Danish midwives warn of risks as unlicensed doulas attend unassisted births

Two senior midwives have condemned the practice of unlicensed doulas attending unassisted home births in Denmark, calling it “an insanely dangerous situation,” Danish broadcaster DR reports.

Some doulas now offer to act as the sole birth attendant during frifødsler—unassisted births without a licensed midwife present—according to DR’s investigation. While most doulas provide emotional support alongside professional midwives, a growing number advertise their services for fully unassisted births, charging up to 20,000 kroner (approx. €2,700).

Trine Lind, head midwife at Rigshospitalet in Copenhagen, warned that doulas lack the training to handle emergencies. “In an acute situation, I’m not confident a doula has the skills to manage a critical event,” she said. Jeanette Ziska, head midwife at Aarhus University Hospital, called the practice unacceptable: “They’re placing themselves in a position of enormous responsibility and exposing the woman and child to unreasonable risk.”

The criticism follows recent reports in Weekendavisen and The Guardian detailing unassisted births where infants died or mothers suffered severe injuries. Unlike midwives, doulas in Denmark require no formal certification, and the title is unregulated. Training programs vary, with some offering as little as 84 hours of instruction.

Ann-Emilie Augustinus, a former licensed midwife who now works as a doula, rejected the warnings, arguing that her presence improves safety compared to a partner or friend assisting alone. “Many clients come to me after traumatic hospital births,” she told DR. “This is often a last resort because they don’t feel safe in the public system.”

Doulas are legally prohibited from performing medical procedures, such as examinations or diagnoses, and are not bound by the same clinical guidelines as midwives.