Developing Doulas welcomes any initiative that seeks to uphold the rights, dignity and autonomy of women and birthing people and welcomes the desire to work alongside doulas to this end. However, we must express our strong disagreement with the Nursing and Midwifery Council (NMC)’s publication of this set of principles and the associated recorded meeting.
The NMC does not regulate doulas, nor does it have a mandate to define or oversee the role of doulas nationally. We are equally concerned by the involvement of Doula UK (DUK) in this process. DUK does not represent the full spectrum of doulas in the UK and does not hold a national mandate to speak on behalf of the profession. Their participation in this initiative risks misrepresenting the diversity and autonomy of doulas across the country. We are concerned that the NMC and NHS Trusts across the country will now assume that doulas not affiliated with DUK are providing substandard or even dangerous services to the public. This is, of course, not the case.
The NMC’s approach in this document attempts to regulate women’s choices for support and undermines the autonomy of doulas as non-clinical, emotional and practical supporters. It also disregards the intelligence and agency of birthing people, who are increasingly seeking continuity-based, relationship-driven models of care — including doula support — in response to gaps in the maternity system.
This publication arrives at a time when the standard of maternity services in the UK is at an all time low. The NMC should be advocating for greater support for midwives, including:
- Increased investment in continuity of carer models
- Expansion of home birth support teams
- Urgent recruitment and retention strategies for midwives
Instead, the focus appears to be shifting toward scrutinising doulas, despite a lack of evidence that doulas are overstepping their role. This misdirection is deeply concerning and risks diverting attention from the real systemic challenges facing maternity care.
Like any profession, there will, of course, sometimes be doulas that do not uphold the high standards we teach and expect. It would have been more constructive to engage with a wider stakeholder group, including Doula Course Providers and parents, to discuss ways to ensure that parents are kept as safe as possible and understand the roles and boundaries of doula support.
The NMC has failed to define what constitutes clinical care. It is vital that both midwives and doulas have a deep understanding of our respective remits and, crucially, where there may be overlap. This omission creates ambiguity and risk. For example, if a doula is asked by a client to provide a tool such as a rebozo for birth positioning, or an aromatherapy oil for relaxation, is this considered clinical care? Without a clear definition, the NMC cannot reasonably engage law enforcement or regulatory action based on suspicion of overstepping. The lack of clarity opens the door to misinterpretation and unjust scrutiny of doulas who are working within their non-clinical remit.
It is also important to state that article 8 of the European Convention on Human Rights protects a family’s right to give birth wherever and with whomsoever they choose. The collection of doulas’ names who are invited to share these birth spaces with the intention of gathering evidence for prosecution, based on mere hearsay, is entirely problematic. Instead, we would call for the health service to work with the doula community to share our concerns around individual practitioners who may be working in a problematic way. We do not see how a police register of names can do anything to keep the public safe or support both doulas and midwives to work together collaboratively for the collective benefit of our professions and the families we serve.
To pregnant people and birthing families:
You have the right to choose who supports you during your pregnancy, birth and postnatal journey. Engaging a doula is a very personal, intelligent and informed decision — one that reflects your understanding of your own needs and values. Doulas offer emotional, practical and informational support, and work within clearly defined non-clinical boundaries. The NMC’s principles and the associated online meeting were developed and delivered without the inclusion of pregnant people in the debate, which is a serious oversight. Your voice matters. Your choices matter. And your ability to seek support from a doula should be respected, not regulated.
At Developing Doulas, we train doulas to work within clearly defined non-clinical boundaries. Our values — the 7Cs — reflect a commitment to compassion, cooperation, and community. We support birthing people in making informed choices, and we work respectfully alongside midwives and maternity teams.
This approach by the NMC and the suggestion that law enforcement may be involved in investigating doulas has deepened the disconnect within the birth world at a time when women and birthing families urgently need to see more connection, collaboration and care. Rather than fostering trust and unity between midwives, doulas, and families, this regulatory overreach risks creating fear, division and confusion. It undermines the shared goal of supporting birthing people with compassion and respect and distracts from the pressing need to strengthen maternity services through investment, continuity, and genuine partnership. The birth space should be one of solidarity, not surveillance.
We urge the NMC to reconsider its position, to respect the legal and ethical boundaries of its regulatory role, and to engage in meaningful dialogue with the wider doula community — not just a single organisation — to better understand our contribution to safe, supported and autonomous birth experiences.
15th Sept 2025
