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WHAT IS A DOULA?

A SisterCare Village discussion of why doulas matter to Black women



The History of Doulas


The term “doula” was coined in 1969 by Dana Raphael, an American anthropologist (The New York Times, 2016), to describe a competent woman who supports a pregnant woman through the course of her pregnancy (before, during, and after). A doula provides emotional support and coaching to pregnant women and their families and serves as a supplement to other health care providers involved in pregnancy and birth. Doulas ultimately act as birth advocates for the pregnant woman as she and her family undergo the life-changing experience of having a baby.


The need for such a woman emerged during the natural birth movement in the 1970s. A period marked by women’s dissatisfaction with the rising rates of cesarean sections and hospital births. Expectant mothers began to seek non-medical interventions and invited female relatives or friends with knowledge of childbirth to provide emotional support and guidance, as well as advocate for them in preventing procedures that could lead to a cesarean delivery.



Doulas gained popularity in the 1980s to address women’s need for birth care, and by 1992, the non-profit organization Doulas of North America, subsequently renamed DONA International, was established, becoming the first to instruct and accredit doulas. DONA International defines a doula as:


“a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible.”

(DONA International, 2018)



Significance of Doulas in Black Culture

The concept of having a birth attended by a woman with similar characteristic of a doula is not a foreign concept in the African and African American culture. At one point in American history, these group of women were known as Granny Midwives, not to be confused with the modern midwives who are trained health providers. In understanding the role of Granny Midwives, it is important to note that the practice of midwifery has existed long before the establishment of hospitals as birthing spaces. In America’s history of enslavement of Africans, experienced midwives were very much a part of the enslaved people who lived through the middle passage and continued their birth work even in enslavement. These early American midwives were important parts of society, attending the births of fellow enslaved women as well as attending the birthing process of white women. These African American midwives began to be identified as “Granny Midwives” in the periods after emancipation (National Museum of African American History and Culture, 2022). They continued to attend the births of both black and white women in various parts of the South as hospitals were still inaccessible.


Contemporary doulas play a similar role that Granny Midwives played in the lives of Black women many centuries ago. Although doulas typically do not deliver the baby, they are able to help guide a pregnant woman through her pregnancy journey as was expected of Granny Midwives. Today, more Black women are opting for Black doulas to help counter the higher Black infant and maternal mortality rates faced in the Black community. For many Black pregnant women, a Black doula is viewed as someone with whom they have a shared history (of being Black in America), someone that they can connect with, and thus someone who can understand and validate their shared experience as African Americans.



Black doulas tend to root their service provision in addressing and undoing the intergenerational trauma of racism and subjugation of Black women rather than gloss over it by an otherwise unaware non-Black, and/or non-woman maternal care provider. The utilization of these Black doulas may help us begin to realize a reduction in Black infant and maternal mortality rates, significant decreases in adverse health outcomes for Black pregnant women (e.g., pregnancy-induced high blood pressure and diabetes), and tackle the issue of social isolation and depression that many pregnant Black women may experience. All in all, Black doulas can serve as both literal lifesavers and vessels of empowerment for Black pregnant woman.



References

  1. DONA International. (2018, December 5). What is a Doula. https://www.dona.org/what-is-a-doula/

  2. National Museum of African American History and Culture. (2022). The historical significance of Doulas and midwives. https://nmaahc.si.edu/explore/stories/historical-significance-doulas-and-midwives

  3. Papagni, K., & Buckner, E. (2006). Doula support and attitudes of intrapartum nurses: A qualitative study from the patient's perspective. Journal of Perinatal Education, 15(1), 11-18. https://doi.org/10.1624/105812406x92949

  4. The New York Times. (2016, February 20). Dana Raphael, proponent of breast-feeding and use of Doulas, dies at 90. The New York Times - Breaking News, US News, World News and Videos. https://www.nytimes.com/2016/02/21/nyregion/dana-raphael-proponent-of-breast-feeding-and-the-use-of-doulas-dies-at-90.html?smid=url-share



Written by Kayla Fomengia (UMBC Shriver Center Intern, 2022)


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SisterCare Village is The Aafiyah Project's maternal & child health platform with the goal of making pregnancy and childbirth safe for Black women through education and information sharing in our discussion series, webinars, blog posts etc.


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