Learn about trends in the Doula and Midwife industry and find out more information about how to start a Doula or Midwife Service. Don’t forget you can receive free or low-cost training and free professional business advice from your local Small Business Development Center!
Get free Doula and Midwife business plan template on our Business Plans page.
Doula Service Forecast
The doula and midwife industry has been growing in popularity as demand for services increases from mothers seeking safe birthing alternatives. Accelerated by the pandemic, more mothers explored at-home delivery options to minimize the risk of exposure. In the most recent assessment, 87% of hospital births in the U.S. included midwives, emphasizing doulas progress in collaborating with hospitals and integrating into the health care system as a whole. Certified Nurse Midwives (NM) work closely with obstetricians and gynecologists, making them an accredited source in the industry, and the most in demand.
In 2025 and beyond, states will continue to expand healthcare coverage and educational efforts to meet the growing demand for services. States are seeking to establish lower Medicaid costs and reimbursements for doula services. This will help calm the economic inequalities in maternal and infant healthcare. Doulas are also seeing a growing demand for virtual care. With future technology advancements, interest in this offering will grow as more doulas connect with their clients through apps. Here are some post-pandemic business resources specific to this industry:
- SBDCNet Small Business Pandemic Resources
- DONA International Recommendations
- Voices for Birth Justice Resources
Doula Industry Overview & Trends
NAICS Code: 812990, SIC: 7299
Doula services are an important segment of the U.S Maternity Care Industry and has had a significant impact on the childbirth. Increasing involvement of midwifery in maternity care has resulted in a 12% reduction of cesarean deliveries and mothers were 74% less likely to be induced.
This OBGYN industry summary is from First Research which also sells a full version of this report.
- “Physicians in this industry provide pre-, post-, and perinatal care, deliver infants, and treat health issues specific to women. The industry has no dominant companies. Women in many developing nations have limited access to effective contraception, emergency obstetric care (including cesarean section procedures), and safe abortion facilities. Worldwide, about 260 million women are not using safe and effective family planning methods due to lack of access to information or services and lack of support from their communities and partners, according to the United Nations Population Fund (UNPF).
- In the US, there are about 25,000 physicians that specialize in obstetrics and gynecology (OB/GYN), according to Zippia.
- Competitive Landscape: Demand is driven by population growth and private insurance and government health care policies. In private practices, profitability depends on insurance participation and reimbursements, patient volume, and administrative efficiency. In hospitals and outpatient clinics, profitability largely depends on reputation and geographic location. OB/GYNs practicing in large groups enjoy economies of scale in hiring support staff and purchasing medical equipment. Smaller practices can compete effectively by developing strong referral networks. OB/GYNs may compete with general practitioners, laborist physicians, or midwives in some markets. Some rural and low-income regions are experiencing a shortage of OB/GYNs.
- Products, Operations, & Technology: Services consist primarily of patient care and lab tests; some practitioners also engage in selling supplies.”
Doula Technology
Technology is a developing segment in the doula business industry. Here is information on new technology in the midwife industry.
- Advancing Equity in Maternal Health with Virtual Care – expanding equity in maternal health care through virtual doula services
- Driving outcomes through virtual care – clinical search on the impact of virtual doula support
- Technology rushes to fill the ever-widening gap in US pregnancy care – At home monitoring technology for expecting mothers
For more information on technology, visit our AI for small business Guide.
Doula Customer Demographics
According a study from the Cureus Journal of Medicine, findings reported that middle class doula-supported mothers were 50% more likely to attend childbirth preparation classes, and 72% were less likely to use epidural or pain medication during labor.
Major customer segments for Midwives and Doulas are reported by IBISWorld, which offers full versions of the reports for purchase here.
- The Midwife and Doula markets are segmented by race.
- The largest segment is made up of non-Hispanic, and single raced mothers, accounting for 62.1% of the market share.
- Mothers of Hispanic origin make up 24.5% of the market share
- African American mothers make up 13.4% of the market share
- Mothers apart of all other race segment use Certified Nurse Midwives for delivery. More than three-quarters prefer to use CNM’s above all other types of Midwives, due to the fact that they work directly with doctors. They are also certified to perform more medical procedures, and have cost reimbursements that that may contribute to more mothers choosing their service.
Additional information on doula and midwife services can be found from a variety of sources, including:
- The trend of Black women using doulas to overcome maternal death rates – CBS News
- The Medical Minute: Growing number of women seek midwifery’s natural approach to care – Penn State Heath
- Midwives are Growing in Popularity. Here’s What You Should Know. – Summa Health
Doula Startup Cost
According to Entrepreneur Magazine the following is the cost to start a doula business:
- “Startup Costs: Under $2,000
Home Based: Can be operated from home.
Part Time: Can be operated part-time.
Online Operation: Yes”
Doula Business Plans
The following are sample Doula Business Plans for reference. For additional business plan samples, visit our Business Plans Guide.
- Midwife Service Business Plan – The Finance Resource
- Doula Service Business Plan – Profitable Venture
- Doula Business Plan Template & Guidebook – New Foundrz
Midwife Business Associations
Trade associations often are excellent sources of information on an industry. Here are some relevant industry associations:
- The Doula Foundation
- Dona International
- American College of Nurse-Midwives
- Midwife Alliance of North America
- American Pregnancy Association
- Childbirth and Postpartum Professional Association
- Every Mother Counts
- National Institutes of Health
Doula Business Publication & Resources
- Midwifery Today
- American College of Nurse-Midwives
- Women, Midwives and Midwifery
- Midiris
- Birthing Magazine
- The Educated Birth
- Everyday Birth Magazine
- The Bump
- Healthy Mom & Baby Magazine
Midwife Business Regulations
This section is intended to provide a general awareness of midwife business regulations and agencies to consider when starting a doula service. Check with your state and municipality for rules and regulations that may impact the business in your area.
Although there are currently no federal agency providing regulatory oversight of this industry, practitioners are expected to protect client information following the Health Insurance Portability and Accountability Act (HIPAA). Additionally, individuals interested in this as a career or business should seek out certification from an accredited training program and any applicable state licenses.
- Doula Medicaid Training and Certification Requirements – summary of state approach and recommendations from National Health Law Program
- DONA Birthing Certification – birth doula certification from DONA International
- CAPPA Training & Certification – Certified Labor Doula (CLD) and Certified Postpartum Doula (CPD) along with others from the Childbirth and Postpartum Professional Association (CAPPA)
- CNM and CM Credential – Certified Nurse-Midwives (CNMs) and Certified Midwives (CMs) from the American College of Nurse-Midwives
- Midwives: Information on Births, Workforce, and Midwifery Education – study from the U.S. Government Accountability Office on the outcome of midwife-attended births, the profession, their education, among other related issues
- S.1851 — 118th Congress (2023-2024) – proposed bill expanding educational opportunities for midwives at institutions of higher education and nursing schools
Doula Business Employment Trends
Understanding employment trends in your industry is important when starting a new doula service. Doulas encompasses a variety of jobs. The following are insights from the Bureau of Labor Statistics into one of the main occupations, nurse anesthetists, nurse midwives, and nurse practitioners. A more specific breakdown of the nurse midwives occupation is available from the Bureau of Labor Statistics.
- “Pay: The median annual wage for nurse anesthetists, nurse midwives, and nurse practitioners was $129,480 in May 2023. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $95,530, and the highest 10 percent earned more than $211,820.
- Work Environment: Nurse anesthetists, nurse midwives, and nurse practitioners held about 323,900 jobs in 2022. Employment in the detailed occupations that make up nurse anesthetists, nurse midwives, and nurse practitioners was distributed as follows:
- Nurse practitioners 266,300
- Nurse anesthetists 49,400
- Nurse midwives 8,200
- Job Outlook: Overall employment of nurse anesthetists, nurse midwives, and nurse practitioners is projected to grow 38 percent from 2022 to 2032, much faster than the average for all occupations.
About 29,200 openings for nurse anesthetists, nurse midwives, and nurse practitioners are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.”
Additional Resources
Already in business or thinking about starting your own small business? Check out our various small business resources:
- View more business reports here: Small Business Snapshots
- View small business help topics here: Small Business Information Center
- View industry-specific research here: Market Research Links
- View business plans samples here: Sample Business Plans
Remember, you can also receive free professional business advice and free or low-cost business training from your local Small Business Development Center
Photo by Omar Lopez on Unsplash
