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Writer's pictureKat Thompson

Behind the Scenes: Unveiling the Controversies, Misunderstandings, and Complaints Surrounding Doulas

Saddle up! This is a big one…I can’t always have positive blog posts about Doulas or support professionals. I want to be able to provide you with as much information as possible and not just gloss over some of the negatives that you may have heard.


So, let’s get into it…


While doulas play a valuable role in providing emotional, informational, and physical support, there can occasionally be controversies, misunderstandings, or complaints between doulas, medical professionals, other doulas, and even with terminology.


Firstly, controversies:

Some common controversies include issues related to the scope of practice, conflicts with medical professionals, and concerns about adherence to evidence-based practices. These controversies arise from differing perspectives and opinions about the role of doulas in the process and the potential for interference or misinformation. It is important to note that these controversies do not represent the views of all doulas and that many doulas work collaboratively with healthcare providers to provide holistic care to individuals.


Secondly, misunderstandings:

There are a few common misunderstandings about doulas that are important to address. One misunderstanding is that doulas are in direct conflict with medical professionals or aim to replace them. In reality, doulas work alongside medical professionals and complement their care by providing emotional support, advocacy, and personalized attention to that person, their partner(s), and their family.


Another misunderstanding is that doulas only support natural or unmedicated births. While many doulas do have expertise in supporting natural births, they also provide valuable assistance and guidance during medicated births, cesarean sections, and other interventions. Doulas adapt to the individual needs and preferences of the birthing person and provide support regardless of the birth plan.


Yet another misunderstanding is that a doula is either a Birth or Postpartum Doula or both and there's no other type of doula out there. This is a hurtful misunderstanding and it should be recognized that doulas work in all different aspects of a person's journey, not just labour, birth, and postpartum. To say doulas only operate in the birth and postpartum world only devalues and excludes the wealth of knowledge and experience, and, in some cases, training and certification in other areas that you may need our services. To learn more about different doulas, check out my previous blog post titled: The Doula Directory.


Overall, it is essential to have accurate information and understanding about doulas to fully appreciate their role and the benefits they can bring to your experience.


And lastly, complaints:

Some complaints that medical professionals may have with doulas include:

Scope of Practice: Doulas are not healthcare providers, and their role is distinct from that of medical professionals. Occasionally, there may be instances where the scope of a doula's practice overlaps with medical tasks, leading to confusion or potential conflicts.


Overstepping boundaries: In some cases, doulas may be perceived as overly assertive or intrusive, crossing boundaries that should be maintained between the doula, medical professionals, and their client/patient or family.


Conflicting advice or interference: Doulas might provide suggestions or advice that contradict medical recommendations or interfere with the care provided by medical professionals. This can create confusion or tension between the doula and the medical team.


Lack of medical training: Doulas do not have medical training and their role is to provide emotional, physical, and informational support, rather than medical expertise. Some medical professionals may express concerns about doulas offering medical advice or information beyond their scope of practice.


Disruption of the medical environment: In busy hospital settings, the presence of a doula might be seen as an additional person in the room, which can impact the workflow or dynamic between medical professionals.


Advocacy: Doulas are advocates for their clients, ensuring their preferences and desires are respected and communicated effectively. While this can foster a positive and empowering experience, there can be instances where it may clash with medical protocols or decisions.


Communication and Boundaries: Effective communication between doulas and medical professionals is essential, but challenges can arise when there are differing opinions, miscommunication, or a lack of clarity about roles and responsibilities.


It's important to note that these complaints are not universally applicable and that many medical professionals appreciate the valuable support doulas provide. Open dialogue, mutual respect, and a clear understanding of respective roles can help foster a collaborative environment that prioritizes the well-being of the person and their journey’s outcome.


Alright, you made it through all of that, but let's not stop there. What about concerns or complaints doulas have about other doulas?


It is not uncommon for some doulas to have complaints or concerns about other doulas. These concerns can vary and may include issues related to professionalism, ethics, scope of practice, or disagreements about specific approaches or techniques. Doulas, like any other profession, can have different perspectives and approaches to their work, which can lead to disagreements or conflicts within the doula community. However, it's important to note that not all doulas have complaints or concerns about others, and many doulas work collaboratively and supportively with their colleagues.


Let’s break down some of these complaints or concerns that some doulas may have….


Differences in Scope of Practice:

Doulas can have different scopes of practice based on their training, certifications, and personal preferences. Some doulas primarily focus on providing emotional and physical support, while others may also offer support during the prenatal and postpartum periods. Additionally, doulas may specialize in certain areas such as fertility, pregnancy loss, breastfeeding, or specific birthing techniques. The scope of practice can also vary in terms of the level of medical knowledge and interventions a doula is comfortable with, as well as their ability to provide informational support and advocacy for their clients. It's important to communicate with a doula directly to understand their specific scope and whether it aligns with your needs and preferences.


Differences in perspectives and approaches:

Doulas can have different approaches to their profession based on their personal beliefs, training, and experiences. Here are a few examples of different approaches a doula may have:


Holistic Approach: Some doulas adopt a holistic approach, focusing on the physical, emotional, and spiritual aspects of your journey. They may emphasize natural and non-interventionist approaches and promote a sense of empowerment and self-advocacy for their clients.


Advocacy Approach: Doulas who take an advocacy approach prioritize advocating for their client's rights, choices, and preferences. They may help clients navigate the healthcare system, provide information and resources, and ensure that their clients' voices are heard and respected.


Evidence-Based Approach: Doulas who follow an evidence-based approach emphasize the use of current research and evidence-based practices in their support. They stay updated on the latest research and recommendations and provide information and support based on the best available evidence.


Cultural or Spiritual Approach: Some doulas integrate cultural or spiritual practices into their support, taking into account their client's cultural background, traditions, or spiritual beliefs. They may incorporate rituals, ceremonies, or specific cultural practices to create a meaningful and culturally sensitive experience for their clients.


Collaborative Approach: Doulas who take a collaborative approach work closely with their client, their partner(s), and the healthcare team to create a cohesive and collaborative care environment. They aim to foster effective communication, build trust, and promote a positive and respectful atmosphere for all involved.


It's important to note that these approaches are not mutually exclusive, and doulas may incorporate elements from multiple approaches in their practice. Each doula brings their unique perspective and expertise, tailoring their support to the individual needs and preferences of their clients.


Differences in techniques:

While doulas generally share a common goal of providing support and care to individuals and families, there may be disagreements or differences in opinion regarding specific techniques or approaches. These disagreements can stem from variations in training, personal beliefs, or professional experiences.


One last concern that I will mention that I have heard is terminology. Such as using Mother's Helper, Birth Worker, Practitioner, etc instead of a "Doula". Let's look at that for a moment:


There can be variations in terminology used within the birth and reproductive support field. While the term "doula" is widely recognized and commonly used, some practitioners may choose to use alternative terms such as "birth worker," "fertility practitioner," or "mother's helper" to describe their role and services. These alternative terms may reflect the specific focus or emphasis of their practice or align with their personal preferences. However, it's important to note that regardless of the terminology used, the core essence of providing support, guidance, and advocacy to individuals and families remains consistent.


Postpartum Doula vs. Mother's Helper

There are differences between a Postpartum Doula and a Mother's Helper in terms of their roles and responsibilities. Here's a general distinction:

  1. Postpartum Doula: A postpartum doula is a trained professional who provides physical, emotional, and informational support to families during the postpartum period. Their primary focus is on assisting the new parents and promoting their well-being and adjustment to parenthood. Postpartum doulas offer practical help with newborn care, breastfeeding support, light household chores, meal preparation, and emotional guidance. They provide evidence-based information and resources, offer non-judgmental support, and help nurture a positive postpartum experience for the family.

  2. Mother's Helper: A mother's helper assists a mother or parent in their childcare duties. They work under the supervision of the parent and provide support with tasks such as babysitting, light household chores, running errands, or playing with older siblings. Unlike a postpartum doula, a mother's helper may have less training or experience in newborn care or postpartum support.

While both postpartum doulas and mother's helpers can provide assistance to families during the postpartum period, the level of expertise, training, and the scope of their responsibilities may differ. Postpartum doulas are specifically trained to offer comprehensive support to new parents, while mother's helpers generally provide more general assistance and often work under the guidance of the parent.

Fertility Doula vs. Fertility Practitioner vs. Fertility Specialist

There can be differences between a Fertility Doula, a Fertility Practitioner, and a Fertility Specialist, although the specific roles and responsibilities may vary depending on individual practices and contexts. Here's a general distinction:

  1. Fertility Doula: A fertility doula is a trained professional who provides emotional, informational, and practical support to individuals and couples navigating their fertility journey. They offer compassionate guidance, education, and advocacy throughout the process, addressing emotional well-being, self-care, and coping strategies. Fertility doulas often focus on the emotional and psychological aspects of fertility challenges, offering support during fertility treatments, miscarriage, or pregnancy loss.

  2. Fertility Practitioner: A fertility practitioner may refer to a fertility doula that has additional specialties within the healthcare or support care profession, such as counselling. Or it can also refer to a healthcare professional specializing in reproductive medicine, such as a reproductive endocrinologist, fertility specialist, or fertility nurse. They have specialized medical training and qualifications to diagnose and treat fertility issues. Fertility practitioners may provide medical interventions, such as fertility testing, fertility treatments (e.g., assisted reproductive technologies like IVF), hormone therapies, and surgical procedures.

  3. Fertility Specialist: A fertility specialist often refers to as a reproductive endocrinologist, is a medical doctor who specializes in the diagnosis and treatment of fertility issues. They are trained in reproductive medicine and can provide medical interventions, such as fertility testing, assisted reproductive technologies (ART) like in vitro fertilization (IVF), hormonal therapies, and surgical procedures to help individuals or couples conceive.

While you may find Fertility Doulas and Fertility Practitioners use these terms interchangeably, generally, Fertility Practitioners have more knowledge and training in supporting individuals and couples in their journey to conceive. In either profession, both play very important roles in supporting individuals and couples dealing with fertility challenges. Their primary role is focused on providing emotional support, helping individuals navigate the emotional and logistical aspects of fertility struggles, and complementing the medical care provided by Fertility Specialists. Fertility Specialists provide medical diagnosis, treatment, and interventions and hold medical degrees specialized in the field of fertility.

Birth Doula vs. Birth Worker

The terms "Birth Doula" and "Birth Worker" are often used interchangeably and can refer to the same role. Both Birth Doulas and Birth Workers provide support to individuals during the childbirth process. They offer emotional, physical, and informational support to pregnant individuals and their families before, during, and after labour and delivery.

The term "Birth Doula" is more commonly used and recognized in the doula community. It specifically refers to a trained and experienced professional who assists individuals during childbirth. Birth doulas provide continuous support during labour, including comfort measures, advocacy, and guidance. They work alongside healthcare providers to ensure the birthing person's needs and preferences are respected.

On the other hand, the term "Birth Worker" is a broader term that can encompass various professionals and individuals involved in supporting birthing individuals. It may include not only birth doulas but also midwives, nurses, childbirth educators, lactation consultants, and other professionals who provide care and support during the childbirth process.

While the terms "Birth Doula" and "Birth Worker" can be used interchangeably, "Birth Doula" is more specific to individuals who provide dedicated support during childbirth, while "Birth Worker" can encompass a wider range of professionals involved in the birthing process.

I'm glad you made it to the end. That was a lot to digest. I hope this is helpful to you and your journey.


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