5 Ways Doulas Have Changed in the Last Six Years

It has been over six years since I began my journey as a doula. Much has changed in such a short amount of time. Six years ago in Houston, there was no Texas Children’s Pavilion for Women. Now it is one of the hospitals where I attend most births. Six years ago, I began a list of VBAC Friendly providers. Very few are still on that list. Some don’t even attend VBAC patients anymore. Six years ago, I had one child. Now I have three.

1. Doulas were “pit bulls.”

Six years ago, doulas were hired to be advocates. Doulas were hired to be protectors of the birth space. Planning a VBAC? Hire a doula! Don’t trust your provider? Hire a doula! Want a natural birth? Hire a doula! I read an article by a well-known midwife that said that we needed more “pit bull doulas.”

I am not, nor have I ever been, anything resembling a “pit bull doula.” I admit that I was intimidated by the prospect of speaking for clients, advocating for clients, protecting clients from bad care providers, and being a “pit bull doula.” I thought I was a bad doula, maybe not cut out for this work, when I just couldn’t be that kind of doula.

2. Doulas were advocates.

I learned how to be an advocate at my very first doula training. It was not really about standing up to care providers as much as it was about teaching our clients how to stand up for themselves. It was about helping them to understand that they are allowed to say no, and they are allowed to ask questions. They are allowed to collaborate with their care provider, even switch care providers if necessary, in order to receive the very best care. After my training, I shared with one of my friends that doulas are not actually supposed to speak to the care provider on behalf of our clients. She asked, “Well, how do you advocate for your clients, then?”

It was a fair and valid question. And it was one for which I didn’t have a good answer. Yet.

I learned that instead of trying to change a care provider’s mind about the way birth should be done, a person should find a care provider with which they already share the same birth philosophies. I learned how important a good care provider is for achieving the birth that you want. I learned that if a person is afraid of asking their care provider questions, it is a better idea to find a care provider with which they feel comfortable asking questions. I learned how to help clients communicate with their care providers without inserting my own agenda or biases. I learned that I didn’t have to stand up to care providers, and in fact, that doing so was a bad idea!

3. Doulas focused on improving birth outcomes. 

I saw the conversation change from “doulas improve birth outcomes” to “doulas are not responsible for birth outcomes.” Overall, very few people hire doulas, so we are affecting very little change in the birth world. Our change comes one family and one birth at a time. Yes, we are changing lives. Yes, we do a valuable work. But we are not putting a dent in our broken maternity system. It is going to take those who are giving birth to stand up for a better system.

4. Doulas fought for change.

I’ve seen the conversation change from “doulas are birth advocates. Doulas fight for better birth practices” to “the birth room is not the place.” Some have even suggested that doulas shouldn’t be seen at events like birth rallies or peaceful protests because that implies an agenda. Doulas are supposed to be without an agenda. Doulas support ALL births.

5. Doulas burned out a lot. 

I’ve been hearing more and more about sustainability in doula work. Doulas have discussed ways to make this work something we can sustain for many years. I’ve seen practices change from charging one flat fee no matter how long a doula is needed to incorporating “12 Hour Language” and charging an hourly rate for anything over 12 hours of support.

I’ve seen new doulas being expected to provide free births until they are certified to new doulas starting out charging a living wage.

For several years, I observed all of these changes, and felt alone in my thoughts. I wasn’t sure that I was actually doing the right thing by not standing up to care providers, by not having an agenda, by not being a “pit bull doula.”

Then I discovered Birth Boot Camp. I became an Instructor in 2013 and a DOULA in 2014. I found my tribe and a philosophy I can get behind. Like finding the perfect care provider, I have found an organization that thinks like I do. And I feel like a weight has been lifted. I have seen many changes in my short time as a Birth Boot Camp Instructor & DOULA, but I am excited about these changes. There is more to come, and I can’t wait!

Change is good, but change can be difficult. I am proud to be part of an organization that helps me to stretch and grow, but also supports, encourages, and uplifts me. I am excited to see what the future holds!


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