Texas doulas report low pay and growing financial strain in new survey

A Texas Doula Association survey of 156 active doulas found that more than half earned under $10,000 from doula services in 2024, raising concerns about workforce sustainability. The findings also show broad advocacy engagement, wide service coverage across Texas and persistent barriers in medical settings.

Why it matters: - The survey points to a workforce that families rely on but many doulas may not be able to sustain financially. - Texas Doula Association says stronger pay and support could improve maternal health outcomes and family support across the state.

What happened: - Texas Doula Association released results from its first Texas Doula Workforce Survey. - The survey included 156 active doulas across Texas and was conducted between May and June 2025. - Each participant received a $50 gift card from Texas Doula Association. - DeAnna VonBartheld, Texas Doula Association president and co-founder and founder of DelvaDoulas, said the survey shows Texas can do better for mothers, babies and doulas.

The details: - 55% of respondents reported earning less than $10,000 from doula services in 2024. - Average annual doula income among respondents was about $19,000. - 73% of participants identified as women ages 26 to 46. - Respondents lived and worked across Texas, with the highest residential concentration in Travis County (16%) and Harris County (12%). - The highest occupational representation was in Travis County (29%) and Dallas County (22%). - The data suggests doulas work in more counties than they live in, showing wider reach than local residence patterns alone. - Respondents ranged from newly practicing doulas to veterans with decades in the field, with an average of about six years of practice. - 84% identified as birth doulas. - 58% also provide postpartum support. - 35% offer full-spectrum care. - 23% offer loss doula care. - 96% said advocacy is part of doula work. - 69% rated advocacy as very important. - Most respondents said they spend less than 5 hours a month engaging with policymakers and legislation.

Between the lines: - Open-ended responses pointed to limited acceptance of doulas in medical settings, inconsistent compensation and difficulty balancing client work with advocacy. - The survey suggests doulas see advocacy as core to the job, but many have limited time to spend on policy work. - The results also show a mismatch between the importance of doula services and the income many doulas earn. - Texas Doula Association framed the findings as evidence of a workforce under pressure but still delivering broad support.

What's next: - Texas Doula Association is using the survey to guide efforts aimed at strengthening the doula profession and improving maternal health outcomes. - The organization is also fundraising and directing readers to its survey results and campaign materials through its announcement and website. - Texas Doula Association says it wants to improve access to doula services, especially for Medicaid recipients, and push for fair wages and representation in legislation.

The bottom line: - Texas doulas are doing expansive care work across the state, but the survey shows many are not earning enough to make the job financially sustainable.