First, a note on inclusive language in this blog post. I use the terms reproductive health, rather than maternal health and birthing person or folks instead of mother because people of all genders and identities give birth, and not all people choose to or are able to carry their pregnancies to term. Further, I interchange the terms birthworker and doula because the origin of the word doula is complicated, and not all birthworkers identify as doulas. Cornerstone birthworkers (doulas) support all people, and all reproductive health choices, options, and outcomes.

So, what do doulas or birthworkers (same role - different titles, different word origins) do?

Essentially, a birthworker is an integral member of your inter-professional reproductive healthcare team that provides continuous culturally responsive emotional, physical, and educational support to pregnant people, their partner/s, and families throughout the childbearing year. This support also includes advocacy, meaning that doulas are your go-to people throughout your reproductive processes that have your needs and goals at the top of their mind. Your birthworker is committed to your needs, not those of care providers, OBs, nurses, or hospital administrators, and support you regardless of your choices or reproductive outcomes. We will speak up if your choices and needs aren’t being met by your providers or care team, and if you are not being treated in the way that you deserve to be treated.

Birthworkers provide relationship-based, client-centered continuity of care. What this means is that your doula gets to know you, and vice versa - and we commit to being there for you throughout the entire process. This relationship and commitment builds trust, which is a key component of what makes our support so potent and powerful. Birthworkers meet you where you’re at to help you realize your reproductive healthcare and parenting goals, and to support you through the dynamic process that is birth, postpartum, and reproductive health experiences no matter if your plans stay the same, or if they change. Doulas will help you sort through and understand your choices and help you craft a birth and/or postpartum plan, we support you with accessing the resources and community support that you will need throughout your fertility journey, pregnancy, labor, birth, loss, abortion, and postpartum period. Doulas also provide childbirth education, we help with navigating systems, barriers, and access, and we provide physical support and comfort measures like therapeutic touch, breathing, visualization, movement, and help with positions. We also offer lactation education and hands-on bodyfeeding and lactation support, run errands, cook, help with baby care, help with comfort measures during healing from birth and abortions, we facilitate ceremony and community building, we are your cheerleaders and your shoulder to cry on, we provide mental health support and crisis response, abortion support, fertility support, death and grief support, and so much more. 

The thing that birthworkers don’t do is practice medicine, which we leave to the primary care providers, midwives, perinatologists, and OBGYNs. We don’t diagnose or prescribe, but we can help you and your partner/s with making informed decisions about the care that you receive, and we partner with your providers as integral care team members to ensure that your needs are being met on both the individual and community levels. 

Birthworkers are unlicensed care workers, meaning that we do not have an overseeing or licensing body; we are autonomous. Some doulas are certified, and some are uncertified - both are equally relevant, and certification is not the most important thing to take into consideration when hiring a doula. It is incredibly important to note that the services doulas provide will vary widely depending on the training organization that they chose to train with, and the particular training that they have received. Cornerstone birthworkers and doulas are trained through a culturally responsive and intersectional lens to provide full spectrum (meaning that they serve folks throughout every reproductive experience) support that is rooted in community, trauma informed care, patient rights, and client advocacy. 

You can hire a doula at any point in your reproductive journey when you need support - fertility, IUI, pregnancy, postpartum, to accompany you to your abortion, and in times of grief and loss. There are even gender affirming surgery and transition doulas! When looking for your doula - the person who is right for you, find out about their training, their philosophy, and their services provided. Where do they stand on advocacy? Will they be able to provide the culturally relevant and responsive support that you and your partner/s need? Do they work with backup in case of emergency, illness, or a long birth? Will they stand with you no matter what you choose in your care, and are they flexible if your plans change? *If you’re hiring a doula to be present at your birth, we recommend hiring your birthworker in the second trimester to create space for time to get to know one another and build that trust, but you can hire your birthworker earlier or later than that; we are flexible and always present.

Lastly, doula care is important. We fill in major gaps in the reproductive healthcare system that most pregnant people and their partner/s and families are navigating. Just the brief synopsis above of what doulas do highlights many spaces where gaps exist, and where your needs may not be fulfilled by your providers. With a reproductive healthcare system that is wrought with inequity and disparities, doulas are leading the charge in bringing forth more dignified, inclusive, equitable, and safe reproductive healthcare for all people.

If you are looking to hire a doula, check out our birthworker database here: https://www.cornerstonedoulatrainings.com/community

If you are wanting to become a birthworker, check out Cornerstone Birthwork Trainings for online courses in labor, birth, postpartum, full spectrum, home birth, and childbirth education specialties, as well as advanced birthworker trainings. cornerstonedoulatrainings.teachable.com

Be sure not to miss Cornerstone’s first annual virtual conference on June 3 - 5, 2022: 

Access & Action: community based strategies for connection, organizing, and change featuring special guest adrienne maree brown, tickets on sale now here: https://www.cornerstonedoulatrainings.com/early-bird

About Nickie Tilsner:

I am a Registered Nurse, Harm Reductionist, and birthworker with 20 years experience as a doula. I have been an activist ever since I can remember, and frame both birthwork and my work as an RN as transformative social justice activism. My main purpose through Cornerstone Birthwork Trainings is to advance Birth and Reproductive Justice by equipping birthworkers with tools to provide full spectrum reproductive care, advocacy and support to ALL people. It is with absolute reverence for the Black Women and Femme leaders of the Reproductive Justice movement that I do this work, and I specifically name that my role in the RJ movement is that of listener, learner and accomplice.