How Continuing Education Helps Doulas Maintain Evidence-Based Practice

By Birth & Baby University · Last updated: October 2026 · 3 min read

Most doula certifiers require continuing education, and most doulas collect contact hours. The less comfortable question is whether those hours change what you do with clients. Research from other health professions suggests that attending a course often changes practice only a little, and that how you learn matters. This article summarizes the requirements, the evidence and a way to plan learning that sticks.

Key takeaways

• DONA requires certified doulas to earn 15 contact hours of approved continuing education every three-year certification period, including one hour of DEI training for recertification, and to maintain continuous membership.
• A Cochrane review of 215 studies of educational meetings found they probably slightly improve compliance with desired practice, with an adjusted risk difference of 6.79%, and probably slightly improve patient outcomes.
• A meta-analysis of 23 studies found spaced online education was superior to massed online education for knowledge (moderate certainty) and for clinical behavior change in a small number of studies.
• These studies concern clinicians. No study read here evaluated continuing education for doulas.

What the research and guidance say

What certifiers require

DONA’s recertification page says certified doulas recertify every three years, maintain continuous membership and earn a minimum of 15 contact hours of approved continuing education during the period: for birth doulas in a birth and parenting related field, for postpartum doulas in areas relating to the perinatal or postpartum period or early parenting. Its cost page adds that all recertifications must include 1 hour of DONA-approved DEI training and lists ways to earn hours, from free member meetings to paid conferences. CAPPA’s labor doula page says recertification is required every three years. These are one organization’s rules and others differ.

Does attending education change practice?

The 2021 Cochrane review of continuing education meetings and workshops included 215 studies and more than 28,167 health professionals. Educational meetings as the single or main intervention probably slightly improve compliance with desired practice (adjusted risk difference 6.79%, 95% CI 6.62% to 6.97%, median 4.00%, interquartile range 0.29% to 13.00%) and probably slightly improve patient outcomes, with considerable variation between studies. In plain terms, a course can help, but the average effect is small and uneven. The review concerns clinicians, not doulas.

Which formats help more

A 2024 systematic review and meta-analysis of spaced digital education for health professionals included 23 studies, most at unclear or high risk of bias. It found spaced online education superior to massed online education for postintervention knowledge (SMD 0.32, 95% CI 0.13 to 0.51, moderate certainty) and, in three studies, for clinical behavior change (SMD 0.67, 95% CI 0.43 to 0.91, moderate certainty). Spacing learning over time appears to help retention and application, though evidence is mostly from clinical trainees.

What doulas say they need

In a survey of 252 doulas, doulas overwhelmingly wanted more training in emotional support and preferred in-person training built into foundational workshops. In a Georgia study of 17 doulas, training, mentoring and networking were said to help build their businesses.

What this means for doulas

• Hours are a floor, not a goal. Meeting a renewal requirement does not by itself show better practice.
• Pick learning that changes behavior. Choose topics tied to a gap you noticed, and plan one concrete change per course.
• Space it out. A series of shorter sessions with practice in between may help more than a single day.
• Check currency. Guidelines change, so verify that course content cites current sources.

Putting the evidence into practice

• At the start of each certification period, write the renewal rules and list the topics where you want to improve.
• For each course, record before you start what you hope to change in practice and, afterwards, what you will do differently within the next month.
• Prefer courses with case discussion, practice and follow-up, and sessions that reuse content over weeks.
• Mix sources: a certifier webinar, a peer case review, a journal article with a mentor and a clinical update from a professional body.
• Keep certificates and notes together, and review them with a mentor before renewal.

The bottom line

Continuing education keeps credentials current, and the research on other professions says courses alone change practice only slightly. Plan learning around specific gaps, space it and connect it to feedback, and check that the content reflects current evidence.

Related reading: Why Mentorship Matters for New Doulas: Exploring Research on Professional Learning; The Role of Reflective Supervision in Improving Perinatal Support; From New Doula to Experienced Professional: Building Competence Through Deliberate Practice.

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. Recertification (page read October 2026). Read the source
• DONA International. Certification & Renewal Costs (page read October 2026). Read the source
• CAPPA. Labor Doula Certification (CLD) (page read October 2026). Read the source
• Forsetlund L, et al. Continuing education meetings and workshops: effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews 2021. Read the source
• Martinengo L, et al. Spaced Digital Education for Health Professionals: Systematic Review and Meta-Analysis. Journal of Medical Internet Research 2024. Read the source
• Hall EM, et al. Doula support for perinatal mental health needs: perspectives on training and practice. Midwifery 2025. 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

Continuing education works best when you plan it. Birth & Baby University’s For Doulas page describes recertification, training and mentorship options for doulas at different stages. Check your certifier’s current rules for what counts toward renewal before you pay for any course.

More for professionals: the Professionals Blog.