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UK ‘brand of doula – the lay role, why professionalise it?

“The UK is one of the first countries beyond North America to have wholly embraced and adapted its own ‘brand’ of doula on a nationwide scale. Yet while the UK doula is to an extent modelled on that of the US, there are fundamental areas of definition where their characteristics differ, importantly around issues concerning qualification and status.
Described as ‘professionally trained’ (2) and ‘certified’, suggesting that she has acquired ‘qualified’ and ‘expert’ status, the terms used to describe the US doula present a conundrum in view of UK understanding of her lay status. As Penny Simkin explains however, this may be partly due to semantics: in the US, the term ‘professional’ is more likely to mean someone who works ‘in a professional way’, someone who is ‘reliable, honest, ethical’, whereas in the UK it is more often used to describe someone who is ‘a professional worker’, such as a midwife (3). Although the term ‘training’ is mutually understood within both cultures to represent a ‘prolonged period of study leading to professional qualification’, it is nonetheless used to describe the period of preparation undertaken by doulas on both sides of the Atlantic, regardless of its lack of clarity and consistency. This in itself is perhaps misleading to the UK public who might not unreasonably assume that if the doula is ‘trained’ she must be a ‘qualified, registered professional.”

“The difficulties with professionalising the role of the doula in the UK is additionally complicated by the autonomous status of UK midwives, who feel that the provision of emotional and spiritual support lies as much within their scope of practice as physical, clinical care (13). Furthermore, as Australian midwife Fiona Bogossian discovered, while the US doula’s scope of practice can include performing clinical interventions such as vaginal examination, in the UK, this procedure falls strictly under the midwife’s clinical remit and for a doula to undertake such a task would be deemed unlawful (14). The rationale behind UK doula courses consisting only of days, maybe weeks, rather than months or years, of preparation, perhaps therefore reflects the pertinent question, what exactly is the doula being ‘trained’ for? And indeed, if not professionally trained, why is there any need for her to be ‘certified’ or ‘registered’? When under scrutiny therefore, and in UK understanding, I would suggest that the doula’s lay status inherently means that she is not professionally trained, qualified or certified/registered, for indeed, if she were, she would surely be some kind of midwife? And in view of this, I would stress that the professionalised attributes used to describe the US doula’s qualification and status cannot, and should not, be directly transferred and applied to the UK doula.”

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