Doulas are becoming increasingly popular in the United States and are active on many labor suites across the country. DONA International is the oldest and largest of the doula organizations in the United States. It has more than 5,800 members, including 2,300 certified birth doulas in all 50 states. Many hospitals and health systems hire doulas directly, but it is also common for doulas to contract separately with the patient. The term doula is derived from Greek and refers to the most important female servant in the ancient Greek household. Today’s doulas are caregivers whose primary role is the emotional support of the mother during labor and delivery. Anesthesiologists and nurse anesthetists working on labor units will encounter doulas but are often confused about their role in the birth experience. It is important for them to have a general understanding of this caregiver’s role to facilitate optimal care for obstetric patients.

Doulas are not licensed providers; therefore, there are no state requirements for doula education. However, DONA International offers a certification program that consists of completing a reading list; completing a workshop of a minimum of 16 hours; and documentation of previous experience in childbirth care by training in childbirth education or midwifery, work experience as a labor nurse, or observation of a childbirth preparation series. After completion of this program, the new doula must provide service to at least three clients and document the births with a 500- to 700-word firsthand account of each experience. In addition, the new doula must provide evaluations from three clients, three primary care providers, and three nurses or midwives.