Admittedly much of the literature written on doulas does apply words such as ‘qualified’, ‘professionally trained’ and ‘certified’ to the lay childbirth companion, but this is because the vast majority of these texts are American. And the way American English is used to describe the US doula does, in many ways, make her a different entity to the UK doula.
The reason for this difference however, is because midwifery practice in the US is also very different to that in the UK. And it is the midwife-doula relationship that lies at the heart of my argument against the professionalisation of doulas.
There has always been discussion among the doula community – as the newcomers to the UK childbirth arena – about how to creatively build bridges with midwives, in the belief that this can only help towards sensitively and effectively supporting women and birthing families. While the doula’s first allegiance is to the mother and father she is working with, she is also mindful that her positive relationship with the attending midwife can play a key part in ensuring the protection of an undisturbed birth environment.
Equally, there is concern among the midwifery community regarding the increasing number of birthing mothers and couples who are enlisting doula support and how, hand in hand with Government cuts, the presence of doulas may be aiding the erosion of the role of the midwife. Why, if the UK midwife autonomously provides physical, emotional as well as spiritual care to the birthing family, should there be a need for any additional support? What can a doula provide that women and couples are not already offered by their midwife?
I make no excuse in refraining from attempting to respond to these questions here, for to remotely adequately comment on this sensitive issue deserves an evidence based paper written for another time and place. My point is not about what the doula or the midwife does or does not do in any case. Rather to suggest how insulting it might feel for the midwife, who is a professionally trained, qualified and registered practitioner, to contend not only with another figure in the childbirth arena who potentially threatens her very existence, but also with one who – further to having undertaken a course comprising of just a few days as opposed to years – deigns to describe herself as a ‘professionally trained’ or ‘qualified’ practitioner.
This is my point against the professionalisation of doulas.
I have to admit that I just do not understand why some doulas and doula organisations choose to use this terminology at all. Does it stem from the need to big-up the doula role, to make it more acceptable, more accountable, more credible? Does it come from a place of lack of confidence in the right to ‘be’ there as a non-professional support person? Or is it down to people simply not thinking through what they are saying, not considering the implications behind the words they are using? Perhaps not fully understanding the role of the midwife too?
As part of the doula community’s commitment to building bridges with midwives and maintaining harmony in the way that birthing families are supported in the longterm, I would so welcome an ‘outing’ of this issue. And I would so like to hear Doula UK, as the leading voice for UK doulas, take a much stronger position against the use of professionalised language in reference to doulas for all the reasons I outline in this post.
To end on a positive note however, much to encourage and support the coming together of doulas and midwives, to share learning, skills and knowledge of our not dis-similar yet in many ways very different roles, is already unfolding. Meetings, MSLCs, workshops and study days are providing forums for discussion and exchange, to build on understanding and to air concerns regarding each other’s roles. And I applaud those who are instigating these opportunities. Let’s keep working on it!