By Birth & Baby University · Last updated: October 2026 · 4 min read
A doula’s referral network works in two directions: who you can confidently send clients to when a need exceeds your scope, and who knows enough about you to send families your way. The first is a safety and quality matter. The second is also a business matter, and the two should not be confused. This article looks at what the evidence and standards say about both and how to build relationships honestly.
Key takeaways
- DONA’s birth doula standards state that for client needs beyond the scope of the doula’s training and capacity, referrals are made to appropriate resources, and DONA certification requires developing a community resource and referral list.
- ACOG’s August 2026 Committee Statement 31 says doulas may build out the care team through partnerships with providers such as mental health therapists, counselors, pelvic floor physical therapists and lactation consultants, and offers strategies hospitals can use, such as badges, tours and recurring meet-and-greets.
- In a survey of 252 doulas, doulas overwhelmingly wanted more training in emotional support and referral sensitivity within their scope.
- We found no studies measuring which referral network practices lead to better outcomes or more clients, so the practical steps are suggestions.
What the research says
Standards on referral
The DONA International birth doula standards include a referrals provision: for client needs beyond the scope of the doula’s training and capacity, referrals are made to appropriate resources. The DONA birth doula certification page lists development of a community resource and referral list among its requirements. The Illinois Medicaid-Certified Doula Guide expects doulas to recognize complications and refer the client to healthcare professionals when clinical assessment, medical diagnosis or prescriptions are needed, and says doulas encourage clients to seek help from their obstetrician or primary care physician. These are standards for particular organizations and programs.
What clinicians’ organizations suggest
ACOG’s Committee Statement 31 describes doulas providing referrals and resources, including for preventive health and social needs such as transportation, food and housing, and potentially building the care team with other holistic and clinical providers. For hospitals, it suggests identification badges, tours, reporting pathways, keeping a list of trusted and representative doulas to share with patients and recurring community meet-and-greets. These are clinician-facing recommendations, so a given hospital may not have adopted them.
What doulas report about mental health referral and collaboration
A survey of 252 doulas across the United States found they overwhelmingly wanted more training in emotional support, and nearly all perceived emotional distress in their clients. The authors suggested training could refine doulas’ sensitivity to clients’ mental health referral needs while remaining within scope. In a 2026 interview study of 29 doulas, participants said they are not mental health professionals but often serve as early witnesses to distress, and the authors pointed to the value of apprenticeship models and interdisciplinary collaboration.
Networking and business
In a Georgia study of 17 doulas, participants said training, mentoring and networking help build their businesses. A futures-oriented study of 26 community doulas identified doula collectives as a way to decrease burnout and a chain of learning through mentorship. These are small studies, and they describe perceptions.
What this means for doulas
- Separate the two functions. A referral out is about the client’s needs. A referral in is about your visibility. Do not let the second shape the first.
- Refer to people you know. Meet providers, learn how they work and ask what they need from a referral.
- Be transparent. Tell clients if you have any relationship or financial arrangement with a provider.
- Give options. Provide more than one name where possible so the client chooses.
- Respect confidentiality. Share client information with a provider only with the client’s informed consent.
Putting the evidence into practice
- Build a resource list with categories: lactation support, pediatric care, mental health, pelvic floor therapy, social services, interpreters and emergency numbers. Add the date you last verified each entry.
- Contact each practice with a short introduction, your scope and a request for what they look for in referring clients to or from a doula.
- Visit local hospitals’ birth units if tours are offered, attend community meet-and-greets and introduce yourself to charge nurses and midwives.
- After a referral, with the client’s permission, ask the client whether it helped and update your list.
- Check your state and payer rules, and consult a qualified professional, before accepting or offering any payment or gift connected to referrals.
- Review your list every year and remove providers who are hard to reach or who clients report as unhelpful.
The bottom line
Referral relationships are part of safe, scope-aware doula practice and also help people find you, but the research on how best to build them is thin. Treat the network as a living, client-first resource, built on real relationships and consent.
Related reading: How Doulas Can Build Productive Relationships With Obstetricians and Midwives; What Research Says About Interprofessional Collaboration in Maternity Care; Independent Doula Versus Doula Agency: Comparing Business Models and Career Opportunities.
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
- DONA International. Birth Doula: Standards of Practice (revised September 2025). Read the source
- DONA International. Birth Doula Certification (page read October 2026). Read the source
- SIU School of Medicine. Illinois Medicaid-Certified Doula Guide (posted December 2024). Read the source
- 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
- Hall EM, et al. Doula support for perinatal mental health needs: perspectives on training and practice. Midwifery 2025. Read the source
- Shklarski L, et al. “We’re not clinicians, but we see it”: doulas’ roles in supporting clients with perinatal mood and anxiety disorders. Midwifery 2026. Read the source
- Mosley EA, et al. “I want…to serve those communities…[but] my price tag is…not what they can afford”: the community-engaged Georgia doula study. Perspectives on Sexual and Reproductive Health 2023. Read the source
- Darvish N, et al. What Do Community Doulas Think About the Future of the Doula Workforce? Maternal and Child Health Journal 2024. Read the source
A referral network starts with knowing your scope and your community. Birth & Baby University’s training, mentorship and agency-building resources are described on the For Doulas page. Compare any program with the requirements of your certifier and your state before you enrol.
More for professionals: the Professionals Blog.
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