How Doulas Can Build Productive Relationships With Obstetricians and Midwives

By Birth & Baby University · Last updated: October 2026 · 4 min read

Whether a doula is welcomed or tolerated often depends less on the doula’s skill than on whether the clinician knows who they are. Obstetricians and midwives vary widely in their experience with doulas. This article summarizes what professional bodies say, what surveys and interviews show about attitudes, and how a doula can build working relationships that help clients.

Key takeaways

• ACOG’s August 2026 Committee Statement 31 and the American College of Nurse-Midwives both describe doulas as valuable members of the care team, and ACOG recommends that clinicians welcome doulas, learn their scope and create channels for feedback.
• Attitudes are mixed. In a 2024 pre-implementation survey at one hospital, 18 of 38 clinicians with doula experience reported at least one negative experience while 29 reported positive experiences.
• Exposure matters: in a survey of 704 labor nurses, working with doulas at their primary hospital was associated with more positive views.
• The most reliable foundation is clarity about role and respect for the clinical team’s responsibility.

What the research says

What professional organizations say

ACOG’s Committee Statement 31 calls on obstetrician-gynecologists to learn about doulas’ range of practice, create respectful teams, welcome doulas to patient appointments, hold meet-and-greet events with community doulas and provide ways for doulas to share feedback. The American College of Nurse-Midwives position statement on birth doulas says doulas are an integral part of the maternity care team, attending to nonclinical needs and enhancing communication among client, midwife, physician and nurse. It states that decades of research demonstrate that continuous labor support improves outcomes without risk of harm. That is the organization’s summary, and the evidence has caveats noted below.

What clinicians and doulas report

A multi-hospital interview study of 47 practitioners found that positive experiences centered on doulas’ supportive role, that some conflict stemmed from a cultural divide between obstetric culture and a natural birth counterculture, and that improvement centered on mutual respect, education about doulas’ training and role clarification. A 2024 survey of 48 clinicians and leaders before a doula-hospital partnership pilot found that among 38 respondents with doula experience, 18 reported at least one prior negative experience and 29 reported positive experiences, with an overall attitude score of 12.62 on a scale of 3 to 15 and strong readiness to implement the program. A cross-sectional survey of 704 labor and delivery nurses and 1,470 doulas found that exposure to doulas at nurses’ primary hospitals was associated with more positive views, while overwork and a preference for clinical tasks over labor support were associated with more negative ones; for doulas, working mainly in one hospital and being certified were associated with more positive views of nurses. A 2019 scoping review found only three eligible surveys on physicians’, midwives’ and nurses’ attitudes and said more research is needed.

Structured partnerships

The Champion Dyad Initiative, described in a 2025 article in the Journal of Midwifery & Women’s Health, pairs a community-based doula organization with five clinical sites using bidirectional feedback. The article is a program description, not an outcomes study, and reports challenges with documentation, funding and institutional support.

A caution about the outcome evidence

Professional statements describe strong benefits, but a 2025 meta-analysis of 18 studies found a lower cesarean rate with doula support in randomized trials (pooled RR 0.71, 95% CI 0.53 to 0.95) alongside substantial heterogeneity and borderline signs of publication bias, and no statistically significant effect in four U.S. trials. Clinicians who have read that nuance may expect you to be equally measured.

What this means for doulas

• Familiarity is the strongest lever in the research. Attend tours, meet-and-greets and community events so clinicians know you before a client’s birth.
• Introduce your scope before a conflict arises. A short, one-page description of what you do and do not do answers questions in advance.
• Do not set yourself up as an inspector. Frame questions as “help us understand,” and let the client lead.
• Respect the obstetrician’s or midwife’s legal and clinical responsibility. Disagreement about care is addressed through the client, not by challenging clinical judgment.
• Be accurate about outcomes. Say “associated with” and cite the research.

Putting the evidence into practice

• Offer to meet the practice’s nurse manager or office staff with a short introduction and your contact details, and with your clients’ permission, a note on shared patients.
• Ask clinicians what helps them when a doula is present and what has gone badly, and listen without defending.
• Use a consistent introduction at each birth: your name, your role, whom you support and “I do not give medical advice.”
• Thank people specifically, and if something went wrong, follow up with the client’s consent and with attention to privacy.
• Seek mentorship from experienced local doulas who know the practices and hospitals.

The bottom line

Doulas are most welcome where clinicians understand their role and have met them. Professional bodies support partnership, surveys show mixed experiences, and the practical routes to trust are role clarity, familiarity and respect for clinical responsibility.

Related reading: Effective Communication Techniques for Doulas in Hospital Settings; What Research Says About Interprofessional Collaboration in Maternity Care; Building Strong Referral Networks With Hospitals, Midwives, Pediatricians, and Other Perinatal Professionals.

This article is for professional education. It is not medical, legal, financial or tax advice. Check the standards of your certifying organization and the rules where you work.

Sources and further reading

• American College of Obstetricians and Gynecologists. Committee Statement No. 31: Partnering With Doulas in Clinical Settings. Obstetrics & Gynecology 148(2), August 2026. Read the source
• American College of Nurse-Midwives. Position Statement: Birth Doulas (undated file read October 2026). Read the source
• Neel K, et al. Hospital-based maternity care practitioners’ perceptions of doulas. Birth 2019. Read the source
• DaCosta MC, et al. Readiness to Implement a Doula-Hospital Partnership Program. JOGNN 2024. Read the source
• Roth LM, et al. North American Nurses’ and Doulas’ Views of Each Other. JOGNN 2016. Read the source
• Lucas L, et al. Attitudes of Physicians, Midwives, and Nurses About Doulas: A Scoping Review. MCN: The American Journal of Maternal Child Nursing 2019. Read the source
• Marshall C, et al. An Interprofessional Collaboration Between a Community-Based Doula Organization and Clinical Partners: The Champion Dyad Initiative. Journal of Midwifery & Women’s Health 2025. Read the source
• Dias Y, et al. Intrapartum Doula Support and Cesarean Delivery Rates: A Systematic Review and Meta-analysis. Obstetrics & Gynecology 2025. Read the source

Collaboration skills are part of professional doula practice. Birth & Baby University’s birth doula training and mentorship, outlined on the For Doulas page, are one place to build them. Ask any program how it prepares you to work alongside clinicians.

More for professionals: the Professionals Blog.