The doula at a turning point in the history of childbirth

(extract from "The Farmer and the Obstetrician" by Michel Odent. Free Association books 2002)

The Doula Phenomenon

It is in such a context that the concept of a doula suddenly appeared and developed in the UK. Ideally, a doula has herself given birth without any medication and without any intervention; she is an experienced mother or grand-mother. More and more young women feel that there is something wrong in the current system. They meet a series of midwives for ante-natal care. They experience one or several shifts of midwives during labour and they usually meet other midwives for post-natal care. They feel the need to rely on one only mother figure before, during and after the birth. For many reasons peculiar to our time many women do not want to or cannot rely on their own mother. On the other hand a certain number of mothers and grand-mothers feel that they can help inexperienced women. The time is ripe for the emergence of the doula.

The doula phenomenon is thought-provoking because it appears as a resurgence of "authentic" midwifery, via lay women belonging to several generations. It is the unexpected expression of the most deep-rooted needs of pregnant women, labouring women and lactating mothers. Interestingly the doula movement started in the USA, which is a country where the midwives had almost completely disappeared. It is now reaching other countries where the midwives survived, but their role was dramatically altered by the protocols and regulations associated with the industrialisation of childbirth.

The reason for doulas – and for authentic midwives in general – can be interpreted from the perspective of physiologists. In the language of these scientists who study the body functions it is easy to explain how certain situations can inhibit the birth process. This is the case when a labouring woman feels observed, a situation which tends to activate the part of her brain (the "neocortex") that should be at rest during labour. In other words, privacy appears as a basic need. This is also the case in any situation associated with a release of hormones of the adrenaline family. This means that feeling secure is another basic need of pregnant women. The physiological perspective helps understanding why all over the world and through the ages women always had a tendency to give birth close to their mother or close to an experienced mother or grand-mother. It helps understanding the role of the doula as a mother figure. In an ideal world one does not feel observed and judged, and one feels secure in the presence of one’s mother.

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