Shift from “Doula” to “Birth Companion”

In recent years, there has been a growing conversation around the language we use to describe birth support professionals. One term that has sprinkled debate in the birth community is “doula,” a word that has become widely associated with professional birth support or labor coaches. However, many have raised concerns about the word’s historical roots, which trace back to the Greek term for a female slave or servant. In a time when equity, dignity, and respect are central to improving maternal healthcare, it’s important to consider how the terms we use reflect these values. As a result, some birth professionals are choosing to embrace the term birth companion instead.

The Historical Context: Doula and its Associations

The word doula has been in use for decades to describe trained professionals who support pregnant individuals through childbirth. While the services provided by doulas are invaluable, the historical and linguistic association with servitude can carry unintended connotations, particularly for communities that have experienced systemic oppression. Many Black women, in particular, have expressed discomfort with the word, given its connection to slavery and the legacy of exploitation that has disproportionately affected their reproductive rights. Also, doulas have also historically worked for low wages considering the very long hours and other “on call” factors at play. For some, making the profession of personalized labor support means we need to reevaluate. We may ask “what’s a person doing labor support for a hobby and what’s this called when a person is doing birth support as a profession?” Clearly, the one doing this as a full time occupation isn’t a servant and has much boots-on-the-ground experience to offer families. 

For years, doulas have filled the gaps that insurance and hospital policies have created. We need to begin to understand that birth workers aren’t fully capable of changing those policies the day of their client’s particular labor. Women must get informed by their birth companions, ahead of time, in pregnancy and vote with their dollars. When women are empowered by their birth companions support and morally encouraged, they can feel good about the choices they make. This far exceeds the experience of being on the conveyor belt of the average hospital. In a nutshell, birth workers do best when working in connection with their clients. 

Birth Companion: A More Person-Centered Approach

The term birth companion offers a more person-centered and empowering alternative. Unlike “doula,” the phrase carries no historical baggage and places emphasis on partnership, mutual respect, and care. A birth companion is not seen as a servant but as an equal participant in the birthing process, someone who supports, encourages, and uplifts the birthing individual.

Birth companions are trained to provide emotional, physical, and informational support throughout pregnancy, labor, and postpartum, just like doulas. However, the shift in terminology can reshape the dynamic of the relationship, ensuring that it is built on shared decision-making and empowerment rather than one person hiring services or being  “above” or “under” another. Birth is a complex right of passage as a woman. Hiring support is not like getting a pedicure or massage. It’s a unique service that includes deep personal connection and spiritual support. 

The Role of HypnoBirthing Birth Companions

One of the key roles birth companions can play is within the realm of HypnoBirthing—a method of childbirth that focuses on relaxation, self-hypnosis, and guided imagery to ease labor. HypnoBirthing birth companions are trained in specific techniques that help birthing individuals remain calm, focused, and more during the labor process.

These birth companions are not just emotional supports; they are equipped with skills to create an environment conducive to hypnosis and deep relaxation. Their presence can help reduce the need for medical interventions, improve the birth experience, and promote a sense of safety and autonomy for the birthing individual. The partnership between HypnoBirthing birth companions and women emphasizes respect for the body’s natural processes and the power of the mind in navigating labor.

Why Birth Companions are Vital for Improving Birth in the United States

The United States is facing a maternal healthcare crisis, with rising maternal mortality rates and significant racial disparities in outcomes. Birth companions, particularly those trained in person-centered and holistic methods like HypnoBirthing, play a critical role in addressing these challenges.

Studies have shown that having continuous support during childbirth leads to better outcomes, including lower rates of cesarean sections, shorter labor, reduced need for pain medication, and higher satisfaction with the birth experience. Birth companions provide not only physical and emotional support but also help advocate for the birthing individual’s preferences, making sure that they feel heard and respected in the often-overwhelming medical environment. 

For marginalized communities, in particular, the presence of a birth companion can be a game-changer. Black women in the U.S. are three to four times more likely to die from pregnancy-related causes than white women. Birth companions can bridge gaps in communication, advocate against bias, and ensure that the birthing person receives respectful care.

Moving Forward: A Call for Change

As we continue to seek ways to improve maternal health outcomes and promote equity in the birth space, it’s essential that we rethink the language we use. Adopting terms like birth companion reflects a commitment to person-centered care, where the individual giving birth is treated as a respected partner in the process rather than a passive recipient of services. Sometimes, women mistakenly think that by hiring a birth doula it will magically be a great birth. This isn’t necessarily true. It does tend to improve outcomes, yet the mother must take care of her own body, mind, health, and choose a good care provider in pregnancy as well. The language of birth companion also suggests the birth helper isn’t just telling the mother what to do, but the two are working together in relationship. 

Birth companions—especially those trained in HypnoBirthing— can create a more empowering and respectful birth culture that honors the autonomy and dignity of the emotional and physical health that is sometimes lost in “the system.” 

This shift is more than just a change in terminology; it’s a reflection of the evolving values in maternal healthcare. By recognizing the impact of our words and choosing terms that center care and mutual respect, we take an important step toward improving the birth experience for everyone.

Learn more about my HypnoBirthing Childbirth Classes in Tampa and Birth Companion Services.