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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 And what they find there is usually a jumble of horror stories, outdated information, and forum posts that leave them more confused than when they started.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