The Commodification of Birth Work

I had a conversation with a couple of doulas recently, and I spent the rest of the day perseverating over something that came up.

Birth work has become a business model. A system. A funnel. And too often, a trap.

A couple years ago, I nearly got sucked in myself. But after doing what I do (reading the f*ck out of everything I can get my hands on when something piques my interest), I came to a sobering conclusion: this isn’t a “we’re all empowered women now” situation. It’s giving Sheryl Sandberg vibes, not birth justice.

Doulas give everything to their clients. They give their sleep, their presence at their own child’s birthday party, their hands, their hearts. They show up at 3 a.m., navigate deeply medicalized hospital systems, hold trauma, advocate fiercely, and hold space for moms who are owning their power. 

There’s almost no work more intimate. And yet, more and more often, it’s being siphoned into someone else’s brand.

The Problem with the Doula Agency Model

Here’s how this works: one person—usually white, often wealthy—starts a doula agency.
They invest in marketing, SEO, and curated aesthetics to dominate Google and Instagram.
Families looking for birth support land in their inboxes.

And then the agency assigns out doulas from a roster—usually lower-paid, less-visible, and often from marginalized backgrounds—to do the actual work.

It’s packaged as professional and empowering. But in reality it’s just extractive.

Agencies often take a large percentage of the fee—sometimes up to 60%. The doula is left grateful for the opportunity and “exposure,” even though she’s doing the hard stuff: the on-call time, the support, the emotional labor.

Clients don’t usually get to choose their doula. Doulas don’t get to choose their clients. Autonomy gets stripped on both sides—and autonomy is the very thing birth work is supposed to restore.

If you’re searching for a doula, odds are high you’ve landed on one of these agencies without realizing it. They’ve optimized everything except ethics.

The Evidence: Research-Backed Harm

This isn’t just a personal gripe. The research confirms what many of us have felt in our bones.

• A 2023 study in The Journal of Midwifery & Women’s Health reported that community-based doulas are being pushed out of birth work due to lack of pay, burnout, and exploitative conditions. The doulas best equipped to provide culturally competent, trauma-informed care—especially to Black, Indigenous, and low-income families—are the very ones being edged out.
  

• Another 2023 study found that doulas improve outcomes across the board: lower cesarean rates, higher satisfaction, increased breastfeeding success. But those outcomes come at the cost of unrecognized labor and unsustainable conditions when doulas are funneled through hierarchical agency models.
  

• And MACPAC’s 2023 Medicaid Case Study explicitly stated that Medicaid dollars should go directly to doulas, not to third-party agencies that skim from the top and offer little accountability.

It’s Happening with Placentas, Too

This commodification isn’t just happening in birth. It’s happening postpartum, too.

Placenta encapsulation is ancestral, sacred work. It requires presence, care, and relationship. But here again, we’re seeing people with privilege turn something deeply personal into a scalable, shippable commodity.

For example, Mommy Made Encapsulation, based in Los Angeles, ships placenta kits via UPS Healthcare to clients across the U.S. It’s a glossy, celebrity-endorsed, drop-ship model. And it’s pulling business away from local encapsulators who do this work with their hands, hearts, and whole nervous systems.

When someone in South Jersey Googles “placenta encapsulation near me,” they’re often funneled into a paid ad or SEO trap that leads them to California. Mommy Made has the money to dominate the top results. And local encapsulators like me get buried.

The result:

• The money goes to California instead of staying local.
  

• The labor is done invisibly.
  

• The opportunity to build trust and relationships in our communities is lost.

This is just capitalism dressed up as convenience.

Who Gets to Lead—and Who Gets Left Behind

When agencies dominate SEO, when hospitals “partner” with only one birth org, when funders write grants only to nonprofits with polished branding, we create a system where a few rise and the rest are left scrambling.

And let’s be honest, the people who rise almost always already had access.

I can hear the capitalists now – 

I can hear the capitalists now:
“You’re just jealous.”
“That business owner took the risk, they deserve the reward.”
“That’s just how business works.”

But birth work isn’t just business. It’s care. It’s bodies. It’s community.

And we can’t keep pretending that predatory models are “mentorship” just because somebody can afford Canva Pro or a Dubsado subscription and somebody else can’t.

Yes, starting a business takes risk. But let’s be real about who gets to take those risks: people with generational wealth, financial safety nets, and time. Not the single mom scraping together gas money to get to a birth. Not the community doula juggling unpaid labor and a side hustle.

The real “risk” in this system is shouldered by the birth workers—especially those from marginalized backgrounds—who are doing hands-on labor, often without benefits, boundaries, or fair pay.

This is the logic of capitalism:

• Extract from those who do the work

• Funnel the rewards to those who own the brand

• Call it empowerment

• And gaslight anyone who challenges it

This isn’t about jealousy. It’s about justice.
It’s about naming structural inequality masquerading as mentorship.
And it’s about calling out the exploitation of care labor in the name of “growth.”

We don’t need more CEOs of birth. We need more community.

What Ethical Models Look Like

It doesn’t have to be this way.

There are birth workers building models that are just, sustainable, and community-rooted:

• Worker-owned collectives, where pay and power are shared.
  

• Medicaid reimbursement structures that pay doulas directly, without agency skimming.
  

• Local, independent providers offering placenta encapsulation, postpartum care, and birth support without the markup or middlemen.
  

I’m calling for:

• Transparency in pricing and pay splits
  

• Accountability in how doulas are treated inside agencies
  

• Client education on what they’re getting—and who they’re supporting
  

• Doula directories that don’t prioritize whoever pays the most
  

If You’re a Parent Looking for Support

If you’re pregnant or postpartum in South Jersey and you’re searching:

• “birth doula Camden County”
  

• “placenta encapsulation in New Jersey”
  

• “postpartum help near me”
  

… understand that you have options beyond the agencies that dominate the search results.

Reach out to independent doulas. Scroll down a little on the search results page. Ask who’s doing the work. Ask who’s getting paid. Ask if you can meet your doula before signing a contract. Ask what postpartum support actually looks like.

And if you go through an agency be sure to ask how much of your investment your doula is receiving. If the answer makes you cringe, it might be time to choose differently.

If You’re a Doula Feeling Stuck or Burned Out

You are not the problem.

You’re not lazy. You’re not underqualified. You’re not too sensitive. You’re not less-than. You’re not “bad at marketing.”
You just don’t have thousands to dump into Google ads. And you’re doing care work in a system that depends on unpaid labor to survive.

If you’re giving your all and still wondering if you’ll ever be able to make this work, I’m sending you love. This is not you. This is structural. And it’s not okay.

We need to talk about it. We need to write about it. And we need to name it, so we can change it.

Final Thoughts

Birth work is sacred.
Placenta work is sacred.
Postpartum work is sacred.

We can’t build birth justice on stolen labor. If you’re leading an agency, ask yourself:
Are you lifting others up—or just climbing on their backs?

If you’re a parent, ask:
Who is being supported when I buy this service?

If you’re a doula, keep going.
We need your fire. We need your truth. We need you.

Let’s build something better—together, not under someone else.

About Me

I'm a local, independent placenta encapsulation specialist, postpartum educator, and mentor for new moms. I’m based in South Jersey, and do placenta work for families in Camden, Burlington, and Gloucester counties—and I travel up to 90 minutes from Cherry Hill to bring this service to you.

I also support moms everywhere, virtually, through my Mom As You Are Method—designed to help you avoid, mitigate, or heal from postpartum anxiety and rage without pretending to be someone you’re not.

My work is rooted in anti-capitalist, feminist, and neurodivergent-informed care. I believe postpartum support should be built on real relationships, and accessible to all.

Curious? Overwhelmed? Need a gut check?

I offer a free Ask Me Anything service—no pressure, no upsell, just honest answers from someone who gets it. 

👉 Click here to submit your question and I’ll personally get back to you with a short video message.
Because the answers you deserve shouldn’t be behind a paywall. And you deserve more than posting anonymously in a Facebook group or anxiety-ridden google searches at 2 AM.