D-O-U-L-A! When I became a doula in the early nineties I frequently spelled the word to help people who had never heard it before. I often had to explain what a doula was and how we were different than midwives. Times have changed and the doula profession has grown up. I don’t spend nearly as much time as I used to explaining that doulas provide professional labor support. It seems many people now know that we help mothers and families by offering informational, emotional, and physical support. Viewers of the tv show About a Boy watch Minnie Driver play a doula, and there have been doulas or doula references on Bones, Mulaney, Jane the Virgin, and others. Doulas might not always like how we are portrayed, but the concept of professional labor support is getting out to the mainstream public. We’ve come a long way.
Last year the American College of Obstetricians and Gynecologists (ACOG) announced new recommendations for practice that are aimed at lowering our dangerously high cesarean rate. While the World Health Organization (WHO) says that cesarean rates above ten to fifteen percent cause more harm than they prevent, our rates in the U.S. are over thirty-percent. The ACOG recommendations included the use of doulas, saying, “Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula.” Doulas are so effective at providing emotional and physical support for birthing women and their families that Dr. John H. Kennell has said, “If a doula were a drug it would be unethical not to use it.”
As a doula trainer and mentor I’ve thought a lot about how to help new doulas prepare to begin this important work. The paradox is that most of the preparation is head work. Students attend trainings, read books, observe childbirth classes. But the work of doulaing is heart work. The art is reaching into a reserve of knowledge and pulling out one simple skill. It might be applying pressure to the mom’s back during contractions, or helping her turn screaming “no” during contractions, into moaning “down.” The most important thing we do as doulas is to show up with our minds focused, our hands ready to help. We need to be ready to do a variety of different tasks, or sit quietly, holding the space, doing seemingly nothing at all.
The paradox of doula continuing education is that even as experienced doulas, there is always room for us to learn and grow, while newly trained doulas do truly know enough to begin this work. So to beginning doulas everywhere, you are enough to be of service. As Travis Smiley says, “We find our path by walking it.” And the doulas who have been practicing over this past generation are here to help you.