What is a Doul-a and What Do We Do?

When I first heard the term doula, I literally spoke the words: “a what-nah?” Fast forward two years and here I am: a practicing doula. The term ‘doula’ is ancient Greek and roughly translates as “a woman who serves.” For a professional movement that aims to empower, advocate and offer caring, non-judgemental support during pregnancy, birth, and the postpartum period, this definition, while providing the gist, falls short. (Oh, and there’s no rule that men can’t be doulas.) If you don’t know about doulas, or if what you do know makes you scratch your head in confusion or suspicion, do me this favour and bear with me as I hopefully debunk some common myths and share what I know to be true about the doula role.

A common doula image has been the hippy-dippy, placenta eating type (while the healing benefits of this practice can be argued) the bottom line is that doulas do not force-feed their clients placentas, a myth that can create real barriers to doulas being taken seriously in broader systems of care – someone who wafts into a room ripe with patchouli oil and is dismissive of doctor’s orders.

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Art courtesy of the author, Rachel.

Here are some frank but concise things to know: 1) if a doula has been trained well, they will know the role is not a clinical one, and 2) that while a ‘hippy-dippy’ approach is often scoffed at, it seems clear that our culture is starved for what might better be termed ‘holistic care.’ I feel lucky to have attended births where medical staff and holistic practitioners worked symbiotically. The outcome was stunning. Our mutual respect and willingness to complement each other’s roles disproved the notion that ‘medical births’ and ‘natural births’ must be separate entities. This type of bridging is one of a doula’s most astonishing tasks and achievements. The doula’s role is that of an impartial diplomat, offering translations, support and conflict resolution if tensions may be running high. A doula also runs interference between expectant parents and well-meaning but occasionally overbearing family members.

Through intuition and experience doulas learn when to speak and when to be silent. The world of birth is a political one. Are you using an OB or a midwife? Will you breastfeed or bottlefeed? Drugs or no drugs? Unless you are some astonishing superhuman, becoming a parent and, of course, giving birth are both daunting and transformative experiences. While the array of alternatives are a privilege, they can be overwhelming. Amidst a sea of opinions, procedures, and adrenaline – the most important focus of the doula is to seek the mother’s voice. While it seems like common sense to say a mothers voice and agency must be heard in the birthing culture and process, the maternity field has been historically male dominated.

Doulas stand by you, start to finish. Once the baby has arrived doulas are there to squeeze your hand and assure you that while you haven’t slept in days, and have literal baby poop in your hair – you are doing a great job. It’s guaranteed that there is some other parent going through the same insanity with even more baby poop in their hair. Yes, it’s okay if you and your partner are struggling or feeling distant. Yes, it’s normal that you haven’t bounced back and the house is a mess. You are allowed your feelings. A new life that you are entirely responsible for has entered the picture – and it’s rocking you. You are entitled to every ounce of extra support, forgiveness, and understanding. Doulas don’t go anywhere, and this is key. The bond that they form is unlike any other. It is fast, deep, and all-encompassing. Doulas work from the heart to earn the privilege of sharing this intimate time and bearing witness to your experience, start to finish.

Statistically, if we’re going to number crunch, it’s this piece of service that dramatically alters the numbers. Women are “statistically more likely to feel less pain when a Doula is present” (Dekker, 2013). In addition, this continuous labour support lowers the likelihood of labour inducing drugs like Pitocin by 31%, the risk of C-section by 28%, and a 34% decrease in dissatisfying birth experiences (Dekker, 2013). By lowering the use of drugs, interventions, and fear we increase women’s confidence in their ability to birth. This being said, no birth is the ideal. Doulas aim to dispel any stigma or negativity around the many ways babies come into the world. Vaginal births are great, but what is greatest is a healthy mother and baby. When risks or complications arise, modern medical interventions are a blessing. Whatever way birth comes to a mother doulas are there to celebrate it and ensure informed choice.

Not every parent will be fortunate enough to have support networks. Some mothers are embarking into parenting on their own, with any number of additional challenges or obstacles. Doulas considering birth and pregnancy through a reproductive justice lens are now supporting mothers who may have to make the difficult decision to terminate. Whatever the situation, doulas have a unique presence in that they provide impartial companionship and guidance. It is a doula’s duty to be informed on everything and anything birth and family related, and as it’s a paid service (though some doulas also volunteer), you can reach out for any reason, at any time,  guilt-free. Doulas are there to listen, whatever the topic. They know it is possible to rage and flounder while still moving forward.

The ultimate term of care, the most radical expression (in my opinion) that doulas utilize unlike anyone else is ‘holding space.’ It seemed undefinable at first, a term I know my fellow peers and I grappled with. There are endless discussions of how we would ever convey this ideology as a practical, marketable skill to our future clients. In the short time I have practiced, and the few births I’ve been privileged enough to attend, I’ve come to better articulate what this term is. Holding space is the subtle service of sitting in discomfort, welcoming it even. Doulas grip that mother’s wild gaze as her eyes pool with something between fear, pain, and elation. To meet her there – not to remove her from that raw place she has gone to, but to assure her it is safe to stand there, and that she doesn’t stand alone.

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Photo courtesy of the author, Rachel.


RACHEL is (you guessed it) a doula and perpetual student. She battles with ‘writers stage fright’ despite her perpetual infatuation with words, especially storytelling. She thinks humour paired with raw and heartfelt experience is an unbeatable combo, and that connecting through weird and wild stories is at the heart of social change.   

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One response to “What is a Doul-a and What Do We Do?

  1. I loved having my midwife as a doula during the birth of my 4th child in the hospital. My 3rd was “caught” by said midwife at home, but after a health scare late in my 4th pregnancy, my husband and I chose to forgo a home birth and I was admitted to the hospital. My midwife talked my husband through the crowning process and the catch all the while my OB just sat back with his staff just in case they were needed. My husband had to slide the cord off my daughter’s shoulder and he help turn her a bit as he was the first contact she had with this world. It was amazing and I am so glad for the collaboration.
    I would like to mention that some may wonder why a woman would need someone other than their significant other or mother. My husband was so wrapped up in the emotions of the experience as well as my pain that he didn’t think of some things, such as turning the lights down a bit, or needing an extra pillow. As well as the hospital environment being a bit intimidating. My doula was able to remind the staff that we would wait for the cord clamp and that we wanted immediate skin contact. While my husband and I were enjoying our new baby, my doula was essentially my voice with the staff. I would recommend a doula any day of the week.

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