Red Flags When Hiring a Doula, and the Green Flags to Look For

Why a short list of warning signs helps

Many doulas you meet will be kind, careful people. But you are inviting someone into your birth room or your home at a vulnerable time, often overnight, and you may be too tired to trust your instincts. Knowing a few clear warning signs ahead of time lets you notice them in the moment instead of a week later.

Picture the third night home. The doula you hired says the baby will settle better on his tummy "just for a few hours", or that the warm forehead you noticed is nothing to call anyone about. You are exhausted, she sounds sure, and it is 2 a.m. If you have already decided what you will and will not accept, that moment is much easier to handle.

None of these signs means a person is bad at heart. Some come from habit, old training or wanting to please. They still matter, because a doula's job is to support your choices and your care team, not to replace either.

Red flags about medical care and safety

These are the most serious, because they touch your health or your baby's. The doula organizations draw the line clearly. DONA says its doulas "do not perform clinical or medical tasks." CAPPA says its postpartum doulas "do not dispense medical advice." ProDoula says its doulas may not give medical advice or interfere with advice from medical professionals. Be careful if a doula:

• Promises outcomes, such as a shorter labor, no cesarean, or a baby who sleeps through the night by a certain age.
• Tells you a symptom is normal and you do not need to call your provider, or tells you to skip or ignore your provider's advice.
• Offers to take your baby's temperature, give medication or supplements, or use herbs, oils or other remedies as part of doula care. CAPPA lists taking an infant's temperature and giving medication outside its postpartum doula's role, and says complementary therapies must be offered separately.
• Suggests sleep practices that differ from AAP guidance, such as bed-sharing, putting the baby down on the side or stomach, inclined sleepers, or pillows and loose blankets in the sleep space. The AAP recommends placing babies on their backs for all naps and at night on a firm, flat surface, and sharing a room but never a bed.
• Feeds your baby or changes the feeding plan without your agreement, for example by offering formula, a bottle or a pacifier you did not ask for. Feeding choices are yours; CAPPA says its postpartum doulas do not make parenting or infant care choices or decisions.
• Offers to drive your family, buckle your baby into a car seat or install one. CAPPA lists transporting family members and buckling children into car seats outside its postpartum doula scope.

Red flags about how she does business

These are less dramatic, but they cause more day-to-day trouble. Think twice if a doula:

• Will not give you a written agreement, or wants payment before you have seen one. Our contract guide lists what it should cover.
• Has no backup plan, or says "it has never happened" when you ask who covers. DONA's standards ask doulas to state backup arrangements in the contract, including when a backup is not an option.
• Is vague about training: she cannot name the organization, the credential or the year, or calls herself certified when she has only started the process. Our guide to doula certifications explains what each credential involves.
• Will not share references or put you in touch with a recent family. Our post on questions to ask a doula says plainly that refusing to share client feedback is a red flag.
• Pressures you to decide at the first meeting, offers a discount that "expires tonight", or makes you feel guilty for comparing doulas.
• Is hard to reach before you have even signed. If she misses calls now, ask yourself how that will feel in early labor.

Red flags about boundaries and respect

A doula should fit into your family's life, not take it over. Notice whether she talks more about her own birth stories and opinions than about your plans, criticizes your provider, your partner or your relatives in front of you, or pushes a birth or parenting philosophy you did not ask for.

Privacy is part of respect. A doula should not post photos of your baby, your home or your birth, or share your story, without your clear permission. She should not bring other people into your home or ask you for personal favors. It is fine to set these expectations out loud and in the agreement.

Trust your discomfort. If something felt off in the consultation, it rarely feels better at 3 a.m. You do not owe anyone an explanation for choosing someone else, and our post on changing doulas mid-pregnancy covers what to do if you have already hired someone.

Green flags: what good looks like

A reassuring doula tends to show the same handful of habits, whatever her training or style:

• She explains what she does and does not do before you ask, including that she does not give medical advice.
• She says "let's call your provider" readily, and helps you write down questions for your appointments.
• She knows current AAP safe sleep guidance and follows it in your home.
• She asks about your feeding plan and supports it, whether you breastfeed, pump, use formula or combine.
• She names her backup and offers to introduce you.
• She gives you a written agreement and time to read it.
• She can tell you where she trained, what credential she holds and how to check it.
• She asks about your values and plans, and does not judge them.

What to do if you see a red flag, and where Doulas of the Valley fits

Raise it directly; some concerns clear up with one honest conversation. If the answer does not reassure you, keep looking. If you have already hired a doula and something unsafe happened, tell her agency if she has one, and consider contacting her certifying organization: DONA has an ethics claim process for its certified doulas and members, and the ADHS doula page has an online complaint form. If anyone is in danger, call 911.

Doulas of the Valley is a small mother-daughter team. You can meet the team on the doulas page and ask us any of these questions in a consultation through the contact page. For a fuller decision path, see the guide to choosing a doula in the Phoenix area.