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There is a misconception that doulas are for uncomplicated, low-intervention births. That they belong in birth centers and water birth stories, not in MFM offices or hospital rooms with monitors and IV poles. That misconception costs families. The truth is this: when a pregnancy becomes medically complex, the need for a consistent, knowledgeable, emotionally grounded support person does not go away. It increases. The medical team does not shrink when a pregnancy gets complica

Labor pain is not like other pain. And comfort measures are not just hand-holding. Here's the physiology behind why they work, and why the evidence shows they matter more than most people think.

A typical day on Labor & Delivery. One spontaneous labor. Thirteen 39-week inductions. This is what "routine" looks like now. If you've been following our blog, you've already seen our deep dive into the ARRIVE trial and what it means for elective induction at 39 weeks. (If you haven't read that yet, start there, then come back. It'll give you important context for what follows.) Now there's a new piece of research worth your attention. A 2024 retrospective cohort study out o

Billing BCBSRI as a doula doesn't have to be a mystery. In Part 1 of this series, we covered taxonomy codes, procedure codes, modifiers, and diagnosis codes for doula billing across payers. Now we're going to get specific: if you're a doula in Rhode Island billing Blue Cross and Blue Shield of Rhode Island (BCBSRI), here is exactly how to do it. BCBSRI was one of the first commercial insurers in the country to formally cover and credential doulas. That's genuinely good news.

I've been doing healing work since 1991, long before doula was a word most people recognized. So when I talk about community, lineage, and honoring the work of others, I'm speaking from over three decades of showing up. This post is about what that time taught me: why gatekeeping diminishes the work, why the rising tide only works if it lifts everyone, and why the people I train lift me right back.

"We'd like to talk about induction." Six words that send most pregnant people straight to Google at 11pm. And what they find there is usually a jumble of horror stories, outdated information, and forum posts that leave them more confused than when they started. Induction of labor — the process of starting labor artificially before it begins on its own — is one of the most common obstetric interventions in the United States. More than 30% of births now involve some form of ind

I n 2018, a study published in the New England Journal of Medicine quietly shifted the landscape of obstetric care in the United States. The study was called the ARRIVE trial — A Randomized Trial of Induction Versus Expectant Management — and its headline finding was striking: elective induction of labor at 39 weeks in low-risk, first-time pregnant people resulted in a lower cesarean rate than waiting for labor to begin on its own. That finding landed in a health system that

There is a moment in almost every birth - sometimes early, sometimes not until transition - when a laboring person looks up and says some version of: I can't do this. What they usually mean is: I don't understand what's happening to me (and I'm tired as hell). That's not weakness. That's a knowledge gap. And knowledge gaps are fixable. Understanding what your body is actually doing during labor - the hormones, the mechanics, the cascade of events that unfolds over hours - doe

And why the “doulas vs. nurses” framing hurts families, and where the actual problem lives. May 2026 · Lorie Michaels, CD(DONA), LCCE, CLC, PMH-C The dream team is possible. It starts with showing up as one. Let me say this plainly: Doulas are not in competition with hospital staff. I have worked alongside L&D nurses for years. I have watched them love families through terrifying moments, advocate quietly in ways that never made it into the chart, and hold space for people

A trauma-informed, non-judgmental look at why this happens, what it means, and what actually helps. What You're Not Seeing in That Neighborhood Drive through certain parts of coastal New England and the picture looks prosperous. Large houses set back from the water, restaurants full on summer weekends, the kind of scenery that reads as comfortable and established. What that picture doesn't show is what happens in October. When the seasonal restaurants close, the summer rental

What every birth worker needs to know about obstetric racism — where it came from, how it operates, and why it’s still running. The “Mothers of Gynecology” monument honors the sacrifice of Anarcha, Lucy, and Betsey, the enslaved experimental subjects of the “father of gynecology,” J. Marion Sims. Black women die from pregnancy-related causes at nearly 3.5 times the rate of white women. That disparity holds across income, education, insurance status, and zip code. It is not ex

For families choosing a doula and birth workers figuring out where they fit There's a growing trend in maternity care that sounds like good news on the surface: hospitals partnering with doulas, doula agencies getting "preferred provider" status, birth centers maintaining rosters of recommended support people. More doulas in more birth spaces — that should be a win, right? Sometimes it is. But it's worth slowing down and asking a question that doesn't get asked enough: whose

May is Maternal Mental Health Awareness Month. This post is for birth workers, doulas, and perinatal providers who serve — or want to serve — military and veteran families. The Numbers Birth Workers Need to Know Most perinatal mental health statistics are sobering. The numbers for veteran and military-connected families are in a different category entirely. As many as 46.7% of female veterans report perinatal depression, compared to roughly 1 in 7 civilian women. Military-con

Part of the BirthPro Business Basics series If you've applied for your NPI number (if not, start here), you've probably hit a screen asking for your taxonomy code and thought: what is this, and does it even apply to me? It does. And once you understand what these codes are and how they work together, billing gets a lot less mysterious. What Is a Taxonomy Code? A taxonomy code is a 10-character code that identifies what type of provider you are. It's maintained by the National

A plain-language breakdown of the current guidance — and why the real answer is more complicated than "just don't do it." The Standard Message — and Why It Falls Short If you've had a baby recently, you've heard it. Back to sleep. Firm, flat surface. Nothing in the crib. Baby in your room but never in your bed. End of conversation. The American Academy of Pediatrics (AAP) updated its safe sleep guidelines in 2022 and their position on bedsharing is unambiguous: they don't rec

April is Medicaid Awareness Month. And if you work in birth — or you're training to — this is a moment worth paying attention to. Here's the tension: we are living through the most significant expansion of Medicaid doula coverage in U.S. history, happening at the exact same time federal Medicaid funding is being cut to the bone. Progress and threat, simultaneously. That's where we are. The good news first As of March 2026, 26 states and Washington DC now provide Medicaid cove

A practical, no-nonsense guide for aspiring birth workers who want to make a good decision the first time. So you've decided you want to be a doula. Maybe you've known for years. Maybe a birth experience — your own or someone else's — flipped a switch and you haven't been able to think about anything else since. Either way, welcome. This work matters more right now than it ever has. And then you Googled "doula training" and immediately fell into a rabbit hole of programs, cer

What nobody tells you is how much feeding your baby benefits you. Pick up almost any resource on breastfeeding or chestfeeding and you'll find the same list: immune protection, brain development, bonding. All for the baby. Which, great — but that's only half the story. The benefits to the parent who lactates are real, well-researched, and honestly pretty remarkable. And yet they almost never come up in prenatal appointments or hospital discharge packets. So let's talk about t

This is what reclamation looks like. April is VBAC Awareness Month — and if you've spent any time supporting birthing families, you already know that a VBAC isn't just a birth plan. It's a reclamation. It's a person walking into a hospital or birth center carrying a previous cesarean, a stack of opinions from providers who may or may not be supportive, and a hope that this time will be different. That's a lot to hold. And it's exactly why doula support for VBAC families isn't

There's a conversation happening in birth worker circles that tends to get heated fast. It goes something like this: Should contracts include a time clause — say, 18 hours of continuous support — after which an additional hourly rate kicks in? Some birth workers say yes, absolutely. Others say it's harmful. And a surprising number are somewhere in the middle, quietly wondering if it's okay to even consider it. Let's talk about it. Where the idea comes from Birth worker burnou