doula zoe etkin sitting in room wearing polka dot shirt
Birth covid 19 doula doula training memphis doula Parenthood Pregnancy

Is Fear Your Methodology?

woman who is a doula sitting down with arms out, hands together. wearing white and black polka dot shirt in a room

As I am building the vision of Embodied Doula Trainings, mentoring doulas, and navigating my own doula career, which is now nearly a decade long, it’s becoming clear to me how fear has come to rule (maybe always ruled?) the land of doulas (and other birth workers). As supporters of birth, and especially supporters of births in hospitals and in America, I believe many of us work from a foundation of fear, and that fear gets perpetuated, like generational trauma, throughout each new generation of birth pros. How can we then, being built into this fear system, support birthing people in confronting or overcoming their fears in pregnancy, birth, and postpartum? The answer is, what we are doing, and the paradigm of fear we are working within, is not working.

The dominant narrative around doula work is fear-based. If we have trained with some of the old school training orgs, we received messages such as, “Don’t speak to nurses and doctors directly, only speak to your client,” “If you say the wrong thing [or anything], you’ll get kicked out,” “If you do the wrong thing, the hospitals won’t let any doulas in,” “You’ll have to bite your tongue a lot as a doula,” “Never undermine your client’s confidence in their care provider [no matter what you know about them],” and more. There is fear of advocacy, fear of activism, fear of fitting into the medical industrial complex in order to slide by, unnoticed. In many ways, these fears are understandable. It takes incredible strength to stand up to a system as deeply rooted and culturally engrained as hospital based obstetrics. Most doulas receive little to no training on how to artfully advocate for their clients’ rights (both patient and human). Personally, I still feel ill-equipped to navigate it, especially in the South, where respect of patient rights are far from centered.

Thankfully, there are a lot of people working in the birth world who counter this narrative of “the good doula.” But I see the fear mounting among those who are invested in the old way. They know their power is slipping, that doulas are waking up to the ever-changing dynamic of our work, and that we have to evolve, lest we become obsolete. The old way is obsolete. It doesn’t work. I hear more visionary doulas pointing this out and my whole body screams in agreement! Doulas have existed for decades and the proof, as they say, is NOT in the pudding. We have done little to change the system within which most people birth in this country. On an individual level, of course doulas do good work and offer valuable support to their clients, not saying that we don’t, but the fear methodology has kept doulas working at the “bedside” and not for larger, systemic change. And when I speak in these general terms, I primarily mean white doulas, and I primarily mean doula organizations that were founded between the 70s-90s, and still have a stronghold on training new doulas today.

The past year, and COVID-19 (and its accompanying restrictions on doula hospital access… and all that came with that…), has highlighted even more the need for doulas. Families facing childbirth and parenting during this pandemic need more support, more familiarity, more feelings of connection that are being stripped from them for necessary and (to my mind) unnecessary reasons. Doulas have shown up in big ways to help families navigate birth and new parenthood in an incredibly isolating, scary time. I’ve seen some great strides in some communities to get doulas back into hospitals, and yet, the “biggest” doula orgs in the country did nothing to help. Let their purported power and influence go to waste when we as individual doulas have been struggling to survive, to show up for our clients, to figure out what “virtual” doula work looks like, etc.

It comes back to fear. Fear of rocking the boat. Of not being “good girls,” though we know not all doulas are female-identifying. Fear of change. Because they see us new/newer doula orgs out here working hard to teach advocacy, anti-racism, affirmation/inclusivity, real business skills, burn-out-prevention, and more, and know that it is dismantling, nay, crumbling their very beliefs, their very being. Doing the work to create EDT, to train doulas to be successful business owners who not only skillfully and compassionately support their clients and community, but work for bigger change, is hard. It’s taxing. I am exhausted already and we’re just at the beginning. But it is worth it. Every student doula, every client, every childbirth class, every utterance of “you are a human being, you have rights, you can say no, I will say no with you,” is doing something positive, something needed. A propeller forward.

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