Doula, Birthworker, Birthkeeper…do you know the difference ?
A doula? A birthworker ? A birthkeeper ?
I must admit, it can be quite confusing nowadays. This role of accompanying women and birthing people on their journeys towards motherhood and parenthood. This role which has existed for ever because that’s how we used to give birth in the past too: surrounded by women, by those who were there for us, who believed in us. This role goes way back, into pre-historic times.
Doula, birthworker, birthkeeper…those are titles, but what do they mean ?
The Doula
The word “doula” comes from the old Greek language and means “slave to the birthing woman” but has transformed by now into “companion, the one who mothers the mother”. The role how we now it today started to gain more momentum in the 1960s in the USA as a response to women and birthing people wishing for less medicalized and more respectful birth experiences.
In most cases a doula accompanies during pregnancy, birth and postpartum, sometimes altogether, sometimes specialized in one single field. That said, there are also doulas who accompany regarding fertility questions, during menopause or when facing death. Some accompanying during all phases. Some work more on a rational and emotional level, other work holistically including also the spiritual side of our experience.
Anybody can be a doula. To be a doula one does not have to go to school, follow a course. That said, we have seen more and more schools and organisms that offer officialized courses and certificates. Depending on the organism and country, there are no up to a list of requirements that need to be met (i.e.a certain age, having birthed a baby already, having accompanied at least 2 births…) in order to qualify as a doula and receive the certificate. Some organisms do also set rules for what a doula can and cannot do (i.e. not attend free births) but here again, this differs from organism to organism, some set not rules at all, others set a long list of policies.
Especially when wanting to get doula fees reimbursed by social security organisms or being able to enter certain hospitals, said organisms and hospitals sometimes require official certificates issued by more formal doula schools.
Formation and certificates aside, I have made the experience that the word “doula” is often easier understood by women, people and families in comparison to birthworker or birthkeeper. Though I must say, often the word doula isn’t known either because the role and profession is still rather new to the majority of people…
The Birthworker
The name “birthworker” is usually linked to those who touch on all things pregnancy, birth, postpartum which can also include loss, abortion and death. The name has a less “female heavy” and more gender neutral meaning. Courses offering training for birth workers are in general rather independent, following a more intersectional, culture sensitive, community and social approach. Just because the name may sound more neutral doesn’t mean that those who hold it work in a less holistic way. Very often birthworkers do in fact provide a full layered companionship that goes way beyond the general birth preparation class.
The Birthkeeper
And then there is the birthkeeper, the keeper of birth. It’s a movement that has started when the doula profession went the more official and hence policy bound route which limits the way how doulas can support women and birthing people. This would go totally against the birthkeeper’s philosophy, which is honoring, respecting and “keeping” the physiological birth process just how it was naturally designed to be. This includes all parts that are part of the reproductive and overall life cycle, meaning that the scope goes form life to death. Some birthkeeper courses say that doulas have become the handmaiden’s of the violent and mysogynic medical system as they help maintain the system instead of dismantling it. Hence, some birthkeeper courses are never certified in order to not fall as well into the partriachic way of regulating and controlling things. Some birthkeepers used to call themselves doulas first but changed their title to highlight them not being associated with the medical system and clearly distancing themselves from any partaking in supporting obstetric violence and the non-respect of life and death. This also means that a lot of birth keepers do not accompany any hospital births (unless if needed for a transfer during a home birth). From my observation, language tends to be less inclusive but rather female/woman centered when it comes to birthkeeper profiles (courses, teachers, birth keepers themselves).
So what is the difference ?
As you can see, there are nuances that indicate how these three titles differ from another. The thing is though: you can actually be a doula but a birthworker too. Or a birthworker and a doula. Or a doula and a birthkeeper. Or a birthkeeper and a doula. Or even a birthkeeper and a birthworker. Really. At the end, it all depends on how independently one works, how one indentifies and the values one stands for; the philosophy one feels and breathes, the goal one is serving and defending.
My approach
This is why personally, I don’t really care about the label because titles and meanings do change with time anyway. Also, at the end it comes down to who I am as well as why and how I do what I do. Sure, I use the word doula so that the few people who actually know what that means can find me. And even more, because the name does not limit my doing to birth related things only.
With being on the route of traditional midwifery though, I look at all those titles with a slight smile because what the three - doula, birthworker and birthkeeper - are doing is so deeply ingrained into the work and vocation of traditional midwives anyway. They serve women, people and families, from life to death. Out of love and devotion. This is just called traditional midwifery.
So when it comes to me, what I do is that I accompany you with love, passion and my deepest trust in each and every single part of you. I welcome all your facets. I see your light and your shadow. I embrace your joy and your pain. And everything that’s between the lines, everything that can‘t be put into clear words, too.
Full spectrum, before, during and after birth. In times of life and also when facing death. Authentic, trauma and pain informed, culture sensitive, a wholesome companionship for you, your spirit, your mind, your body, your womb and all that’s beyond!
Doula, birthworker, birthkeeper…call it what you want. I just know that I am Neram and this is what I do.
