Beyond Standardization: Birth Ideologies, Doula Care, and the Power of Unregulated Support

• In Event: 50412 - Informal and Unregulated Economies

Abstract

Doulas enter birth work driven by deeply held beliefs about childbirth, care, and advocacy, shaping the way they approach their clients and define their roles. Unlike medical professionals bound by standardized protocols, doulas operate in an unregulated space that allows them to provide highly personalized, relationship-based support. Through ethnographic fieldwork and interviews with doulas across the U.S., this study explores the diverse ideological motivations that lead individuals to doula work—ranging from commitments to holistic, physiological birth to a focus on trauma-informed and culturally responsive care. The lack of formal regulation enables doulas to tailor their practice to their own philosophies and the specific needs of their clients, creating a model of care that is deeply individualized and emotionally driven. However, this flexibility also contributes to tensions surrounding professional legitimacy, certification requirements, and the integration of doula care into formal healthcare systems. As states move toward Medicaid reimbursement and institutional oversight, questions arise about whether increased regulation will enhance access or diminish the personalized nature of doula support. This study highlights the unique position of doulas in the maternal care landscape, where ideological diversity and the absence of rigid structures allow for a deeply human-centered approach to birth work.

Author

• Anna C Delapaz, Syracuse University