Over the past several weeks, there’s been increasing conversation — and rightful concern — about the National Doula Certification Board (NDCB) and its recent efforts to formalize a national doula certification process. If you haven’t been following closely, you may wonder why so many doulas, birth workers, educators, and advocates are sounding the alarm.

If you’re a birth worker — or someone who cares about equitable maternal and perinatal health — it’s worth paying attention.

Let’s be clear: this isn’t a conversation about whether standards, training, or accountability matter in our field. Of course they do. But who creates those standards, how they are shaped, who they serve, and who they leave behind — that’s what makes a world of a difference.

The NDCB’s recent rollout of its “Certified Professional Doula” designation raises some serious red flags. A growing coalition of birth workers, midwives, healthcare professionals, and researchers have signed onto a public letter calling for the dismantling of the NDCB entirely. And after reviewing their proposed process and structure, I understand why.

What’s Wrong With the NDCB Model?

The open letter written by birth workers, advocates, and researchers through The National Action Doula Network outlines this incredibly well (read it here), but let’s break down a few of the key concerns here as well:

1. It creates massive barriers to entry and threatens workforce sustainability.
The NDCB proposes certification costs upwards of $5,550. That alone creates a massive barrier to entry. But beyond the cost, their pathway mandates clinical hours in medical settings, signed off by approved medical professionals — not doulas. This dismisses decades of lived experience, grassroots training, and community-rooted care, and imposes a hierarchical medical lens onto a profession intentionally built outside of that structure.

2. It limits access to culturally congruent care.
When barriers to becoming a certified doula increase, the people most likely to be shut out are Black, Brown, Indigenous, and other birth workers from marginalized communities — especially those serving their own communities. That has a ripple effect. When there are fewer BIPOC, disabled, LGBTQIA+ (etc.) doulas, there’s less access to culturally congruent support, which we know improves outcomes.

3. It creates an unreasonably narrow route to training and entry.
One of the most revealing aspects of the NDCB’s model is that, as of now, they only recognize a single training program — Allo Doula Academy — as meeting their certification eligibility requirements for their “Pathway 1” option.

Let’s sit with that for a moment. There are hundreds of training programs across the country and around the world, including well-established, BIPOC-led, LGBTQIA+ inclusive, and community-rooted programs that have been supporting families for decades. And yet, this national certifying body has chosen to recognize only one — and one that, based on their own published materials, raises some serious concerns about equity and access.

To even apply for the Certified Professional Doula (CPD) credential under this model, applicants must meet the following criteria outlined by Allo Doula Academy:

• Must be 18 years of age or older
• Must have a valid high school diploma or GED
• Must meet physical exertion demands, including the ability to lift up to 50 lbs, stoop, bend, and remain seated or standing for long hours

Let’s break that down.

📌 Tying eligibility to a high school diploma or GED disqualifies people with lived experience, community credibility, and hands-on expertise who may not have followed a traditional academic path. This disproportionately impacts people who have navigated systemic educational barriers — particularly Black, Brown, Indigenous, immigrant, and low-income individuals.

📌 Requiring specific physical exertion abilities fails to account for disabled birth workers and those with chronic illnesses or physical limitations — many of whom are deeply skilled and effective in this work, often with creative adaptations that keep them and their clients safe and supported.

📌 Limiting certification to one training program places a gate in front of countless doulas who have trained, certified, and worked through other pathways, often in ways that reflect their cultural context and communities. Their only alternative? To do the “Pathway 2” option requiring 200+ hours of training AND a minimum of 75hrs of hands-on clinical experience in a medical facility with a preceptor.

This is not just gatekeeping. It’s a re-creation of the very same oppressive systems that birth work was meant to push against. It's a perfect example of how policy masquerading as professionalism can quietly (and clearly) erase, exclude, and devalue community knowledge and community members.

4. It disrespects the leadership of existing organizations.
Across the country, local collectives, nonprofits, and cooperatives — many of them Black-led — have been doing this work for years. They’ve built systems of support, created training programs, advocated for Medicaid reimbursement, and designed care rooted in the values of their communities. The NDCB’s model undermines all of that. It recenters power in a centralized, white-led institution and strips community workers of their autonomy.

5. It echoes the very same systems we’ve been harmed by.
This isn’t new. It’s a repeated pattern of erasure — of Black, Brown, Indigenous, queer, and disabled leadership being sidelined in favor of "standardization" that’s based on white institutional norms. It’s the same approach that pushed Black midwives out of practice, the same strategy used to delegitimize traditional knowledge systems and community care.

You can read the full outline of the NDCB's Certified Professional Doula (CPD) Initial Certification Requirements here.

But Isn’t Having Standards a Good Thing?

This is the part that requires nuance. Of course we want doulas to be well-trained. Of course we want families to be protected. Of course we want pathways for sustainable income, access to public funding, and wider recognition of the work we do.

But that doesn’t mean we need to give up the very values that make birth work care what it is. Standards do not have to come at the expense of equity. Certification should not require conformity to a singular, medicalized, white-centered view of birth support. And we can’t pretend that professionalism is synonymous with hierarchy.

There’s a straw man argument floating around that those who oppose standards like those proposed by the NDCB just don’t want accountability. That couldn’t be further from the truth. We want real accountability. We want structures that support the wisdom of birth workers in all forms, from all communities. We want options, pathways, and tools that build with us, not over us to push us down.

Where Do We Go From Here?

This isn’t just about the NDCB. It’s about how we respond — collectively, strategically, and with care — to ongoing efforts to co-opt community-rooted work and fold it into systems that not only were never made for us — but that we have been directly working the buffer the harmful impact of.

We need to:

• Protect and invest in community-led doula training programs and collectives.
• Advocate for state-level and institutional partnerships that center equity, flexibility, and multiple training pathways.
• Push for funding that reflects the labor and leadership of Black, Indigenous, and Brown doulas — not just their statistics.
• Continue building, organizing, and resisting with clarity and intention.

You can read the full open letter created by The National Action Doula Network here and sign their call-to-action that NDCB Halt Their Activities here as well.

To everyone watching this unfold — especially to new doulas trying to find their way — I want you to know this: There is space for you in this work. You don’t need to spend thousands of dollars to be “real.” You don’t need to conform to a system that doesn’t reflect your values to make an impact.

You do need to be in community. You do need education that respects your humanity and prepares you for excellence in service. You do need systems that serve you and your clients. And you do deserve leadership that sees and values the entire community — of both families we serve and the professionals who serve them.