ACOG’s new guidance on doulas and what it means for your hospital birth
In July, the American College of Obstetricians and Gynecologists - the professional body that sets clinical standards for OB-GYNs - published a committee statement called "Partnering With Doulas in Clinical Settings." It was co-authored by OB-GYNs and doulas together, and it says, in plain terms, that stronger collaboration between clinicians and doulas leads to better outcomes and better experiences for patients.
Below are some common questions I hear from people planning to give birth in a hospital, and what the new statement actually says in language you can use.
What does ACOG's new statement on doulas actually say?
Doulas and clinicians have different jobs. Your OB-GYN, midwife, or nurse handles medical assessment, diagnosis, treatment, and clinical monitoring. A doula provides continuous, non-medical support. ACOG's statement is explicit that these two roles are complementary, not competing.
At a hospital birth, that means your clinical team is the one reading your labs, interpreting the monitor, and making treatment recommendations. Your doula helps make sure sure you have the time and space to process all of that information and ask the questions you want to, while providing continuous support in a way that staff at a busy L&D unit usually can't.
A doula's job is to help you ask questions. Part of that is creating a space where a fear, a preference, or a concern you're not sure how to phrase can actually get said out loud - and then, if you want, helping make sure it gets heard by the people involved in your care.
Community-based and culturally-specific doula care was named directly. Many deeply experienced doulas are never formally certified - often due to cost, language barriers, or training passed down through family and community rather than a certifying body. Doula training that is culturally responsive includes topics such as implicit bias, reproductive justice, and the lived experiences of Black and Indigenous families.
Does ACOG recommend having a doula at a hospital birth?
ACOG's statement says there is strong evidence that doula support can shorten labor, lower cesarean rates, improve breastfeeding initiation, and increase birth satisfaction. And, it recommends that OB-GYNs actively support doula involvement rather than treat it as optional or unfamiliar.
Will having a doula mean I argue with my doctor more?
No. ACOG's statement frames doula support as a way to reduce misunderstandings and conflict in the room, not increase it. A doula's role is to support you in communicating clearly with your care team, not to challenge your provider's recommendations or speak for you.
What do I say if a nurse or doctor questions why I have a doula?
Something simple and direct works best: "My doula and I work together - she's not here to make decisions for me, she's here to help me understand the ones I make."
What do I say if my family asks why I need a doula when I already have a doctor?
Try: "They're not doing the same job. My doctor handles the medical care. My doula is with me the whole time, helping me stay grounded, providing emotional, physical, and informational support, and making sure I understand what's happening - and ACOG, the group that sets standards for OB-GYNs, says that working with a doula can lead to better outcomes."
This tends to land better than explaining doula support in the abstract, because it names the specific gap a doula fills - continuous presence - rather than implying the medical care alone isn't enough. ACOG’s guidance highlights that clinical care and doula care are complementary, not competing.
What if someone assumes a doula is only for people trying to avoid interventions?
Say what's actually true for you: "That's not really what this is about for me. I want support no matter how my birth goes - whether that's unmedicated, an induction, a cesarean, or something else." Doula support isn't tied to a specific kind of birth, and ACOG's guidance notes that doula support remains valuable through inductions, medical interventions, and cesarean births.
Does this change anything about how doulas actually work at Baltimore hospitals?
Not procedurally - doulas still aren't counted against visitor limits at many Baltimore hospitals, and that hasn't changed. What ACOG's guidance changes is the framing: it gives hospital staff a source for something many of us have been practicing for years, and it may make some staff members quicker to welcome that collaboration instead of question it.
How do I find a doula in Baltimore who works well with hospital staff?
Ask directly: how do you describe your role to hospital staff, what do you do when a birth plan changes, and what's outside your scope.
Bottom line: Doulas and clinicians have different jobs, those jobs are complementary, and hospital systems should be removing friction between the two. Stronger collaboration between clinicians and doulas leads to better patient outcomes and experiences.