The Real Problem: DTI’s Response to “More Doulas Can Help Lower the Cost of Childbirth. There’s Just One Problem”

As someone who has taken an active role in the recruitment, training, and support of new doulas, I’d like to talk about why the recent post, More Doulas Can Help Lower the Cost of Childbirth. There’s Just One Problem is so concerning.

IMG_1139According to the author, Elissa Strauss, it seems doulas have a bit of an image problem to contend with. While I never enjoy hearing someone talk about getting the wrong impression of what doula support is and should be, rather than rush to our defense, we need to first acknowledge the way in which her would-be doula may have fallen short.

She reveals she did not hire a doula because she didn’t care to have what she describes as a natural childbirth agenda pushed upon her. That’s understandable.

Perhaps Strauss interviewed a doula who had not taken a comprehensive training. A good doula training program gives participants many opportunities to practice active listening skills. This is really important because it helps doulas to think outside the box of their own experiences and knowledge, and focus on the unique needs of the pregnant person.

Epidurals, planned or unplanned, have their place, and all doulas know this. Doulas advocate for compassionate care, period. We support our clients’ choices no matter what.

What strikes me as most odd about the post, is that in the same breath as she’s using to criticize doulas, the author makes a very weak attempt at discounting the recent report which unmistakably points to strong evidence in favor of more widely adopted doula care. She even goes so far as to admit, “There’s certainly logic behind the argument that doulas should become a more standard part of our often unwieldy healthcare system.”

So what’s there to argue about? From my standpoint, there really is no contest.

During a lengthy history, Choices in ChildbirthChildbirth ConnectionEvidence Based Birth and other organizations have been working tirelessly to improve the quality of maternityIMG_6002 care by conducting research and providing educational resources to childbearing families. To say that the well-documented benefits of doula care cannot be taken seriously because the profession is not centrally regulated is nothing short of an insult to the vast number of birthing people who have experienced improvements to their health as a direct result of doula care. The quest for improved maternity care clearly needs roadblocks removed, not added.

A mandate to choose one type of certification would unequivocally be a roadblock. While it’s important to talk about the ways doulas and their businesses are evolving to support modern families, it’s simply impossible to regulate something as sacred and ancient as women supporting women during birth. Doulas provide no clinical tasks; there’s simply not enough that’s technical about the job to warrant regulation. Ever.

More importantly, families need to be trusted to choose their own doulas wisely (including the option to not choose one at all, as the author did). Likewise, doulas need the freedom to choose a certification program that suits their needs. Autonomy for the person giving birth and autonomy for the doula.

As a huge supporter of my training organization, DTI, of course I could talk about the many benefits of certification and our program in particular, but at the end of the day, it’s still up to the birthing families to decide.  The consumer must always be the decider here of who is hired in the role as birth support and as advocate.  

Lastly and perhaps most importantly, I feel sad that the author had a time of need in which she was not well taken care of. It’s in these “hurricane” moments (the author’s baby was born during Hurricane Sandy), whether real or figurative, that doulas shine. And if women are choosing not to employ doula services because they perceive that we put our own needs before theirs, it’s time we do a much better job of speaking out about what advocacy truly means.

Written by Jenny Bennett for DTI