Fading into the woodwork: Doula work and hospital-based practice

Doulas offer emotional support to women during pregnancy, childbirth, and the early postpartum period. In hospitals, doulas support their clients without holding formal status as employees or as a regulated profession. Drawing on interviews with 26 doulas in Toronto, Canada, along with analyses of the legacy of medical dominance in maternity care, I examine how doulas accomplish their work in hospitals. I find that doulas face challenges accessing physical resources and struggle to provide their model of care in light of routine hospital procedures and interventions. In response, many doulas develop strategies to address the constraints imposed by their work contexts. These findings suggest that the medical model of birth is resistant to even minor modifications or perspectives that view birth holistically rather than solely dependent on medical intervention.