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Key takeaways
- DONA's birth doula certification needs a 16 to 24 hour workshop, 3 births with at least 15 hours of labor support, and costs an estimated $1,000 to $1,300 in total.
- CAPPA's labor doula program costs $1,200 plus a $75 annual membership. ProDoula's training costs $645 plus $95 a year and doesn't require births for its base certification.
- Michigan, Oklahoma and New Jersey fund free community doula training for eligible applicants.
- Medicaid pays doulas in 28 states and DC. Most states require their own approved certification, and the most a doula can bill for a standard package ranges from $933.20 in Arkansas to $3,500 in Washington.
- 15,433 of the 23,197 doulas with an active NPI got it in 2023 or later, as more states started paying doulas through Medicaid.
To become a doula, take a doula training workshop (usually 16 to 24 hours), support a few births, and complete a certification through an organization such as DONA International, CAPPA or ProDoula. Expect to spend about $740 to $1,300 on training, certification and a year of membership [2][3][4], or nothing if you qualify for a state-funded community program [5][6][7]. You don't need a college degree or a nursing license.
If you want to be paid by Medicaid, there are two more steps: get your state's approved doula certification and a free National Provider Identifier (NPI), then enroll with your state's Medicaid program. Medicaid pays doulas in 28 states and DC as of October 2026, based on our state-by-state doula Medicaid tracker. The full enrollment table is below.
How to become a doula, step by step
- Learn what the job is. Doulas give emotional, physical and informational support before, during and after birth. They don't give medical care. Our guide to what a doula does covers the scope.
- Take a doula training workshop. DONA requires a 16 to 24 hour approved workshop, CAPPA's is 18 hours and ProDoula's is 20 hours [1][3][4].
- Support births for certification. DONA and CAPPA each require you to support at least 3 births [1][3]. ProDoula's base certification doesn't require any [4].
- Submit your certification. DONA charges a $155 processing fee and gives you 3 years from your workshop to submit [1][2].
- Check your state's Medicaid rules. Most states that pay doulas want their own certification, registry listing or training pathway (see the table below).
- Get an NPI. Apply online through NPPES and choose the doula taxonomy code, 374J00000X [8][10].
- Enroll with Medicaid and its health plans. Many Medicaid members are in managed care, so you may need to contract with each plan separately.
- List your practice. Families search by city. Claim or create your profile so they can find you.
Doula certification: DONA vs CAPPA vs ProDoula
Here's how the birth doula programs at three national certifying organizations compare as of October 2026:
| DONA International (CD) | CAPPA (CLD) | ProDoula | |
|---|---|---|---|
| Training | 16 to 24 hour workshop, plus 8 hours of childbirth education and a 3-hour lactation course [1] | 18 hours over 2 days [3] | 20-hour training [4] |
| Births required | 3, with at least 15 hours of labor support in total [1] | At least 3, plus 3 parent and 6 provider evaluations [3] | None for the base certification [4] |
| Other requirements | 4 books from the reading list, 2 position papers, DONA membership [1] | Scope of practice pretest, multiple-choice and essay exams [3] | Open-book online exam and CPR [4] |
| Cost | Estimated $1,000 to $1,300 total, including a $500 to $700 workshop and a $155 processing fee [2] | $1,200, not counting books [3] | $645 training [4] |
| Membership | $100 a year [2] | $75 a year [3] | $95 a year [4] |
| Renewal | $85 every 3 years, plus 15 hours of continuing education [2] | $125 every 3 years [3] | No recertification required [4] |
| Time to finish | Submit within 3 years of the workshop [1] | CAPPA's page says 1 year in one place and 2 years in another, so confirm with them [3] | Not stated |
DONA also certifies postpartum doulas. That path needs a 27-hour or longer workshop and at least 36 hours of support across 3 families, and DONA estimates the total at $1,250 to $1,400 [2]. If postpartum work is your focus, see our guide to postpartum doulas.
Which one should you pick? Check your state's Medicaid list first. South Dakota, for example, names DONA, CAPPA and several others as recognized organizations, while Arizona requires its own state certification and won't accept national certifications alone. A national certification your state doesn't recognize won't get you paid by Medicaid there.
Free and community-based doula training
Several states pay for community doula training. Three examples:
- Michigan: a 4-day, 32-hour training sponsored by the state health department is free for eligible participants, and trainees may get a stipend after joining the state doula registry and enrolling in Medicaid [5].
- Oklahoma: Oklahoma Birth Equity's community-based program combines a 63-hour course with a 75-hour hands-on apprenticeship over 7 months. It's grant-funded and free for accepted applicants [6].
- New Jersey: the state Department of Health funds a collaborative of organizations that provide no-cost doula trainings, and the state's required individual training is a free online course [7].
Ask your state Medicaid agency or health department whether a funded cohort is open near you. Funded programs run on set dates with a limited number of seats, so ask early.
Do you need a license or certification to be a doula?
For private-pay clients in most states, no. There's no national doula license, and certification is voluntary.
Medicaid is where the rules kick in. NASHP found that states paying doulas usually require either a state-approved training program built around core competencies or an experience pathway, and some add an application fee, a registry listing, liability insurance or CPR training [12]. Some states have gone further. Montana's doula licenses are available now and will be required to practice starting January 1, 2027 [14].
How to get an NPI number
An NPI is a 10-digit ID that health plans, including Medicare, Medicaid and private plans, require on claims [8]. Individual providers, including sole proprietors, get a Type 1 NPI, and each person can have only one [8].
- Apply online through the NPPES website. You can also mail a paper form or have an employer or other trusted organization apply for you [8].
- Pick the taxonomy code 374J00000X (Doula) [10].
- Keep your record current. You must report changes, such as a new address, within 30 days [8].
CMS has said since the NPI launched that there's no charge to get one [9]. An NPI doesn't make you credentialed or enroll you in any health plan, so it's only the first step toward billing [8].
Doulas have been signing up fast. In the September 2026 national provider file, 23,197 doulas had an active NPI, and 15,433 of them, about two-thirds, got it in 2023 or later [11]. California has the most (4,566), followed by Michigan (1,677) and New York (1,515) [11]. Those are our counts from the CMS file. See the doula workforce report for the full breakdown.
Medicaid doula enrollment by state
This table covers every state where Medicaid pays doulas now, plus the three that have approved coverage but weren't paying yet as of October 9, 2026. "Most per pregnancy" is the most Medicaid pays one doula for the standard package of visits plus labor support, before extras that need prior approval. Certification rules and rates come from each state's own Medicaid manuals, bulletins and fee schedules, compiled in our doula Medicaid tracker. NASHP's March 2026 analysis counted 26 states and DC with a doula benefit [12], and the National Health Law Program tracks state efforts as they change [13].
| State | Status | What Medicaid requires | Most per pregnancy | Enroll |
|---|---|---|---|---|
| Arizona | Paying | State doula certification from the Arizona Department of Health Services; national certifications alone don't qualify | No fixed total (billed by time) | AHCCCS page |
| Arkansas | Paying | State Department of Health community-based doula certification ($50), age 18+, NPI | $933.20 | Arkansas DHS |
| California | Paying | Training pathway (16+ hours plus 3 births) or experience pathway; CPR and HIPAA training | $3,263.31 | DHCS page |
| Colorado | Paying | Training from an approved organization (such as DONA or CAPPA) or experience pathway; background check | $1,470 | HCPF page |
| Connecticut | Paying | Department of Public Health doula certification ($100 fee) | $1,200 | CT DSS bulletin |
| Delaware | Paying | Delaware Certification Board credential (16 hours plus 3 births, or experience); liability insurance; background check | $1,046.88 | Delaware First Health |
| District of Columbia | Paying | Certification from a DHCF-approved organization; $1M/$3M liability insurance | $4,321.70 (a theoretical cap built from long postpartum visits) | DHCF page |
| Florida | Paying | Set by each Medicaid health plan; no state credential | Set by each health plan | Through each health plan |
| Illinois | Paying | Medicaid-certified doula certificate from the SIU School of Medicine program (no fee) | No fixed total (billed by time) | HFS notice |
| Kansas | Paying | Certification from a training organization or 30+ hours of training, plus 3 births | $1,295 | KMAP bulletin |
| Louisiana | Paying | Registration with the Louisiana Doula Registry Board | $1,016.52 | LDH |
| Maryland | Paying | Certification from a state-approved organization; background check; liability insurance | $1,427.84 | Maryland Medicaid |
| Massachusetts | Paying | Free MassHealth doula training plus a training or experience pathway | $1,700 | MassHealth |
| Michigan | Paying | Listing on the state Doula Registry (approved training certificate) | $2,700 | MDHHS page |
| Minnesota | Paying | Certification from a state-designated organization plus the state Doula Registry ($200) | No confirmed total | Not listed |
| Missouri | Paying | Certificate from a recognized training organization; liability insurance; 6 CE hours a year | $1,250 | MO HealthNet |
| Nebraska | Approved, not paying yet | Rules not set yet | Not paying yet | Not open yet |
| Nevada | Paying | Nevada Certification Board or another state-approved training | $1,430 | Nevada Medicaid |
| New Hampshire | Approved, not paying yet | State doula certification from the Office of Professional Licensure and Certification | Not paying yet | Not open yet |
| New Jersey | Paying | State-approved community doula training; background check; $1M/$3M liability insurance | $1,065 | NJ FamilyCare |
| New Mexico | Paying | Department of Health certified doula (3 pathways); CPR and HIPAA training | $3,300 | NM DOH page |
| New York | Paying | 24 hours of training plus 3 births, or an experience pathway; CPR; liability insurance | $1,500 (NYC) | NY DOH page |
| Ohio | Paying | Ohio Board of Nursing doula certificate ($35) | $1,200 | Ohio Medicaid |
| Oklahoma | Paying | Certification from an OHCA-recognized organization | Rates not published | OHCA page |
| Oregon | Paying | State certified birth doula (28-hour training plus 3 births) | $2,365 | OHA billing guide |
| Pennsylvania | Paying | Pennsylvania Certification Board Certified Perinatal Doula | $2,200 | PA DHS page |
| Rhode Island | Paying | Rhode Island Certification Board Certified Perinatal Doula (20 hours of training) | $1,500 | Not listed |
| South Dakota | Paying | Certification from a recognized organization (DONA, CAPPA and others) | $1,800 | SD DSS page |
| Utah | Paying | Approved training plus 3 births, or an experience pathway; CPR | Rates not published | Utah Medicaid |
| Vermont | Approved, not paying yet | State certification from the Office of Professional Regulation | Not paying yet | Not open yet |
| Virginia | Paying | State-certified community doula (60 hours of training, $100); $1M/$3M liability insurance | Rates not published | DMAS page |
| Washington | Paying | State-certified birth doula (Department of Health) | $3,500 | HCA |
Maine and Montana were working on coverage, and the remaining 17 states had no Medicaid doula benefit as of October 2026. Rates change often, usually on January 1 or July 1, so confirm with your state before you count on a number. Our guide to doula pay shows what these rates add up to over a year.
Get found by families
Once you're certified, families need to find you. Our doula directory lists doulas by state and city from the national provider file, and it flags doulas on state Medicaid lists.
- If you have an NPI, you may already have a listing. Claim it to add your services, photo and contact details.
- Read what providers get from a listing before you sign up.
- Thinking about other paths? Compare midwife pay and lactation consultant pay, or see how families choose a doula.
Questions people ask
How many years do you have to go to school to be a doula?
None. Doulas don't need a degree. Certification programs start with a short workshop: 16 to 24 hours for DONA, 18 hours for CAPPA and 20 hours for ProDoula. State Medicaid training requirements run from 16 hours (California and Delaware) to 60 hours (Virginia).
Can you become a doula for free?
In some places, yes. Michigan's health department sponsors a free 32-hour training for eligible participants, Oklahoma Birth Equity runs a grant-funded program at no cost to accepted applicants, and New Jersey funds no-cost doula trainings.
Can I be a doula without being certified?
For private-pay clients in most states, yes. There's no national doula license. Medicaid is different: most states require their own approved certification or registry listing before you can bill. Montana will require a state doula license to practice starting January 1, 2027.
Is there a demand for doulas?
The number of doulas billing insurance is growing fast. Two-thirds of the doulas with an active NPI got it in 2023 or later, and 28 states and DC now pay doulas through Medicaid, with 3 more approved but not yet paying.
How much does doula certification cost?
DONA estimates $1,000 to $1,300 for birth doula certification, including the workshop and a $100 annual membership. CAPPA's labor doula program is $1,200 plus $75 a year. ProDoula's training is $645 plus $95 a year. State-funded community programs can be free.
Sources
Numbers in brackets in the guide link to these sources.
- 1.Birth Doula CertificationDONA International, 2026
- 2.Certification & Renewal CostsDONA International, 2026
- 3.Labor Doula Certification (CLD)CAPPA, 2026
- 4.Become a Doula: Doula Training and Certification ExplainedProDoula, 2026
- 5.Detroit Doula Training (sponsored by the Michigan Department of Health and Human Services)SMC Doulas, 2026
- 6.Community-Based Doula Training ProgramOklahoma Birth Equity
- 7.New Jersey Doula Training FAQ (Version 2025.1)New Jersey Department of Health, 2025
- 8.The National Provider Identifier (NPI) Fact SheetCenters for Medicare & Medicaid Services (CMS), 2024
- 9.NPI: Get It. Share It. Use It. (July 2006 message)Centers for Medicare & Medicaid Services (CMS), 2006
- 10.Health Care Provider Taxonomy Code Set, version 26.1National Uniform Claim Committee (NUCC), 2026
- 11.NPPES Downloadable File (NPPES Data Dissemination, September 14, 2026)Centers for Medicare & Medicaid Services (CMS), 2026
- 12.State Trends in Medicaid Coverage of Doula ServicesNational Academy for State Health Policy (NASHP), 2026
- 13.Doula Medicaid ProjectNational Health Law Program (NHeLP), 2026
- 14.Montana Doula ProgramMontana Department of Labor & Industry, 2026
