In response to the crisis of racist disparities in maternal mortality, many activists are pushing for increased access to birth doulas for Black women. As states and municipalities respond by incorporating doulas into hospital settings with increasingly common requirements for doula certification, it is more important than ever to investigate the role of doulas, and how that role might change under the medical model of birth within US hospitals. Will activism for doulas turn into arguments for the “right” to a doula? Without the full privileges of citizenship—will the most marginalized women be left out of that right despite their health and safety being at the origins of the activist struggle? To investigate these questions, we can look to the history of midwives in the United States, and examine how the midwifery model of childbirth changed as activists fought for increased access to midwives to improve birth outcomes.