Doulas attend only small percentage of hospital births around the U.S., but their numbers are increasing. As they grow in ranks, they're also growing in strength, attempting to organize, regulate training and become accessible to larger groups of women and families.
The New York Times calls doula-attended births the "latest wave in maternity care," though doulas have been around for decades. The Times says doulas are banding together in some states to demand their clients be able to ask for insurance to reimburse their fees.
Doulas, unregulated but trained women (mostly women) help pregnant mothers thrive in pregnancy and prepare to give birth. During labor, doulas help clients navigate hospital policies and doctor preferences, while supporting and assisting during labor and delivery. They say their goal is to improve maternity care for their clients and, ostensibly, all women. But they haven't always been welcomed into hospitals and among medical staff.
Doulas typically provide support during birth for pain management. They also advocate on behalf of their clients, which can cause acrimony between doulas and nurses or doctors. One doctor in the Times piece, who generally isn't bothered by the presence of doulas in the delivery room, says the doulas need to know their place—they should not contradict the doctor's own medical judgment in front of the patient.
In New York City, the Times reports that doulas attend about 5 percent of all births. Their fees, which are not yet reimbursable in the state, range from $150 to $2,800, depending on experience. On doula interviewed said she had heard of a doula charging $10,000 to attend a birth.