Welcoming a new baby begins long before labor, and it starts with building a trusted care team. Members of this team may include OB/GYNs, midwives, doulas, and lactation consultants, each of whom plays an essential role in supporting the birthing person from prenatal to postpartum. Despite their equal importance, OB/GYNs and doulas are often viewed as separate or even competing parts of maternity care, when in reality they share a common goal: supporting birthing individuals as they bring a new life into the world.
Building a Strong Birth Team
The main distinction between the two lies in their clinical training. Doulas serve as non-clinical advocates offering physical and emotional assistance throughout the birthing process, whereas OB/GYNs function as clinical practitioners responsible for surgical interventions and the management of complex, high-risk pregnancies. Sometimes these differences in certification and training can cause these health professionals to operate in silos rather than as a collaborative team. There is an opportunity to bridge this gap between doctors and birth workers by addressing the biases that shape their perspectives of one another. Bringing true unity to the care team requires that doulas and OB-GYNs understand and respect each other’s roles, ensuring the best outcomes for both the patient and baby.
Recognizing the Value of Doulas
A doula’s job goes beyond simply answering questions about pregnancy. They also provide continuous emotional support, advocate for the patient’s needs, and help engage partners. In the labor room, they assist their client with various comfort measures, from positioning to breathing techniques. Undoubtedly, doulas contribute meaningfully to the care team. However, when among providers, they often feel dismissed. According to a report published by Mama Glow, 77 percent of doulas felt unwelcome and disrespected in hospital settings. Doulas should be recognized as certified birth workers in any health space they walk into. However, providers often ignore their expertise because they don’t hold a medical degree or are simply unaware of what their role entails.
Understanding the Source of Tension
It is important to note that the friction observed in hospital settings is often mutual. Some doulas enter the delivery room skeptical about the medical system, driven by their deep knowledge about health equity and maternal care. Wanting to ensure clients’ concerns are heard and their wishes honored, doulas often try to communicate this knowledge to providers only to be met with resistance. For many birth workers, they do not mean to add to any friction, but their commitment to patient autonomy and informed consent is a responsibility they rightfully feel they must uphold for the well-being and safety of their patient. While it can add to the tension in the room, it is crucial to recognize where the skepticism comes from and that it is rooted in a deep commitment to patient advocacy.
Creating a Collaborative Care Environment
Although each party may share differing perspectives on the birthing experience, they can still come together to create the labor and birth the patient deserves. When hospitals seek “Doula-Friendly” designation, this mission is better realized. Doula-Friendly Designated hospitals formally commit to integrating doulas into the birthing space, ensuring that their skills and expertise are recognized by nurses, doctors, and the rest of the clinical staff. In a friendly environment, doulas are rightfully recognized as members of the care team, as clinical staff are encouraged to update doulas regularly and doulas are protected under policy. Additionally, by formalizing this relationship, health systems create more opportunities to build trust between birth workers and providers, so they can better work towards their common goal and collaborate well. When the doula and providers reach the room, no matter their differing perspectives or goals, they come together to serve the patient during a meaningful time in their life. Ultimately, this collaborative approach shifts the focus back to where it truly belongs: the birthing person. Not only does it improve the quality of care provided, but in turn also maternal and child health outcomes.
Moving Forward Together
Successful partnerships between doulas and doctors are possible but require time, effort, and mutual understanding. If more hospitals become Doula-Friendly Designated Hospitals, it will signal to doulas that they are valued members of the care team, which may help reduce any skepticism they hold towards health systems and medical providers. It takes one step, one action to bridge the gap between birthworkers and providers, but doing so makes a world of difference to birthing people and their babies.
Naa Dei Ashie is a rising senior at Brown University in the five-year Undergraduate/Master of Public Health (MPH) program. She holds a long-time passion for maternal health equity and improving child health outcomes. Equally committed to serving underserved communities, she believes empowerment, support, and education are essential to achieving this goal.
