Traditional Health Worker (THW) Doula Information and Resources

As a part of Legacy’s doula workforce development, we have provided the following information and resources to assist doulas in becoming approved as Traditional Health Worker Doulas, which is Oregon’s process for becoming a Medicaid billable doula. In order to become a Legacy contractor doula, you must first be approved on Oregon’s THW Registry as a THW doula.

Steps for Doulas Applying to the State THW Registry 

Required birth doula training

If you are taking your initial doula training after October 1, 2022, you will need to take an OHA approved doula training in Oregon in order to become a THW doula.  You can find a list of currently approved THW training programs here on the OHA website. 

Doulas who completed their doula training between October 1, 2019 and October 1, 2022 must show a certificate of attendance/completion of a birth doula training that has at least 28 contact hours of education.  If your certificate does not clearly state the total hours or the dates/times or your training, you need to contact your training organization for additional written attestation to provide to the State. 

Per the recent OHA memorandum, doulas trained prior to October 2019 will only be able to meet the training requirement through the State rules “legacy clause.”  The legacy clause for doulas requires evidence of attending 10 births and providing 500 hours of community work supporting birthing persons and families in the capacity of a birth doula as well as provide at least one letter of recommendation from any previous employer. The State provided some additional information in this presentation on what types of evidence they will accept to document at least 10 births and 500 hours – you may email to request additional clarifications. Please remain mindful of HIPAA when communicating specifics of past work.

Required Continuing Education 

Doulas must complete specific continuing education topics in addition to their initial doula training.  The links and resources provided below are consistently available but other CE trainings may be available elsewhere at various times and availabilities.  

Cultural competency - 6 hours total
Doula must complete at least six contact hours of additional cultural competency training. 

Trauma Informed Care, Interprofessional Collaboration, HIPAA - 6 hours total  Previously, doulas just needed a total of six hours of any one or combination of the following. Now, as of October 2022, doulas must show at least the following: 

Trauma Informed Care - 4 hours:

Interprofessional Collaboration - 1 hour and HIPAA - 1 hour: 

  • Low-cost six hour Interprofessional Collaboration training for doulas. Link to register and access trainings here. This training includes .5 hours on HIPAA & handling client privacy. This training is also required for all Legacy-contracted doulas.  
  • Free one hour online HIPAA training.
  • Any other training or combination of trainings in those categories. 

Oral Health Training Doula must show completion of an OHA-approved Oral Health Training  

  • Free 90 minute online training THW OHA Oral Health Certification ( Watch all the way to the end to claim your certificate of completion – take a screenshot to save.
  • Any other previous Oral Health Training for Oregon Doulas

Current CPR certification for children and adults Doula must show proof of current CPR certification.  

  • The State accepts any recognized CPR certification
  • In order to be a Legacy-contracted doula, Legacy requires BLS (Basic Life Support) CPR which involves both online learning and in-person skills testing.
    o First, complete the online training. Go to:, in the Find a Course box use the down arrow and click on Basic Life Support (BLS), click on HeartCode BLS (product #20-3553) - the course is payable to the AHA ($32.50) 
    o Attend a free in-person skills validation session. Email to schedule.

Attendance of three births and three postpartum visits

Doula must attest that they have attended at least three births and then three postpartum visits for those birth doula clients attended after the completion date of their doula training. Do not send in any birth or postpartum documentation to the State - this is a HIPAA violation. Sign the Birth Doula Certification Checklist and Attestations form below.

  • For new doulas, some Legacy clinics are able to work with students to support them in gaining enough experience to qualify for the THW Registry.  Please contact the Legacy Doula Program Coordinator at for more information.
  • Any three birth and postpartum clients that you acquire on your own, through a training organization, or through a local doula group.

Resource list

Doulas must also attest that they have completed a basic resource and referral list for the area that the doula serves. Since THW doulas will be serving under-resourced Medicaid clients, we recommend including and being aware of area social service resource hubs like 211info - Connect. Inform. Empower. and Rose City Resource (

Apply to the THW Registry 

Respond to the Background Check Application

One to two weeks after your THW application has been processed, you will receive an email from the Background Check Unit asking you to complete a background check application.  If you do not receive an email within one to two weeks of submitting your THW application, check your spam folder for any emails from “ORCHARDS” or “Background Check Unit.”  You must respond to this email within less than two weeks to give permission for your background check.  If you do not respond in time, your THW application is stalled and you may need to re-apply.  You will not be notified if your background check has timed out.  

Placement on the THW Registry

Once all requirements are met, you will be placed on the THW Registry and your THW certification will last for three years. Renewal application must be sent 60 days before current registry expiration. 20 hours of CEUs are required for recertification.

As of July 1st, 2022, all THW renewals will also be required to have six hours of suicide prevention as a part of their 20 total CEU hours. Here is a list of suicide prevention training resources put together by the State to assist providers in finding the necessary trainings.

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