How to choose a doula: questions to ask before you hire

Start looking in your second trimester, interview two or three doulas, and choose the one you trust most who can commit to your due date, has a named backup and puts the fee and services in writing.

Why bother being picky? The benefits of continuous labor support were strongest when the support person was in a doula role, neither hospital staff nor a friend or relative ^[6]. ACOG says that kind of one-to-one support, on top of regular nursing care, is associated with better outcomes in labor ^[10]. You're hiring someone to be with you for hours at your most vulnerable, so fit matters as much as the résumé.

When should you start looking for a doula?

A good target is the second trimester. That leaves time to:

• Interview a few doulas before their calendars fill for your due month
• Check whether Medicaid or your insurance will pay, and find a doula who can bill it
• Fit in the prenatal visits a birth doula package usually includes
• Build a relationship before labor, which is the point of the prenatal visits

If you're further along, don't skip it. Many doulas take late bookings when they have room. For a postpartum doula, start talking to people during pregnancy so help is lined up before the baby arrives.

Where to find doulas

• Our directory. Browse doulas by state. Where states publish their lists of Medicaid-enrolled doulas, we flag them.
• Certifying organizations. DONA runs a directory of DONA-certified doulas ^[7], and ICEA lists doulas it certifies ^[9].
• Your midwife, OB or birth center. They see which doulas work well with their teams.
• Your Medicaid plan or insurer. If your state covers doulas, ask your plan for its list of enrolled doulas.
• Community doula programs. Some areas have community-based programs, often nonprofits, that match families with doulas at low or no cost.
• Friends and local parent groups. A personal recommendation is a good start, but still do the interview.

Doula interview questions

DONA suggests covering training, certification, experience, availability, services, fees and whether the doula feels like a fit for you ^[1]. Here's a checklist you can bring.

Availability and backup

• Are you available for my due date, from 37 to 42 weeks?
• How many clients do you take per month?
• Who is your backup? Can I meet them?
• When does your on-call period start and end?
• Do you have any travel or time off planned near my due date?

Training and experience

• Where did you train, and are you certified? By whom, and when?
• About how many births have you supported?
• Have you worked at my hospital or birth center?
• Have you supported births like mine (first baby, VBAC, induction, planned cesarean, twins)?

Approach

• How do you support someone who wants an epidural? Someone who doesn't?
• How do you work with my midwife or doctor and the nurses?
• How do you include my partner?
• What do you do if my birth doesn't go as planned?

Services and fees

• How many prenatal and postpartum visits are included?
• When do you join me in labor: at home, or at the hospital?
• What's the total fee, the deposit, and when is the balance due?
• Do you take Medicaid or my insurance? If not, can you give me a receipt with your NPI to submit for reimbursement?
• Do you offer a sliding scale or payment plan?

For typical fees and what drives them, see how much a doula costs.

How to check training and references

Certification. No law requires doulas to be certified. But certification shows someone finished structured training and supervised births. DONA's birth doula certification, for example, requires ^[3]:

• A DONA-approved workshop of 16 to 24 hours
• An 8-hour childbirth education course and a 3-hour lactation support course
• Continuous in-person labor support at 3 births, with at least 15 hours of labor support
• Submitting the full packet within 3 years

Ask which organization certified the doula and when, then look them up in that organization's directory ^[7]. If they say they're "trained" rather than certified, ask what training they did and how many births they've attended since.

NPI. A doula who bills Medicaid or insurance needs a National Provider Identifier ^[4]. You can look up any NPI in the public federal registry ^[8], which confirms the name and provider type on file.

References. Ask for two or three recent clients and call them. Good questions: Was the doula there when you needed them? Did they get along with your nurses? Would you hire them again?

Finding a Medicaid-enrolled doula

As of September 2026, 28 states and DC were paying doulas through Medicaid ^[11]. Most states cap the number of visits ^[4]. New York, for example, pays for up to eight perinatal visits plus one labor and delivery encounter per pregnancy ^[5].

To get paid, a doula has to enroll with the state Medicaid program. States usually require a state-approved training program or a work-experience pathway ^[4]. In New York, doulas can enroll through either a training pathway or a work-experience pathway with three client or professional recommendations ^[5].

If you have Medicaid, ask your plan for enrolled doulas before you sign a private contract. Check your state's rules on our doula Medicaid coverage page. If you have private insurance, read does insurance cover doulas first.

What should be in a doula contract?

Get it in writing before you pay a deposit. A good contract covers:

• Services: number and length of prenatal and postpartum visits, and labor support
• On-call period: the exact weeks, and how to reach the doula
• Backup: who the backup is and when they step in. DONA's standards say all backup arrangements, including when a backup isn't an option, should be stated in the contract ^[2]
• Fees: total, deposit, due dates, and what's refundable
• Missed birth: what happens to your fee if the doula doesn't make it, for example because labor was very fast
• Scheduled or emergency cesarean: whether the doula can attend and what support continues
• Ending the agreement: what happens if either of you cancels

Red flags when hiring a doula

• Offers clinical tasks. Checking your cervix, listening to the baby's heart rate or giving medical advice is outside a doula's role. DONA's standards say its doulas don't perform clinical or medical tasks and won't diagnose or treat ^[2].
• Pushes one kind of birth. A doula should support your decisions, not their own preferences. DONA's standards center the client's autonomy ^[2].
• Talks down your clinicians. Expect a doula to help you ask questions, not to tell you to ignore your care team.
• No backup and no plan. If the doula can't name a backup, ask what happens if they're sick or at another birth.
• Nothing in writing. Vague fees or no contract make disputes likely.
• You don't feel at ease. Trust your instincts. You'll spend hours together in an intense moment.

New to doulas? Read what a doula does first.