is DONA, and do I need a DONA certification?
You do NOT need a DONA certification to become a doula. It is optional, if you feel you want the additional recognition.
DONA International is a non-profit organization that has created professional education standards for doula training. They don’t operate trainings themselves, they are a non-for-profit organization that seeks to advance the doula profession. The DONA standards are not legal standards, but professional standards (often confused) which any organization offering doula training has the option to comply with. If organizations comply with their standards for education, their graduates can seek a DONA certification.
To get your certification through DONA, you must go through a professional training that complies with their standards, but that’s just the first step.
To become certified, Doula candidates need to attend a minimum of three births, provide labor support as the primary Doula, undergo evaluation, take exam, complete reading materials and agree to abide by DONA International's Code of Ethics and Standards of Practice. There are fees associated with the certification process, including workshop fees, exam fees, and membership fees to maintain certification. Once a doula completes all requirements and is approved, they become a certified birth doula by DONA International.
While you may find it helpful to go through the DONA certification, it’s certainly not required. Increasingly, doula trainings are breaking away from the DONA certification process as it doesn’t offer much in terms of material value as a working professional.
What are my training options?
There are hundreds of Doula trainings that have a vast range from in-person, to live online or all recorded content covering topics such as childbirth education, labor support techniques, postpartum care, breastfeeding support, and communication skills. Because it’s unregulated, trainings can be offered in any format. Over the years, trainings have tended to be broken into smaller and smaller cohorts with individual certifications for “lactation specialist,” “sleep specialist,” “trauma-informed specialist,” etc.
When choosing the right certification for you, it’s important to pick one that you feel will best professionally prepare you to be a doula.
How can I start accepting health insurance as a doula?
Six states (Oregon, Minnesota, New Jersey, Florida, Maryland, and Virginia) have Medicaid plans that reimburse patients for doula services.
Six states (California, Washington D.C., Illinois, Indiana, Nevada, & Rhode Island) plan to get CMS approval to implement doula coverage in Medicaid in 2022 and 2023.
Each state is a bit different, but completing a doula training is the first step to being approved to accept insurance. After you complete the Aura Pregnancy and Fertility training, our lead trainer offers a mentoring program to help you through the processes of getting approved for billing insurance, if that is something you are interested in.
Choosing a Doula Training Program:
The Aura Institute trainings are radically different from traditional education, and when we started our Pregnancy and Fertility training, we designed the program with three things in mind:
We wanted to give our trainees a distinguished education that gives them a true educational and professional backbone, setting them apart from traditional doulas. Because the doula industry is unregulated, we felt a new certification process was necessary to indicate a higher level of care than traditional doulaing. We do this by giving our trainees scientific knowledge about hormones, fertility, and functional medicine which would be essential to creating deeper, more professionally meaningful relationships with clients.
We felt it was unnecessary to have to piece together many different small trainings in the various subject and sub-subjects involved in being a doula. We thought there should be just one training process that covers all of it under one comprehensive certification.
We wanted to reduce “academic fluff” and focus primarily on the aspects of training that are crucial to practice in the real world. We take it seriously to prepare our students for real-world professional practice, including business training. That’s why our trainings are run by leaders who do this work and have made careers in pregnancy support.
I very much look forward to supporting you in your journey to becoming a doula. If you’re interested in learning more, or signing up for our Pregnancy & Fertility Training, you can book a free info call with me here.