Doulas

Traditionally, a doula was a woman who assisted in childbirth and aftercare. Doula, a term coined in 1976 by medical anthropologist Dana Raphael, originally referred to an experienced mother who assisted new mothers, particularly with breastfeeding and newborn care. Today, doulas, who may or may not have given birth, provide nonclinical, nonmedical physical, emotional, and informational support and advocacy for women before, during, and after childbirth, at home and in hospital. This care work is often referred to as “mothering the mother.” Women have always participated in childbirth; however, when hospital birth, presided over by male physicians with the assistance of female nurses, became the standard practice, lay support during childbirth was not allowed or welcomed.

The work of doulas is growing internationally. Childbirth International, an organization that trains doulas in 68 countries, reports that the work of the doula in areas new to doula care includes informing local caregivers and pregnant women about the doula role as well as about less interventionist, more natural childbirth practices. Trainers are required to provide a culturally informed perspective in their training of doulas and in their advocacy for increasing doula participation in these areas.

Within a social model of childbirth, prior to male-dominated obstetrics, women gave birth at home with the assistance of female family members and friends, as well as from midwives. After birth, these women offered continued support to the new mother. This [Page 424]is still the case in locations where medical assistance for childbirth is inaccessible. In the early 20th century, with a growing dominance by medicine, a medical model of childbirth, managed by male physicians, replaced the female-assisted social model of childbirth. As a reaction to the intensification of medical technology and intervention, and depersonalization during pregnancy and childbirth, in the 1980s, child-bearing women began seeking out other women for social and emotional support. Also around that time, midwifery became increasingly regulated and medicalized, further contributing to the demand for lay support from other women in and around the time of childbirth.