A National Review on the Professionalization and Regulatory Oversight of Perinatal Doulas in the United States
Open Access DepositedPersistent disparities and an alarming upward trend in maternal mortality ratios in the United States underscore the need for innovative strategies to improve maternal health outcomes. Doula care, provided by trained professionals offering supportive care during pregnancy and childbirth, has shown potential to address these challenges, although evidence in the United States remains limited. States are gradually expanding access to doula services for Medicaid beneficiaries, yet there remains inconsistency regarding training, scope of practice, and no regulatory oversight. Grounded in a comparative analysis approach, synthesizing academic literature, grey literature, regulations, policy documents, and the Doula Credentialing Model conceptual framework, this nationwide study aims to provide a comprehensive review of the regulatory landscape and professionalization of perinatal doulas. Specifically, it aims to: 1) Offer a descriptive overview of the professional landscape for doulas through comparative analysis of state-based regulatory approaches, including licensure, certification processes, scope of practice, and training requirements; and 2) Examine factors influencing variability in doula regulations and professionalization across states.The comparative analysis methodology involves systematic data collection and analysis from diverse sources, including state regulations, professional guidelines, and scholarly research. By elucidating the regulatory oversight of perinatal doula practice in the United States, this study aims to inform evidence-based policy recommendations to enhance doula professionalization. It has implications for improving maternal healthcare delivery and promoting patient-centered, equitable care throughout the perinatal period. Note: In this study, we acknowledge and deeply respect every individual’s inherent right to self-identify their gender. Gender identity is a deeply personal aspect of one’s identity, and we affirm the importance of respecting and affirming each person’s gender identity. Terminology such as women, woman, mother, maternal, birth person, or birthing people is used to encompass individuals who are biologically capable of giving birth, recognizing the diverse range of identities and experiences within the context of pregnancy and childbirth. We strive to create an environment that respects and acknowledges the diversity of gender identities and experiences, ensuring that all individuals feel seen, valued, and respected in our research.
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