The Hidden History Behind the Word ‘Doula’

Why advocacy in the Western world often puts us on the wrong side of history.

If you Google the definition of the word, doula, your search yields an American explanation, which is the only one most Americans care to hear. But it’s the hidden history behind the word that caught my concern a couple of days ago when a friend interrupted me as I casually blurted it mid-sentence.

“I think that word is offensive, doula.” She clarified. “I think it’s offensive.”

“Are you sure?!” I asked.

I quickly whipped out my iPhone to investigate. My friend just nodded her head as I thumbed through a long line of American explanations.

“When you can,” she said, “you should really look it up.”

Our conversation lingered, as did my curiosity. I thought to myself, how well did I know this word, doula? I’d only heard of it in my early 20’s. Granted, that gave me a cool decade to know whether or not I was using offensive language, but I had to be honest; I didn’t know the origin of the word. However, it wouldn’t be long before that changed; a day-long search produced more than enough evidence to support my friend and her findings. And what I found was an undeniable demonstration of the West’s ability to silence and smother history when it suited them.

In America, doula is a word used to identify a trained birthing companion. A doula provides support to another individual undergoing a significant health-related experience, the one we see most often is childbirth. But they can also assist with other reproductive experiences, such as a miscarriage, induced abortion, or stillbirth, as well as non-reproductive experiences like dying. Doulas provide emotional, mental, and physical support, both before, during, and after the experience. They can also provide information and advocacy, particularly empowering for patients who are members of marginalized communities. The idea of a doula was introduced to me as an earthy solution to the problems facing many mothers of color. We know that Black women are three to four times more likely to die of pregnancy-related complications than white women. American Indian and Alaska Native women are also at extremely high risk, at two to three times the national average. The doula was dressed in empowerment. It quenched my need for ‘new and improved’ and enticed my inner activist. We were taking back our bodies; the fact that the people supporting this new labor and delivery direction looked like me told me everything I needed to know. How seriously shortsighted of me.

The word doula predates its recent resurgence by a couple of centuries. Outspoken anthropologist and American feminist Dana Raphael introduced the term to the Western world during a study on breastfeeding success rates. Raphael credits this treasure to a conversation she once had with an older Greek woman, during which she attempted to explain what made breastfeeding more successful in other areas of the world by exploring how communities do or don’t support new mothers. She mentioned the Latin American tradition of la cuarentena, a 40-day period during which postpartum women refrain from household work and intercourse while family tends to her and the baby. She introduced parts of East Asia to the conversation, where a new mother stays with her parents after childbirth to rest and recover.

“That’s a doula,” the elderly woman responded; Raphael then went on to make the word her own. Featuring it in her 1969 dissertation on cultural breastfeeding practices, and then again in her book, “The Tender Gift: Breastfeeding.” Before long, Raphael would become a well-known breast expert. In conjunction with her advocacy for breastfeeding, she reinforced the regularity of female community members taking part in other women’s labor and delivery. Through her research, Raphael had concluded that the presence of a friend or family member during, before, and after childbirth contributed to successful long-term breastfeeding. “Doula” is what she called it, and when asked, she offered the following definition, “mothering the mother.”

As I searched the word on a Wednesday night, still hellbent on debating my friend, I found an article that delved into the drama surrounding the word and its western adaptation in medical vocabulary. When nurses in Greek medical communities heard the word had made its way around the world, many were moved to anger, understandably so. Up until the West said otherwise, the word in modern Greek, δούλα, (pron. /ˈðula/), a derivative of Ancient Greek word δούλη, meant “female slave” or the slave who serves the childbearing woman of the house. A cultural equivalent might be the mammy; a title used to identify the Black American woman tasked with childrearing and reproductive responsibilities during American slavery. Today in Greece, the term doula still very much minimizes the one who holds the title. Opposers offered up alternatives; “paramana,” a modern Greek word meaning next to the mother, but the wants of the West silenced these suggestions. Petitions to pull the word from the medical masses fell flat. The West had already embraced the expression, becoming emotionally attached to the idea of the lifesaving doula. We likely weren’t letting this go, no matter who found it offensive.

The mammy; a Black woman who worked in a white family and nursed the family’s children during slavery.

Our Western world privilege was rearing its ugly head again. Once more, the moans of an uncomfortable minority were muffled by the efforts of evolution among the uninformed. Raphael had the right idea, and I don’t doubt that her efforts were genuine. Still, there’s an unavoidable amount of privilege in this story, not only in borrowing from a living language but in redefining words to best fit our intended use for them. Not only were the authors of the language ignored in their protests, but policies were passed, ensuring it stayed that way. Doulas of North America was established in 1992, a group founded by five maternal-child health experts who championed using of the word on a local and international level. Organizations began lobbying for funding and federal regulation of doula services. When that happens, we’re no longer talking about ignorance; we’re dealing in intentions and the common belief that only Western oppression is significant.

Language is a living organism, this may be true, but don’t we have an obligation to respect the roots? Don’t we want to know when we’re using language that offends others? And is it essential to rebrand words that have a hurtful history? If it is, that’s up to the offended parties to decide. We may be easier to see on the world stage, thereby making us easier to empathize with. But our evolution doesn’t give us the right to bulldoze the boundaries of other cultures’, no matter how ‘inconvenient’ they may be. Being a global citizen means the dialogue matters, even if only to a minority of the listeners; it’s worth creating space for and considering its validity. We can mean well and still get it wrong. Good intentions are not a get out of accountability card. The likelihood that we backtrack our adoption of the word “doula” is dismal, but knowing better makes us informed, and therefore makes us aware. What we do with that awareness is up to us.

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Arah Iloabugichukwu

Arah Iloabugichukwu

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