Doula Integration Toolkit // Background and Context for Doula Integration

Background and Context for Doula Integration

Use tools in this section to understand why doulas are an evidence-based strategy to improve perinatal care, the role of the doula, and doula training and certification pathways. Examples of state doula landscape survey reports are included. These resources lay the foundation for a more integrated approach for doula services.

The Importance of Doulas

New York City Department of Health and Mental Hygiene:

The State of Doula Care in NYC 2023

“Consistent evidence shows that doula support is associated with improved birth outcomes and a better labor and birth experience, including fewer cesarean deliveries, greater likelihood and duration of breastfeeding, improved mother-baby bonding, and reduced rates of postpartum depression.”

New York City Health and Hospitals:

NYC Hospital Doula-Friendliness Guidebook

Provides a myriad of resources for hospitals specific to doula integration including: Literature review of doula support, a doula-friendly policy example, and communication examples that describe the benefit of doula support.

Missouri PQC:

Integrating Doula Care Into Clinical Care Settings: A Guidance Resource for Health Care Organizations and Clinicians

This resource defines the doula role and provides overview of the benefits of doula care.


Doula Role and Care Models

Missouri PQC:

Integrating Doula Care Into Clinical Care Settings: A Guidance Resource for Health Care Organizations and Clinicians

This resource defines the doula role and provides overview of the benefits of doula care.

Husky Health Connecticut:

Doula Job Description

A sample doula job description, intended to reflect a traditional birth doula role, which would include working with HUSKY Health members prenatally, at birth, and postpartum. This document may be adapted to suit specific doula roles.

California Maternal Quality Care Collaborative:

Toolkit to Support Vaginal Birth and Reduce Primary Cesareans

This toolkit covers the role of the doula, and what they do and don’t do, and doula care models.

Download the Toolkit

New York City Department of Health and Mental Hygiene:

The State of Doula Care in NYC 2023

New York Coalition for Doula Access put together several Principles of Doula Support in a Hospital that outlines what a doula does, does not do and what is found in a doula-friendly hospital.


Doula Landscapes

Betsy Lehman Center for Patient Safety:

Expanding Doula Support Services in Massachusetts: Considerations for Successful Implementation

Provides qualitative and quantitative results from a doula survey conducted in Massachusetts including doula demographics and patient and doula experiences. Concludes with recommendations for doula programs and doula certification.


Doula Training and Certification

National Health Law Program:

Doula Medicaid Training and Certification Requirements: Summary of Current State Approaches and Recommendations for Improvement

Provides qualitative and quantitative results from a doula survey conducted in Massachusetts including doula demographics and patient and doula experiences. Concludes with recommendations for doula programs and doula certification.