The first time I heard the word doula was when I was doing my reading to become a Lamaze® Certified Childbirth Educator 8 years ago. It sounded like an interesting “new” profession. I put the word new in quotations because really it’s one of those professions that are as old as time. See, in the history of human kind, women would have almost always been surrounded by other women in labour and birth. Some would have been self-taught midwives, but many were there for comfort and non-medical duties like fetching items, food, water, and helping the labouring woman with soothing touch. This is the role of the modern-day doula: non-medical physical comfort and emotional support in pregnancy, labour, birth and the postpartum period.
Many people confuse doulas with midwives. I kinda feel bad for the midwives on this one for two reasons: 1-it puts pressure on the midwives to act as doulas when they have a lot of other duties on their plates and 2-it really isn’t fair to compare the extensive education a midwife receives with the limited education and training a doula would receive (on the medical side of things). In Ontario, a province in which midwifery is legislated (regulated and covered by our health care system) midwives take 4-7 years to be able to care for all aspects of a woman’s pregnancy, birth, delivery, and postpartum period (for 6 weeks).
Many doulas wish they could do more things that midwives do: check the baby’s heart rate, check a mother’s cervical dilation (to help her decide if it’s time for her to go to the hospital), and other medical duties. I get it. I see where they’re coming from. I too have been a doula for a mother who felt like it was time to go to the hospital only to get there and find out she’s less than 1cm dilated. So discouraging…and then there’s often no turning back. I too have had times where being able to do those medical things could have been beneficial, but I chose not to become a midwife. I chose to be a doula. The doula role doesn’t include those duties. The most important reason why is because we haven’t had the extensive education – theory as well as practical – that midwives have had to interpret those results. Labour progress is about a lot more than a number of cms. A baby’s well-being is about more than a heart rate between 120 and 160. What more is there? Well, I wouldn’t know because I’m a doula, not a midwife.
The doula role is really so perfect: supporting a woman without judgment of her choices in a non-medical way. That is so wonderful all on its own. I feel sorry for the doulas who can’t seem to find that enough. It IS enough ladies. It’s perfectly enough.
When doulas overstep their role, they hurt everyone. They think they’re “saving” the woman they’re supporting, but they’re really doing irreparable harm to the next woman who won’t be able to have a doula because the hospital she wants to birth in has banned them. She won’t help one bit to advance people’s trust in ‘normal birth’ because she will have turned the other professionals against us.
I am an activist and a feminist at heart, but I leave those hats at the door when I enter a birth room. There I am a doula. That is all I need to be in that moment. I will definitely be an activist in other moments, more appropriate times. For the woman who has hired me though for her birth, I’m a doula…because that IS enough.
