Professional Support during Childbirth: The Role of Doulas in Increasing Mothers’ Agency

The literature on the commercial sector of maternity care in contemporary Russia shows that despite receiving more personal care during childbirth that is based on the model of a self-reliant and well-informed consumer, women continue to be treated by medical personnel as passive and powerless patients. Moreover, women’s attitudes towards obstetrics are characterized by a strong level of general distrust of medicine and dissatisfaction with excessive bureaucratization of childbirth. However, the emergence of new professionals in this organizational field – doulas – might be a response to women’s wish to gain control over their childbirth and their own bodies. Doula is a woman who provides informational, emotional and physical support for women in labor on a commercial basis, and it is a relatively new phenomenon for Russia. Therefore, it becomes important to identify how the professionalization of doulas occurs and how doulas construct their mission in field of delivery care. Drawing on semi-structured interviews with 21 doulas, childbirth workers (a doctor and midwives) and mothers, this study explores in what ways doulas challenge the technocratic model of childbirth and promote a more humanistic approach by increasing mothers’ agency. According to the informants narratives, we can conclude that doulas as new professionals seek to maintain the control of a woman during childbirth and promote her interests and rights in the process of delivery. Consequently, the mission of doulas is to strengthen the role of women/mothers in the organizational field, which at the institutional level can lead to changes in the field of delivery care. The data collected also reveal the process of professionalization of doulas. Doulas organize professional communities, form their own professional ethics and competences in order to widen their jurisdiction in the organizational field.