Ask A Doula - Part 1
Megan Crawford
Let’s start at the beginning, shall we?
What exactly is a doula?
The word “doula” is Greek, and roughly translates to “female helper” or “maidservant”. Traditionally, a doula helps with childbirth and postpartum, but there are doulas now for all sorts of life transitions: pregnancy, birth, postpartum, pregnancy loss, death, divorce, end-of-life, fertility…the list goes on. A doula is a trained professional (NOT a medical professional) that helps with education, and physical and emotional support.
What is the difference between a doula and a midwife?
I get this question almost every time I tell someone what I do. So here’s the jist: A doula is a trained, non-medical support professional who provides physical, emotional, and informational support during pregnancy, labor, birth, and/or the postpartum period. A doula doesn't replace your doctor or midwife; instead, they support you alongside your medical care team.
Midwives provide clinical maternity care. Depending on their credentials and local laws, they may perform prenatal exams, monitor the health of the pregnant person and baby, order or perform certain tests, prescribe medications, and attend births.
A doula does not provide medical care. We don't diagnose conditions, perform clinical exams, prescribe medications, or make medical decisions. Instead, we provide education and continuous physical, emotional, and informational support before, during, and after birth.
The doula’s job is more personal. During pregnancy, we educate you about your options. We give you the evidence so that you make the best decisions for you, your birth, and your family. We are emotional support during pregnancy, birth, and the postpartum period. We also give physical support in the form of counter pressure, massage, . We remind you to change positions if you’ve been laboring in the same position for awhile, we remind your partner to come give you a massage, we play with your hair if you want. We make sure you and your partner stay fed and rested as much as possible during labor. When the doctor or nurse comes in with a choice to make, we remind you of the evidence, your options, and allow you to decide what you want to do.
Having a midwife is like having an OB who specializes in low-risk, natural birth. Having a doula is like having a best friend who happens to know all about birth, but who won’t tell you what to do or judge your decisions, and is on your side no matter what.
Do doulas need to be certified?
Do you legally have to be certified to call yourself a doula? In many places, no.
Doula certification is different from professional licensure. Training requirements may also come into play for specific programs, employers, insurers, or state reimbursement systems.
Before the 1900’s, most births were attended by midwives and doulas with no formal training. They were just women who had given birth (or witnessed birth) and who knew how to help. There are still many countries where this is the norm - including first world countries.
The short answer is: no. There are many certifying bodies for doulas, but these are not required. A person could literally wake up one day and start helping people with their births. And if they are knowledgeable and supportive, they can do a great job.
So why did I decide to certify? A few reasons. First, I want my clients to know that I didn’t just wake up today and decide to help them with no foundational knowledge. Even though I’ve been learning about pregnancy, birth, development, hormones, and the anatomy and physiology of a birthing person and their baby for the last 15 years, I want my clients to know that I am educated in what the certifying bodies find important. I have the same basic knowledge as any other doula who has my same certifications. Secondly, I am something of a perfectionist and a completionist. I’m the sort of gamer that finishes ALL the side quests, collects ALL the armor sets, and maxes out ALL the skills. So when I want to do something, I want to know everything I can about it. I got my certifications for my own confidence. The imposter syndrome is strong with this one. The third reason: I eventually intend on taking Medicaid and insurance, and many of those companies want you to be certified by a particular company to qualify.
So when looking to find what training/experience your doula has been through, you can ask or you can look at the certifications they have. For example, I am currently working on my certification with DONA International as a birth doula. They have been around for a long time and have a very involved certification process. There’s a whole checklist of books you have to read (and give mini book reports), you have to take a 16-24 hour class, go to a 3 hour breastfeeding workshop plus an 8 hour childbirth education course, make a list of local resources, and attend 3 births as the primary doula. It’s… a lot. And it’s an expensive process. I’ve done everything except the last step, which is usually the one that takes the longest. I’ve been to births, but they don’t count if I’m not the primary doula, the visit doesn’t start before active labor, or if I’m not there when the baby is born (which happened once…I was there for 12 hours and had to call in backup!)
As of the date I’m writing this, I am currently certified with ProDoula as a birth doula. This one was a little less intense. The class was only 20 hours, but I also had to take a CPR/First Aid For Infants class as well. I had to read some books and take an online exam, which I passed with flying colors!
I am also a Best Doula Training grad for postpartum support, and a Lamaze Certified Childbirth Educator (LCCE). And in Oct 2026, I’m headed to a Spinning Babies class! I’ve also taken workshops in bereavement and birth photography and TENS units, and essential oils and lactation and food handling and and and and….
And I have many many more on the horizon.
There are many certifying bodies for doulas. If you want to know what kind of training process your doula went through, I’d recommend looking into their certifications. But like I said before, some people have been doulas before certifying was even a thing! Certifications don’t tell you how good of a doula you have, they just tell you what they went through. I know many doulas who aren’t certified by anyone who get clients out the wazoo because they are good doulas. The best way to figure out if the doula you are considering is the right doula for you is to interview them. Meet them. Ask them questions. They can have all the education in the world and have a terrible bedside manner. Or maybe their personality doesn’t mesh with yours. Or maybe your birth philosophies are vastly different. Education is definitely a consideration, but there’s so much more that goes into finding the right doula for you.
Oof. That’s a lot. Part 2 coming soon.
If you are looking for a birth / postpartum doula in St. Louis / Southern Illinois, I’d love to talk with you!
