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A Doula is Not a "Bestie": Part 2

Updated: Apr 12

There is a concern about professional boundaries being crossed when doulas and clients get too" friendly." In the last post we talked about how this negatively impacts our profession. In this post we are going to talk about how this negatively impacts birthing people.



Often I am asked by a potential client, "how will I know I can bond with the doula who is at my birth" or "how will I know I will feel comfortable and at ease and will like the doula who is at my birth"? Why is she asking this?


What I hear in those questions is that the client knows that how she feels around the doula who is with her at her birth will matter. And as doulas we know that is evidence based!


How a birthing person feels in labor will impact how she labors, how she gives birth, and how she looks back on her experience. The same is also true for the nurses who were there, the doctor, midwife, her mother, her partner, etc. and anyone else.


So we know that a sense of trust and safety are the most important aspects of care for a woman in labor. I'll say that again.


A sense of trust and safety are the most important aspects of care for a woman in labor.


She KNOWS this is important. And you know this is important because we talk all about that in our CAPPA trainings. But your client should not feel concerned about whether or not she could be friends with you before or after birth.


The hormonal orchestration of birth and the architecture of a laboring woman's brain is something we should consider in this discussion. High levels of oxytocin can cause a woman to feel bonded to everyone in the room after she gives birth. It's almost like taking a psychotropic drug! How many times have you seen a mom tear-up when talking about you as a doula or the amazing nurse that she had when she gave birth (and may that was the first time they had ever met!)


The same can be said for midwives and doctors. Women "fall in love" with their care providers all the time. In fact they often use that language, "I LOVE my Ob, he stayed up all night to deliver my baby," or "I LOVE my midwife, I would never want to have a baby without her." What is happening here? The hormones of love and attachment certainly have a hand to play in those statements.


As doulas, if our clients are gushing over the work we do for them, we should be grateful! And we should be proud of ourselves. But we should not feed on it or need to affirm our value as professionals.


It is our job to be kind, compassionate, and provide the same emotional support and informational support to all of our clients. That's our job. We are not doing it because we "love" our clients, we are doing it because we are passionate about our work and they are paying us to do a job. We want to do that job well. They deserve the best! And so do we.

You will not let your client down if you emulate good boundaries. She will feel more at ease, more confident in your abilities and the position you play on her birth support team than if you acted as friends.

Doulas are a part of the perinatal workforce.


When a client works with you, they are working with a trained professional in the perinatal field, and ideally one who is either certified or working towards certification. That is not to say that you shouldn't hit it off with your client, because personal connections are important in any professional relationship. However, just like a doctor / midwife / nurse / lactation consultant or anyone on a pregnant person's support team, a doula is professional, not a friend, and a doula's training, experience, and professional boundaries should have the greater impact on choosing whether or not to hire them as a doula.


In Part 1 of these posts, I shared that The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) made a joint statement that regards doulas as"one of the most effective tools to improve labor and delivery outcomes," it's time to take our profession more seriously.

A doula cannot be both friend and doula at the same time. Healthy boundaries are what creates calm and openness and trust in a professional relationship. Working with a doula should feel like the professional relationship that it is designed and needs to be.


What makes CAPPA doulas different?


CAPPA doulas are trained and certified by an international certifying organization that has been educating and training perinatal professionals since 1998.


The CAPPA mission is to provide dynamic training and continuing education opportunities for doulas and educators around the world. CAPPA professionals approach their work with expectant families during the perinatal year with a desire to educate, support, and to see all families succeed. TheCAPPA Approach is built on the CAPPA Vision, which supports the four cornerstones. These cornerstones are:

  • Using evidence-based information in practice

  • Embracing positive mental attitudes

  • Approaching all situations with a loving, non-judgmental mindset

  • Building bridges amongst support and healthcare professionals




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