Doula
A doula is a non-medical companion who supports a person, and their family, before, during and after childbirth.[1] The word is also used for end-of-life doulas, who give non-medical support to a person with a life-limiting diagnosis and to their family.[2] In Australia, doulas of both kinds are not registered health professionals.[3][2]
Description
The word
Doula comes from a Greek word for a female slave or servant. The natural birth movement took it up in the 1970s for lay-trained women who gave non-medical help during and after pregnancy, and end-of-life doulas deliberately borrowed both the name and the model.[4]
Birth doulas
A birth doula gives physical and emotional support. During pregnancy they may share information to help a person get ready for labour, and help them write a birth plan and talk with their doctors and midwives.[1] In labour, a doula may offer reassurance and encouragement, help with changing position or getting into the shower or bath, suggest breathing and relaxation techniques, give massage, and support the birth partner, whom the doula works alongside rather than replaces.[1][3]
A doula who works with a family after the birth is called a postpartum doula.[1] Alongside midwives and maternal and child health nurses, a doula may help parents learn to feed and settle their baby, and some also help with housework, meals or the care of older children.[3] Doulas go to the hospital or birth centre where the baby is born, and may also attend home births.[1]
End-of-life doulas
Palliative Care Australia describes an end-of-life doula as someone engaged, usually for a fee, to support a person with a life-limiting diagnosis. The support is non-medical and aims to make sure the person knows their choices. Services vary, but may include emotional and physical support, help finding a way through care and support options, help with paperwork, and advocacy for dying people and their families. Some doulas also help after the death with end-of-life rituals.[2] Palliative Care Australia notes that the role is also called death doula, death midwife or death-care doula.[2]
Researchers in four countries, Australia among them, describe end-of-life doulas as mainly lay women who offer social, emotional, practical and spiritual support to people nearing death and those close to them. In some places this includes caring for the body after death and helping with funeral planning, and some doulas run community events such as advance care planning workshops and Death Cafes.[4]
Scope
What it includes
- Information, emotional support and practical comfort during pregnancy, labour and birth, and after the baby is born[1][3]
- Non-medical support for a person with a life-limiting illness and their family, including help with plans, paperwork and options for care[2]
- Help after a death, such as end-of-life rituals[2]
What it is not
- It is not midwifery. A midwife is a registered health professional who gives clinical care in pregnancy, labour, birth and afterwards, and practising midwives must be registered with the Nursing and Midwifery Board of Australia. Doulas have no medical training, are not registered, and are not qualified to give clinical advice or emergency care.[3] Anyone having a home birth should have a registered midwife with them.[3]
- It is not clinical care. The Victorian Government says a doula should not give clinical advice, such as assessing blood loss after the birth or interpreting ultrasounds and blood tests; should not make or influence clinical decisions; and should not carry out clinical procedures, such as a vaginal examination or listening to the baby's heart in labour.[3]
- It is not palliative care. End-of-life doulas cannot dispense or discuss palliative care medicines, do not diagnose, and offer options rather than advice. Their role is defined as non-medical and non-clinical.[2] They are also different from palliative care volunteers, who are trained, supported and managed by palliative care services.[2]
Traditions and lineage
Lay women cared for the dying in their communities long before the idea of an end-of-life doula appeared. The first formal use of "doula" for this kind of care was a volunteer program begun in 2001 by the social services department of New York University Medical Centre, which looked after the social, psychological and spiritual needs of dying people at risk of being alone.[4] End-of-life doulas describe their work both as a reclaiming of community tradition and as a new, partly professional role.[4]
A 2019 review by Australian researchers noted that birth doulas had worked with women for many years before death doulas began to appear in end-of-life care. The few published papers then available likened the death doula's role to that of "an eldest daughter", or in some respects to a specialist palliative care nurse.[5]
Context
Within Spiritualism
Spiritfold has found no published source linking doulas with Spiritualism.
In Australian Spiritualism
Spiritfold has found no published source linking doulas with Spiritualism in Australia.
A Spiritualist perspective
Doulas sit outside Spiritualism, but a Spiritualist teacher would recognise something familiar in the work: keeping company with people at the great thresholds of life, and caring for families as well as the person at the centre. Spiritualists hold that life continues beyond death, and some who care for the dying may find that belief gives them steadiness. It is not something to press on anyone else. A dying person and their family are vulnerable, and their own beliefs come first.
From that standpoint, a good doula, Spiritualist or not, stays within a non-medical role, as this page describes. No messages from the spirit world at the bedside unless they are asked for, no promises, and no comment on medicines or treatment. Work alongside the midwife, the palliative care team and the family's registered health practitioners, and step aside when they ask.
Doulas in Australia
Training and regulation
The doula industry in Australia is unregulated, and doulas don't need any particular qualification, although many complete training as birth doulas, postnatal doulas or both.[1] End-of-life doulas are not registered by any Board under the national registration scheme run by the Australian Health Practitioner Regulation Agency (Ahpra), and there are no minimum training requirements.[2] A nationally accredited Certificate IV in End of Life Doula Services exists, but it is not required in order to practise.[6]
End-of-life doulas come under the national code of conduct for health care workers who are not registered, which the Health Complaints Commissioners administer in the states and territories that have passed laws to bring it into effect. The code sets minimum standards of conduct and practice.[2] In its 2024 guide, Palliative Care Australia listed New South Wales, Victoria, South Australia and Queensland as applying it, with other jurisdictions working towards it.[6] In Victoria, a doula is a "general provider" under the Health Complaints Act 2016, and complaints about a doula's service can be made to the Health Complaints Commissioner.[3]
A registered health practitioner, such as a nurse, who also works privately as an end-of-life doula must still meet their own Board's requirements.[2]
Associations
Government health sites point people looking for a birth doula to Doula Network Australia and Australian Doulas.[3][1] For end-of-life doulas, Palliative Care Australia noted in 2024 that a new peak body, Holistic End of Life and Death Care Inc. (HELD), had been set up.[6]
Doulas and palliative care services
The number of people working as end-of-life doulas in Australia is growing. Palliative care services here do not employ them, but where a patient has engaged a doula privately, the service works with the doula to support the person's wishes and care.[2] An Australian survey of death doulas in 2018 received 190 responses and found wide variety in their training, experience and skills. The authors found that the doula's role and scope were not clear-cut even among doulas themselves, and that without regulation or standard training they often worked without oversight and alone.[7]
First Nations doulas
A pilot program has trained First Nations doulas in a remote, multilingual community in northern Australia. The researchers, working with community members, described the principles behind it, including the continuity of First Nations culture and language.[8]
Safety and good practice
Choosing a birth doula
Government health sites suggest asking a doula about their training and experience, the services they offer, their fees, and whether they hold a Working with Children Check and a police check.[1][3] They also suggest asking whether the doula's vaccinations are up to date; Pregnancy, Birth and Baby names whooping cough and influenza, and the Victorian Government adds measles, mumps and rubella and COVID-19.[1][3] The Victorian Government recommends a written agreement so that the support and the costs are clear, and telling the pregnancy care team early if a doula is to be involved.[3]
A doula needs to work cooperatively with hospital or birth centre staff, and must leave the room if a doctor or midwife asks, for example in an emergency.[1]
Choosing an end-of-life doula
People receiving palliative care can be vulnerable in the last stage of life, and Palliative Care Australia asks services to make sure patients and families understand that the doula's role is non-medical.[2] Its recommended questions include what the doula can and can't do, how they will help with paperwork and after a death, what their background is, how they work with the person's GP, community nurse and palliative care service, what they charge and how much time they will give, and whether they follow a code of conduct.[6]
Common questions
Is a doula the same as a midwife?
No. A midwife is a registered health professional who gives clinical care, while a doula has no medical training, is not registered with Ahpra, and can't give clinical advice or emergency care.[3]
Do doulas need a qualification in Australia?
No particular qualification is required, because the industry is unregulated, though many doulas do complete training.[1] For end-of-life doulas there is a nationally accredited Certificate IV, which is optional.[6]
What does an end-of-life doula do?
Palliative Care Australia says the support is non-medical and varies between doulas. It can include emotional and physical support, help with care options and paperwork, advocacy for the person and family, and help with rituals after the death.[2]
Can a doula give medical advice?
No. Pregnancy, Birth and Baby says medical advice is for the doctor or midwife,[1] and Palliative Care Australia says end-of-life doulas do not diagnose and cannot dispense or discuss palliative care medicines.[2]
Related modalities
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 Pregnancy, Birth and Baby. "Birth doulas – what do they do?". Healthdirect Australia, funded by the Australian Government. Last reviewed April 2025 (accessed 14 October 2026).
- ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 Palliative Care Australia. End-of-life Doulas and Palliative Care: Factsheet. Developed by the palliative care peak bodies of all Australian states and territories and Flinders University, 2023 (accessed 14 October 2026).
- ↑ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 Better Health Channel. "Doula". Department of Health, State Government of Victoria. Reviewed 2 December 2025 (accessed 14 October 2026).
- ↑ 4.0 4.1 4.2 4.3 Krawczyk, Marian and Merilynne Rush. "Describing the end-of-life doula role and practices of care: perspectives from four countries". Palliative Care and Social Practice 14 (2020): 2632352420973226. doi:10.1177/2632352420973226 (accessed 14 October 2026).
- ↑ Rawlings, D., J. Tieman, L. Miller-Lewis and K. Swetenham. "What role do Death Doulas play in end-of-life care? A systematic review". Health and Social Care in the Community 27, no. 3 (2019): e82–e94. doi:10.1111/hsc.12660. Abstract read via Europe PMC (accessed 14 October 2026).
- ↑ 6.0 6.1 6.2 6.3 6.4 Palliative Care Australia. Recommended questions to ask an End-of-life Doula. Australian Palliative Care Peak Bodies Network, PDF dated March 2024 (accessed 14 October 2026).
- ↑ Rawlings, D., C. Litster, L. Miller-Lewis, J. Tieman and K. Swetenham. "The voices of death doulas about their role in end-of-life care". Health and Social Care in the Community 28, no. 1 (2020): 12–21. doi:10.1111/hsc.12833. Abstract read via Europe PMC (accessed 14 October 2026).
- ↑ Ireland, S., D. Y. Bukulatjpi, E. D. Bukulatjpi, R. Gundjarraŋbuy, R. Adair, Y. Roe, S. Moore, S. Kildea and E. Ḻ. Maypilama. "Djäkamirr: Exploring principles used in piloting the training of First Nations doulas in a remote multilingual Northern Australian community setting". Women and Birth 37, no. 3 (2024): 101573. doi:10.1016/j.wombi.2023.12.007. Abstract read via Europe PMC (accessed 14 October 2026).
Further reading
- Better Health Channel. "Doula". Department of Health, State Government of Victoria, 2025.
- Krawczyk, Marian and Merilynne Rush. "Describing the end-of-life doula role and practices of care: perspectives from four countries". Palliative Care and Social Practice, 2020.
- Palliative Care Australia. "End-of-life Doulas and Palliative Care" (factsheet, 2023, and recommended questions, 2024).
- Pregnancy, Birth and Baby. "Birth doulas – what do they do?". Healthdirect Australia, 2025.