(Last Updated: 14 November 2019 – Information Incomplete)

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The following information relates to government regulations that are now law, or are in the process of becoming law. Before the year 2019, there were two states (Oregon and Minnesota) in the United States and one country (Australia) to our knowledge that had laws regulating the work of doulas. The nature of laws varies greatly from state to state.

In lieu of a recent surge of research which supports positive outcomes for women in childbirth who received support from a doula and political activity from higher profile doula organizations, many more government organizations have begun to notice and take action. The United States legislature introduced 7 different bills in the 2019-2020 session of Congress. Many states have taken similar action. In research, the American College of Obstetricians and Gynecologists released this statement in 2017 (revised at the end of 2018):

Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by support personnel, such as a doula, is associated with improved outcomes for women in labor.

ACOG Committee Opinion No. 766. Approaches to Limit Intervention During Labor and Birth. December 2018.

What Does Government Regulation Mean?

As research continues to demonstrate the positive benefits of doulas to birthing families, government agencies tasked with improving quality of life for their citizens are now taking focus on improving birth outcomes and mortality rates. These groups are seeking ways to direct funding towards families that wouldn’t otherwise be able to afford the care of a doula. However, in order for government funding to become available to government-run programs, laws have to be enacted to allow for use of those funds.

As lawmakers and government agencies seek to regulate the use of funds, standards are being created for which doulas can have access to these funds. Simply stated, government regulation presently for doulas has mostly to do with granting access to government funding.

There are secondary reasons for the regulation of doulas. As New York lawmakers Amy Paulin and Michaelle Solages explained in a meeting with New York City doula groups, creating a state standard for doulas can help to legitimize the profession in the eyes of government and other professional organizations. Ironically however, the effectiveness of doulas, especially doulas existing outside of government regulation, may be the very reason for its measured success in the research studies that have prompted governments to action.

Can Doulas Practice Without State Recognition?

The short answer is “yes”. While government regulation seems to be an increasing reality, what has yet to be seen are restrictions on lay, non-certified doulas. This means that a doula may practice without any state regulated certification, choosing the certification company of their choice, or no certification at all. So though government is seeking to get involved in allowing funding, the intent doesn’t seem to be to control the work of doulas. Hopefully, government regulations will allow lay and community-based doulas to continue without devaluing their work as non-certified doulas.

A Work in Progress

As states and national governments come on board with regulations for doulas as a profession, what is and is not law, is presently a work in progress. To help navigate the maze of information within different states about doula certification, the following resources are being prepared for the general information of doulas and would-be doulas. Each page in this section is intentionally dated to reflect the timeliness of the information presented. Want to help keep these pages up-to-date? Please feel free to contact us with any pertinent updates to information found on these pages.

National & State Laws for Doulas

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United States – Federal Laws for Doulas

The United States Congress has introduced 7 different bills in the 2019-2020 Session. More details will be provided at a later date.

The Doula Medicaid Project sponsored by National Health Law Program had developed a one-page overview with links to relevant legislation related to medicaid at both the national and state levels.

In addition to federal regulations that are in development, there are currently 15 known states that have reportedly created or are in the process of creating regulations regarding doula certification, These are listed alphabetically by state:

(States marked with an asterisk [*] have no laws or pending legislation)

  • Montana*
  • Nebraska*
  • Nevada*
  • New Hampshire*
  • New Jersey
  • New Mexico*
  • New York
  • North Carolina*
  • North Dakota*
  • Ohio*
  • Oklahoma
  • Oregon
  • Pennsylvania*
  • Rhode Island
  • South Carolina*
  • South Dakota*
  • Tennessee*
  • Texas*
  • Utah*
  • Vermont
  • Virginia*
  • Washington
  • Washington D.C.
  • West Virginia*
  • Wisconsin
  • Wyoming*

(States marked with an asterisk [*] have no laws or pending legislation)

United Kingdom

Australia – National Regulations

(Last Updated: 14 November 2019 – Information Incomplete)