The US doula workforce in 2026
Who's registered, where, and who Medicaid pays. We counted every doula with a National Provider Identifier (NPI) in the federal registry, set each state against its births, and checked it against Medicaid doula coverage.
The Mom Site editorial team · Published October 9, 2026 · NPPES data through September 13, 2026
Key findings
The September 2026 NPPES file lists 23,197 active NPIs with the doula taxonomy code: 20,901 individuals and 2,296 organizations.
15,433 of them (67%) were issued in 2023 or later. 2025 was the busiest year on record, with 5,254 new doula NPIs, 7.6 times as many as in 2020.
Nationally that's 6.4 doula NPIs per 1,000 births. By state it ranges from 1.1 in Mississippi to 25.9 in Oregon.
In the 28 states and DC where Medicaid pays doulas, there are 8.3 doula NPIs per 1,000 births. In the 17 states where it doesn't, there are 2.8.
71% of doula NPIs belong to sole proprietors: self-employed doulas who aren't incorporated.
Two of the state lists we track count Medicaid-enrolled doulas: 365 in California (as of April 2025) and 451 in New York (as of October 2026), equal to 8% and 30% of each state's doula NPIs.
Sources: CMS NPPES, September 2026; CDC/NCHS, Births: Final Data for 2024 (NVSR 75-2), Table 5; The Mom Site doula Medicaid tracker
Doula NPIs by the year they were issued
4,612 were issued before 2020, in all; 5,254 were issued in 2025 alone. Every full year since 2019 has set a record.
* 2026 is a partial year: 3,932 through September 13, 2026. Counts are NPIs still active in September 2026, by the year each was issued.
Show the numbers as a table
| Year | NPIs | Individuals | Organizations |
|---|---|---|---|
| 2005 | 4 | 4 | 0 |
| 2006 | 18 | 16 | 2 |
| 2007 | 49 | 45 | 4 |
| 2008 | 26 | 24 | 2 |
| 2009 | 402 | 386 | 16 |
| 2010 | 494 | 483 | 11 |
| 2011 | 382 | 371 | 11 |
| 2012 | 436 | 419 | 17 |
| 2013 | 444 | 422 | 22 |
| 2014 | 303 | 266 | 37 |
| 2015 | 334 | 276 | 58 |
| 2016 | 285 | 255 | 30 |
| 2017 | 378 | 340 | 38 |
| 2018 | 489 | 458 | 31 |
| 2019 | 568 | 530 | 38 |
| 2020 | 692 | 644 | 48 |
| 2021 | 975 | 906 | 69 |
| 2022 | 1,485 | 1,357 | 128 |
| 2023 | 2,493 | 2,262 | 231 |
| 2024 | 3,754 | 3,400 | 354 |
| 2025 | 5,254 | 4,671 | 583 |
| 2026* | 3,932 | 3,366 | 566 |
15,433
doula NPIs issued in 2023 or later, 67% of all active doula NPIs
5,254
issued in 2025, the busiest year on record
4,612
issued in the 15 years before 2020, combined
Source: CMS NPPES, September 2026
State by state
Doula NPIs per 1,000 births uses each state's 2024 births. Tap a column heading to sort; state names link to our doula listings.
| Oregon | 1,007 | 25.9 |
| Rhode Island | 239 | 23.9 |
| Michigan | 1,677 | 16.9 |
| Massachusetts | 1,052 | 15.4 |
| Washington | 1,221 | 14.7 |
| District of Columbia | 111 | 14.6 |
| California | 4,566 | 11.4 |
| Colorado | 676 | 10.5 |
| Delaware | 92 | 8.7 |
| Maryland | 571 | 8.7 |
| New Jersey | 847 | 8.4 |
| New York | 1,515 | 7.4 |
| Virginia | 682 | 7.3 |
| New Mexico | 152 | 7.1 |
| Missouri | 437 | 6.4 |
| Minnesota | 392 | 6.3 |
| Florida | 1,368 | 6.1 |
| New Hampshire | 59 | 5.0 |
| Pennsylvania | 638 | 5.0 |
| Vermont | 25 | 5.0 |
| Illinois | 625 | 5.0 |
| Connecticut | 169 | 4.9 |
| Nevada | 155 | 4.8 |
| North Carolina | 577 | 4.7 |
| Oklahoma | 225 | 4.7 |
| South Dakota | 49 | 4.3 |
| Georgia | 519 | 4.1 |
| Ohio | 520 | 4.1 |
| Louisiana | 217 | 4.1 |
| Iowa | 137 | 3.8 |
| Kansas | 127 | 3.7 |
| Hawaii | 54 | 3.6 |
| Maine | 41 | 3.5 |
| South Carolina | 182 | 3.1 |
| Wisconsin | 184 | 3.1 |
| Arkansas | 108 | 3.0 |
| Wyoming | 18 | 3.0 |
| Alaska | 26 | 2.9 |
| Arizona | 193 | 2.5 |
| Indiana | 186 | 2.3 |
| Kentucky | 123 | 2.3 |
| Tennessee | 194 | 2.3 |
| Texas | 876 | 2.2 |
| Montana | 24 | 2.1 |
| Utah | 89 | 1.9 |
| Nebraska | 45 | 1.8 |
| Idaho | 42 | 1.8 |
| North Dakota | 16 | 1.7 |
| West Virginia | 27 | 1.6 |
| Alabama | 85 | 1.5 |
| Mississippi | 37 | 1.1 |
Sources: CMS NPPES, September 2026; CDC/NCHS, Births: Final Data for 2024 (NVSR 75-2), Table 5; The Mom Site doula Medicaid tracker
A state is placed by the NPI's practice location address. “New since 2023” is the share of the state's doula NPIs issued in 2023 or later. “Effective” is the date the state's Medicaid doula coverage took effect. “Medicaid pays?” reads Pending where coverage is approved but not paying yet, or rates and rules are still being set.
Where Medicaid pays doulas
States grouped by their Medicaid doula coverage as of October 2026, with doula NPIs per 1,000 births in each group.
8.3
per 1,000 births in the 28 states and DC where Medicaid pays doulas
19,720 NPIs · 2,381,122 births
3.0
in Maine, Montana, Nebraska, New Hampshire and Vermont, where coverage is approved or in progress
194 NPIs · 64,510 births
2.8
in the 17 states where Medicaid doesn't pay doulas
3,283 NPIs · 1,183,302 births
Doulas on state Medicaid lists
Our directory uses five published doula lists, one each in California, Minnesota, New Jersey, New York and Oregon. Each is a different kind of list, published on a different date, so the counts don't compare across states.
California
365
doulas enrolled in Medi-Cal
The state has 4,566 doula NPIs. 308 of our doula listings there carry the flag.
Medi-Cal Doula Directory, as of April 2025
Minnesota
265
doulas listed on the state doula registry
The state has 392 doula NPIs. 155 of our doula listings there carry the flag.
Minnesota Department of Health Doula Registry, as of September 2026
New Jersey
54
doulas listed on a NJ FamilyCare health plan's network list
The state has 847 doula NPIs. 45 of our doula listings there carry the flag.
UnitedHealthcare Community Plan of New Jersey doula list, as of September 2026
New York
451
doulas enrolled in New York Medicaid
The state has 1,515 doula NPIs. 420 of our doula listings there carry the flag.
NYS Medicaid Fee-for-Service Doula Directory, as of October 2026
Oregon
604
doulas listed on the state doula registry
The state has 1,007 doula NPIs. 438 of our doula listings there carry the flag.
OHA Traditional Health Worker Registry (certified birth doulas), as of October 2026
Every state
What Medicaid pays a doula, which visits it covers, and when coverage started, in all 50 states and DC.
Methodology and limits
We counted every NPI in the September 2026 NPPES file that lists the doula taxonomy code (374J00000X) in any of its 15 taxonomy slots, kept only NPIs that are active (never deactivated, or reactivated) and placed each in the state of its practice location address. 20,856 list doula as their primary taxonomy; the other 2,341 list it alongside another code, such as a lactation consultant or nurse.
Individual and organization come from the NPI entity type. Sole proprietor is the NPPES flag an individual sets when they're self-employed and not incorporated. The enumeration year is the year the NPI was issued.
Births are the final 2024 count for all races and origins, by the mother's state of residence, from Table 5 of NVSR vol. 75, no. 2 (3,628,934 births in the 50 states and DC). Our script downloads the report and parses the table, and stops unless all 51 areas are found and add up to the published US total. Doula NPIs per 1,000 births = NPIs / births × 1,000.
Medicaid status and effective dates come from our doula Medicaid tracker (October 2026). 'Covered' means Medicaid is paying doulas now; 'approved or in progress' combines states with approved coverage that isn't paying yet and states setting rates or rules. List counts are the number of doulas on each state's published list on its as-of date.
What this count misses
- An NPI is free, and a doula needs one to bill Medicaid or private insurance. Doulas paid only by their clients have no reason to get one, so NPPES undercounts doulas, and the undercount is likely bigger in states where Medicaid doesn't pay for doula care.
- NPIs don't expire. A doula who stopped practicing keeps an active NPI unless they deactivate it, so some NPIs belong to people who no longer work as doulas.
- One doula can hold an individual NPI and also run an organization with its own NPI, and both are counted.
- The enumeration year is when the NPI was issued, not when the doula code was added. NPPES doesn't record that date, so a nurse or lactation consultant who added the doula code in 2024 to an NPI from 2010 counts in 2010.
- 2026 is a partial year: the file covers NPIs issued through September 13, 2026.
- Births are for 2024, the latest final year; NPIs are as of September 2026. The rate compares the current registry with the most recent full year of births.
- The state Medicaid lists come from different sources (an enrolled-provider directory, a health plan's network list, a state registry) and were published on different dates, so their counts aren't comparable across states. We count only the five lists our directory uses.
- More doula NPIs where Medicaid pays doulas is a correlation. Medicaid coverage gives doulas a reason to get an NPI; it doesn't show that coverage created more doulas.
Every figure on this page is computed by scripts/build_doula_report.py from the files below. NPPES and NCHS data are public domain. Found a problem? Tell us.
Find a doula
Our directory lists doulas from the same NPPES file, by state and city, with the state Medicaid list flags shown above.