The XX Factor

This Is What Happens When #Boss Feminism and the Doula Industry Collide

Having a doula shouldn’t be a luxury.


For a few years now, an internecine conflict has emerged within the American doula community. On one side, there are the women—and as far as I can tell, they are all women—who want to maintain the status quo. They have little interest in formalizing the profession and believe doulas can do their best work in a lightly regulated system that focuses more on individual relationships. Their concern is that any attempt to make their work more official would lead to a commodification of what should primarily be a social and emotional relationship between two human beings.

Others are interested in professionalizing the job through the creation of universal standards of practice and a better regulated certification system. This would earn them more respect in the medical system, hold them more accountable, and likely make it easier for their services to be covered by insurance. Currently, anyone can call herself a doula and, voilà, she is a doula.

Into this fray enters ProDoula, a 3½-year-old for-profit doula certification agency. Founded by doulas Randy “Rock N’ Roll Doula” Patterson and Debbie Aglietti, the organization intends to change the doula industry by stripping it of its penchant for all things natural and turning it into a job women can actually support themselves doing. Some see the women of ProDoula as earnest reformers, bringing dignity to labor that has long been devalued and undercompensated. Others see them as a bunch of charlatans, peddling a #ladyboss version of a Mary Kay pyramid scheme with the main goal of enriching themselves. So far, the group has succeeded, becoming the fastest-growing doula certification agency in the country and, according to them, earning $1.25 million in 2016.

BuzzFeed reporter Katie J.M. Baker recently took a deep dive into the world of ProDoula and the controversy it has created in the doula community. In her story, we learn about the ProDoula private Facebook group “The Business of Being a Doula,” where volunteer doulas are criticized for “devaluing” the profession and are called “oxytocin vampires.” Doulas are drawn in by ProDoula’s mandate to “charge your worth” and look to the organization’s business-centered trainings and support to help them figure out how to do just that. This is not an instance of greed: Most doulas make very little money from the work, and most doula-supporting organizations pay little attention to helping doulas find a way to support themselves and their families with this work.

ProDoula’s empowerment messages come off as both genuine and self-serving. They think women’s work should be valued. Great. They think the doula industry isn’t best served by its association with “all that woo woo, drum circle, doula heart stuff,” as one woman put it. Again, great. I’ve always been put off by the birth-support community’s predilection for all things “natural” and have long wished to see more efforts to create a support network that sees the decision to have an epidural or formula-feed as empowering as it does the decision to go pain-medication-free and breast-feed for years. (I’ve spent the last few months enduring sermons from a variety of prenatal yoga teachers and doulas who unequivocally declare having an epidural as “giving up.”)

Not great: They want to turn doula work into a luxury for the wealthy and think it is not their responsibility to worry about those who can’t afford it. “Do you think plumbers sit around fretting over the problem of people needing plumbing help who cannot afford it?” one doula asked. Also, while some doulas interviewed have found greater financial success through ProDoula, others feel burned by it. They say they felt compelled to spend thousands of dollars on services and courses that ended up being worthless and sometimes put them in debt. There were also anecdotes of the ProDoula community bullying doulas who challenged their orthodoxies. “You have to be all in, or they get rid of you because they don’t want any dissent,” said a woman who was previously involved with ProDoula.

It’s not surprising that an organization like ProDoula has emerged in recent years. Flawed as it may be, it’s clearly meeting a need for leadership and vision in the doula community, while also promoting the idea that this labor is valuable and should therefore be compensated. We don’t balk at the idea that therapists and social workers should get paid for social and emotional support. So why not doulas? The larger doula community should consider borrowing some of ProDoula’s ideas and continue working toward professionalizing their industry while simultaneously holding onto the idea that their services should be available to the rich and the poor, who are often the ones who stand to benefit most from having a doula.