.png)
(No, they did not ask me to write this:)
After interviewing two doulas and reading over fifty birth stories, personally, I am convinced that doulas provide an unparalleled and vital service. There are many benefits to having a doula, including better health outcomes, decreased rates of cesarean, and critically needed advocacy. In addition to the statistics, I hope to communicate all the reasons for having a doula that cannot be captured in numbers.
I. Unparalleled Intentionality
The work of the doulas I have met reflects extreme intentionality. I’m sure we’ve all met the kind of person who would meticulously put together a slide presentation or art project, not because they thought it would bring them any acclaim, but because they cared deeply about what they were doing and the people it might affect even if those people could be counted on one hand. That is the kind of soul I think lives in many doulas. I see it in Mel’s use of birth journals, describing far more than which medical intervention was used at what time, etc. They describe emotional shifts, relationship dynamics, non-medical markers of progress, the effectiveness of different practices in aiding pain and progress, what helped or got in the way of connection to the baby, etc. These observations, and doulas’ intentional responses to them, make doula care unique: they recognize the whole of you, not just the physical you, and the parts of your birthing process that cannot be measured by technology or examinations. Mel described to me how important it is for people to process their birth stories, and described how they try not to change how someone remembers it. That is one example of how doula work recognizes that the pain of birthing people, particularly people of color, is often “overridden, is ignored, is denied, or most frequently, is sidetracked, deflected, and replaced with some other definition of reality.”(1) It reflects the “clear belief within doula culture that a [person’s] experiences of [their] body need not be observable or quantifiable in order to be true or valid.”(1) If someone remembers being cold, they were cold. If someone pushed in agony for hours on end but remembers their childbirth as a joyous miracle, it was a joyous miracle darn it.
Doulas also recognize that every birthing person and team comes in with their own history and needs. As a result, much of the intentionality is assessing what that person needs and tailoring communication, resources, birth plans, etc. to the person – less in a consumerist way and more in an “I know you, so I’m not going to give you a carbon copy of what I gave the last person” kind of way. This practice extends to fertility, birth plans, parenting strategies, postpartum family dynamics, etc. The combination of experience, knowledge, and a willingness to meet you wherever you are, creates a truly unique environment of care that can provide you with what you need. It breaks down the all-too-common implication that there is a “standard” birthing story from which others “deviate” because it honors how vastly different the beginning, middle, and end are for each birth story.
2. Jack of all trades
A doula’s day-to-day work can cross several fields. All in one job, they can teach about biology, teach about childcare, analyze data, run an independent practice, help navigate relationships, read emotions, organize gatherings…, and then there’s everything they do on the “big day”. Doulas offer informational support to partners and birthing people on a client-by-client basis and by teaching classes like EBB classes, Birthing from Within, baby-wearing, or comfort and coping classes. In addition to providing the information, they take the "lifelong learner" phrase seriously, researching and responding to the changes in what clients are told by providers or what media is proposing as best practices and products. When navigating hospital relationships, Carly Ann, a full-spectrum doula in Chicago, noted that she changes her approach to advocacy based on the provider to preserve whatever dynamics will allow her client's voice to be most amplified. This is a result of the fact that, in hospital settings, doulas “constantly serve as a bridge between the desires of birthing women and the protocols of the medical system in which they practice.” Even with all the many tasks and titles that go into doula work, there is one centralizing factor: they are doing it to honor you, the baby, and the miraculous process of life-giving involved in childbirth.
3. Principled in Beliefs about Social Justice and the Power of Community
Like many professions, there is a range of philosophies and practices within doula work. However, with Mel and the other doulas I have met, one thing is certain: this might be the most truly client-focused profession out there. No tricks, no gimmicks. Doulas have a calling to care for people, and they can follow it wholeheartedly because of the unique structure of doula and midwifery work that, while it has to operate under capitalism, lies outside of the institutions and professionalism that make it hard to integrate a care ethic thoroughly. Doulas provide continuous and personal care unseen elsewhere. They have intentionally chosen a job where their timetable, duties, and responsibilities are determined by you and your soon-to-be little one. Through pregnancy, childbirth, and postpartum, while checks-in with a provider may center around the physical health of you and the fetus, doulas check in about physical healing and…everything else.
In addition to this care, the way doulas describe their profession seems selfless, springing from a strong understanding of our current situation, and strong belief in community as a remedy. All three doulas I have met relayed the belief that hopefully, one day, their job would be obsolete or at least less necessary, as families and communities could rally behind birthing people, provide the needed support (including partners helping with postpartum care rather than having to go back to work, for example). As Carly Ann aptly put it, it is a “capitalist solution to a capitalist problem.”
Doulas are not just agents of change concerning the overmedicalization of birth, but also often combat issues regarding race, class, gender, and sexuality within the hospital and beyond it, crafting their practices to reflect these values. Beyond that, their profession by nature combats the individualism and lack of community care that has made childbirth even more difficult over the years. This belief includes their own recovery after births, (although we as community members should do a better job of rallying behind birthworkers through this process). Doulas also emphasizes the mind-body connection, which on the face of it may not seem like a particularly new or revolutionary idea, but yet it seems many of us still “‘walk around every day pretending that we don’t have bodies.’”(1) Reflecting on witnessing empowering birth experiences, one doula in a research paper noted: “I see [my clients] change. I see them get bigger and stronger in their bodies. They heal from old wounds. They live the rest of their lives with the knowledge that they are powerful. It is a gift and an honor to be a witness to this.'”(1) Doulas witness, teach, and facilitate a transformative societal shift toward embracing the existence and power of bodies, one birth at a time. In ideology and in practice, doulas are bringing us toward a better world one push at a time ;)
The philosophies of care that underlie doula work acknowledge emotional, intellectual, physical, and social well-being as necessary ingredients to health, and therefore a healthy birth. Consequently, their practices, resources, advice, etc. include all of these elements, recognizing that they largely spring from relationships built through continuous and familiar care. I think you’d be hard-pressed to find any profession like it. Doulas will be the first people to tell you to schedule interviews, ask for resources, and make the decision that feels best for you. As someone who has been invited into the world of doula-ing over the past few months, I’ve got to tell you, I’d get in on this action!
Comments