Dear Doulas: WE have a professional problem

Doulas- 

We have a problem. It’s a problem that has existed for way too long and it’s time to address the elephant in the room. 

I am tired, no, I’m exhausted from constantly trying to prove to care providers that doulas have a place and can be professional and respectful and we can all work together as a team to accomplish the goals. 

The problem here is not actually the care providers. They are reacting to what they see and what they hear and what they experience. This means that our BEHAVIOR, our WORDS, our PRESENCE, and our REPUTATION need to be 100% PROFESSIONAL. 

I have worked really hard over the last few years to get to know a lot of care providers and sit with them to come to common ground and build relationships. Almost every single one of them have told me a story about a doula who acted unprofessionally, acted outside of scope, said some bogus medical stuff, threw herself in front of the door to stop from going back to the OR, touched sterile instruments in the OR, told a client to go home AMA, put a hand in front of the perineum to prevent an episiotomy, I was told that a doula gave a vaginal exam in front of a nurse, turned on oxygen for her client without any medical personnel present, client was told by her doula that her baby was a “devil baby,” and the list goes on and on. A few weeks ago, our agency got a call for some last minute support because her doula bailed on her. BAILED. The day before her scheduled cesarean. The doula provided no backup support, and was not working on a contract. This is a big problem. 

And here I sit with my second birth this weekend; yesterday I heard, “oh, you’re one of the good doulas,” and today I am not being let into the OR because the anesthesiologist has had a bad experience with doulas not staying in their place in the OR. 

‘One of the good doulas?’ Shouldn’t  we ALL be good? Shouldn’t all anesthesiologists know that we are professional and know our place? 

I’m so sick of hearing this and experiencing the wrath of what some other doula did. I hope this makes you cringe too.  

Doulas, we have got to step it up and do better. If we want to really make a difference and make improvements to our birth culture and maternal health and wellness, we can absolutely be a huge part of it by not being the problem. The work we do is so impactful to our clients with all the education and information sharing, and the emotional side of work, but it won’t make a difference to the medial community if they don’t see us as professionals. 

There’s no set standard in the doula industry and there is no real accountability system either. So how do we hold our fellow doulas accountable to their behaviors? How do we make change in the way doulas are practicing?  

Until something (regulatory) is in place, we must do some self-reflection and have tough conversations with our peers about topics like scope of practice, contracts, and our place in the medical world. We must learn when to speak up and when to be silent, and when to know the difference. We must do better at understanding how to prepare our clients to advocate for themselves and to not take on that burden nor any responsibility for outcomes. We are not here to save. We are not here to prevent anything, nor are we here to guarantee a certain path or experience. It is my personal conclusion that some of these underlying principles are not fully understood nor practiced upon. 

We are professionals so we should act accordingly. We want care providers to take us seriously, then maybe we should take ourselves seriously and step up our game. Doulas can step up by having a clear scope, having standards of care, following professional business practices including contracts and policies. Doulas should take professional development courses, have discussions with other doulas and other professionals. Doulas should read books and have a commitment to growth and further learning. Find a mentor. Expand the view and get out of the echo chambers that it is us against them. 

Don’t be that doula that ruins it for the rest of us. What you say and do will reflect on our profession as a whole, it will reflect on your training organization, it will reflect on your peers, and it will reflect on you. This includes your social presence and what you do both personally and publicly. You never know who is watching, and someone is ALWAYS watching. 

There will always be multiple sides to every story. Taking the high road does not always mean sharing your side. The truth will prevail eventually, and the cream always rises to the top. 

We have a saying in our doula group that a rising tide lifts all ships. But the opposite is true too, a low tide can ground all ships. 

I am struggling with how to evoke change in doulas (and doula trainings) in order to stop this pattern of unprofessional behavior that is affecting all of us in such a detrimental way. 

I hope that by calling attention to this, it can be a moment for all to become more aware of our actions, AND also the consequences of those actions. 

It is important to remember that when you find yourself in a tough situation with a care team, we MUST know the respectful way to approach the situation regardless of what is going on. What’s in the best interest of the clients may actually be to keep the mouth shut, and bring it up later. Remember that your presence and non-verbals can definitely be disrespectful or misinterpreted and cause problems bigger than you realize. Words that are uttered in jest or under breath can also be harmful in many ways. 

You may not always like all members of the care team, but you still have to work together-and the difference here is that YOU can be kicked off the team by the other members, but you can’t kick them off. 

STEP UP doulas, evaluate yourself, evaluate your behaviors and your words, evaluate your place and your scope of practice. If you don’t have a scope of practice or don’t know what that is, come talk to us at AlloTribe Training Academy. We would be more than happy to help you define one. 

STEP UP and have conversations with your peers about these subjects, have conversations with the care team, and definitely seek out some professional development. There is so much to learn and room for growth for all of us, let’s hold each other accountable, and let’s move this profession forward. WE can make a difference, but it starts with us.