A wide range of voices informed the project.

New Mexico benefits from strong coalitions and collaborative work of Black, Indigenous, People of Color-led organizations who have been working together for years to improve maternal health outcomes and promote equitable policies and practices in the field. Many participated in a 2012 Birth Summit — and, in 2021, another Birth and Reproductive Justice Summit — hosted by Tewa Women United.

Participating BIPOC led organizations, along with independently practicing doulas and other, similarly-focused organizations led by white allies, brought their voices, experience and passion to this project. From the Dine’ Doula Collective in the northwest quadrant, to the New Mexico Breastfeeding Task Force in the south, to the UNMH Birth Companion Program in Albuquerque, ten organizations partnered with TWU to explore the issue of doula training and retention in New Mexico.

  • Bold Futures
  • Navajo Breastfeeding Coalition/ Dine’ Doula Collective
  • NM Doula Association
  • The Birthing Tree
  • UNM-H Birth Companions Program
  • Breath of My Heart Birthplace
  • NM Breastfeeding Task Force
  • NM Transgender Resource Center
  • Black Health NM
  • Indigenous Women Rising

Six of the ten partner organizations, plus Tewa Women United, have offered or sponsored doula or lactation training in the state. The graphic below identifies those, along with other training opportunities offered in New Mexico. Please note as well the “coming down the waterway” section to explore anticipated next steps for several of the organizations.

Another twelve practicing doulas, listed below, contributed their thoughts, perspectives and stories via one-to-one interviews and by participating in the convening. Aspen Mirabal and Kimberly Talachy have facilitated the YVK doula training as well as providing independent doula services.

  • Tauz TamuPovi
  • Freyr Marie
  • Tintawi Kaigziabiher, CLC, CBD, Trainer CBI
  • Andrea Stanley
  • Shileah Binnaly
  • Jazzy Lamboy
  • Daijah Smith
  • Nandi Andrea Hill
  • Natasha Bowman
  • Abby Bordner
  • Aspen Mirabal
  • Kimberly Talachy

The partner doulas and organizations were essential to recruiting doula respondents for the project survey. This comprehensive questionnaire drew responses from across the state and from various backgrounds and experience levels.

The survey provided insight into what doulas need to continue practicing; why some doulas who train never establish a practice; what doulas look for in trainings; and more.

Respondents received a $50 gift card and a digital copy of Valentine’s Rainbow, a gorgeous zine written by Shileah Benally, a full-spectrum Indigenous doula.

Who responded to the survey?

125 of 264 initial responses qualified for and were invited to the full doula survey. 87 doulas completed the full survey.

Of the 83 folks who currently live in NM, 51 live in urban counties (Bernalillo, Santa Fe, Dona Ana).

80 of 87 have trained as a doula in a recognized program. The most represented primary doula training programs included DONA (21), TWU-YVK (14), CAPPA (11), Zaagi’idiwin (10), and NMDA-CBPA (7), with 17 other programs named.

57 respondents are currently practicing, 18 formerly practiced but no longer do, and 12 have never practiced.

58% of respondents identify as BIPOC; 40% identify as Indigenous.

The communities doulas serve are as demographically diverse as the doulas themselves. Some doulas focus specifically on labor and birth, others on postpartum, while others cover a wider span. Of those 75 who are currently or formerly offered doula services:

  • 61 currently provide (19) or would be willing to provide (42) abortion doula services. 10 do not provide abortion doula services. 4 left the question blank or preferred not to answer.
  • Most doulas work within range of their home, although some are willing to travel and some take on virtual clients. The Albuquerque area is most heavily represented. Unlike those currently practicing, more rural areas are represented among doulas no longer practicing.
  • Besides serving clients in English, 11 respondents offer doula services in Spanish, and 1 offers doula services in an unspecified Indigenous language. Of those no longer practicing, 5 offered doula services in Spanish, 1 in Navajo, and 1 in ASL.
  • Only 1 doula has an entirely virtual practice. The vast majority of respondents usually serve their clients in person, but are available for questions and follow-up by internet or phone.

Hospital births are most heavily represented in the numbers, although home births, birth center births, and doula care outside of birth are also reported.

Six doulas served 100 or more clients. One clarified, “I was a doula for 160 births from 2016-2022.”

Partly because doula care is an ancient tradition with a wide range of culturally-specific practices, there are currently no governing bodies or comprehensive certifying boards in the state. Many doulas reject the idea of certification as an effort to devalue their hard-won, often culturally unique knowledge, experience and understanding.

Consequently, data on the number of practicing doulas and the number of clients they see is sparse. Survey data, adjusted by estimates of response rate, suggest that fewer than one in ten births in NM is attended by a doula. However, the doulas we reached through the survey had strong feelings about the training and support they need. For details on survey responses, please visit this page.

An online convening hosted by Tewa Women United offered a key source of information.

This deep conversation – so relevant to New Mexico – was held in the container of a trusted, facilitated space that brought in both practicing doulas doing on-the-ground work and organizational leads working on policy change and sustainable organizational models.

“I feel like just the way the conversation is going and how it’s the heart and the love that is showing up in this space – it has me very moved.”

As obviously valuable as the mix was, opportunities like this rarely arise. This project has been uniquely able to listen closely to the lived experience of doulas as well as that of those training doulas and those leading community organizations, and has made space for exchange between people working at all scales. It has been remarkably successful at identifying what is available in New Mexico and what’s missing, and the exchange has generated creative ideas around mentorship, doula compensation, training essentials and much more.

To learn more about other training models, we explored the national landscape, identifying more than 52 trainings.

Several key learnings emerged:

  • No accepted, nationwide regulatory body means that programs develop training based on community needs and personal approaches.
  • There is no “doula 101.” Different training programs emphasize various aspects such as business skills, cultural competence, advocacy, resource knowledge, etc.
  • Certification is a contentious topic, with some viewing it as a format aligned with white supremacy, while others offer certification options in partnership with organizations like DONA.
  • The prevalence of virtual and online training options reflects the adaptability of doula training to modern educational formats.
  • The cost of doula training varies widely based on factors such as training length, delivery method, certification offerings, etc. Some programs offer scholarships and grant funding for specific populations.
  • Some organizations focus less on collective needs and shift toward self-promotion, for-profit business, or “celebrity doulas.”
  • Very few organizations engage in both doula work and doula training; fewer still are multi-issue organizations that address other community needs as well. The distinction between doula work and training highlights the complexity of doula-related organizations and their multifaceted roles within the community.
  • Providing abortion doula training can involve legal and social complexities, requiring careful language and considerations to protect participants, organizations and community.
  • In some regions, doula training programs and initiatives like the Doula Registries aim to facilitate Medicaid reimbursement for doula services.
  • While training is increasingly accessible, it’s important to understand retention factors for doulas and how personal motivations and structural concerns impact their long-term commitment to the field.

The doula community is complex and continuously evolving. Continuity of training efforts across the years was more evident in for-profit ventures. The three Indigenous-focused doula training programs thriving in 2016 were no longer functioning in 2023. Reliance on grant funding offers a tenuous foundation for programs that seek to serve communities long term.

To dive deeper into alternative business models, we turned to four organizations that offer unique approaches to related training, serving BIPOC communities throughout North America.

These included:

  • Supporting Organizational Sustainability Institute (SOS Institute)
  • Zaagi’idiwin Indigenous Doula Training (Melissa Brown Sveinson)
  • Hummingbird Indigenous Family Services, Indigenous Breastfeeding Counselor Training (Camie Goldhammer)
  • SMC Full Circle Doula Training (Elder Shafia Monroe)

Key learnings to arise in conversation with doula and Indigenous breastfeeding trainers include:

  • Each training is led by a passionate, deeply experienced birthworker. They feel that the value of their training derives from their deep experience with the content.
  • Each training enterprise complements additional community work, e.g. direct service, cultural competency training, advocacy work, etc.
  • Some exclusively train Indigenous folks, and work with place-based cohorts. All focus on communities of color.
  • The four or five day intensive training format is common.
  • Most training efforts include (and compensate) local knowledge-keepers, and provide local communities a degree of autonomy. In-person, place-based trainings generally rely on communities to provide recruitment, venue, and other participant-related resources.
  • Trainers remain available (in some capacity) to students after the course ends.

Finally, we are grateful to the present and former staff at TWU, the contracted individuals who facilitated the trainings, YVK-contracted community doulas and others who shared their perspectives through interviews and focus groups.

Below please see a condensed description of project methodology.

Program objectives: Explore the terrain of doula training and retention efforts, decide whether/how to upscale TWU’s YVK Doula Training Program, and establish an action plan. In all phases, focus on the needs of and benefit to Indigenous communities.