Attending Theotokos: My Work as a Birth Doula

Published: November 21, 2014

This semester, Lindsey completed an independent study with Dr. Michelle Voss Roberts exploring the work of a full-spectrum doula as a ministry. 

About a year ago, in my second year of divinity school, I began training to become a birth doula.The word “doula” originates from a Greek word meaning “female helper” or “slave.” In the 1970s, people began to use the term to refer to women who supported one another during childbirth.

People often ask me the difference between a doula and a midwife. A midwife provides medical care for pregnant and birthing women, typically specializing in low intervention, vaginal birth. Midwives do not do surgical procedures (such as cesarean birth), and usually have a doctor who backs them up. A birth doula is not medically trained; a doula provides non-medical comfort measures, emotional encouragement, informational support and, by my definition, spiritual witness. Multiple studies have shown that the presence of a trained birth doula reduces the chance of medical interventions like induction, epidural, and cesarean birth, all of which come with increased risk to mother and baby.

One of the most important things a doula provides to a birthing person and their partner is continuous, uninterrupted presence. In the hospital setting, doctors, nurses, and midwives manage multiple patients and work on rotating shift; it’s not possible for them to stay continuously with a laboring patient. Many birthing people have a partner with them; this is a person who knows them, loves them, and, oftentimes a person who will be raising their baby alongside them. Like pastors and chaplains, doulas are not there to disrupt or replace familial relationships; we are there to support them, and to bring an additional base of knowledge to help families process their experience as it happens. A doula is a non-anxious presence in the birthing room.

As a divinity-trained doula, I think of the work that I do in the hospital as counter-ritualization. In Birth: An American Rite of Passage, Robbie Davis-Floyd describes Westernized hospital birth as a “technocratic rite.” This is not to say that our medical system is based on superstition, but to acknowledge that, within the system, there are patterned, habituated actions which enact cultural values. Birth is not a medical emergency, but a person giving birth is certainly treated like a very sick patient, and we have a system which often instills the belief that the patient is not the person who holds power in a hospital room. From hospital gowns to long waiting periods to suggestions which are given as commands, the birthing person is made to feel less and less empowered, more and more like an object.

With the recognition that not everyone who gives birth identifies as female, I try to avoid using gendered pronouns to refer to birthing people. There are, however, historical and cultural ways that female bodies have been treated which are reinforced by today’s dominant ideas about birth. Women are viewed as hysterical and overly-emotional, unable to make rational choices about their own bodies. Womens’ bodies are seen as public property, so giving birth is a civilsocial responsibility rather than a deeply personal, spiritual experience. Women attached to men with societal privilege have been viewed as fragile, with bodies formed to be looked at, rather than to change or grow or birth. Women of color and working class women have been treated as animal bodies, able to perform the function of birthing, but unworthy of reverence and awe. Trans bodies, also, are disrespected and unacknowledged. Pregnancy and birth are treated as experiences which strictly and irrevocably define a person’s gender as female.

For me, the most important work that a doula can do is to stand between a birthing person and these ideas, guarding what is holy and good, proclaiming that this person, in this moment, is the image of God in the world. The work of counter ritualization can be as simple as coming prepared with her favorite scents, or soft pillows, or slippers. It can be helping someone to make their own birth plan, or reminding them that the medical staff are allies—not masters or adversaries. It can be prayer or chanting or a sign on the door reminding people that something sacred is happening in here.

One of the names given to Jesus’ mother, Mary, in the early Christian church, is theotokos, “God-bearer.” This comes from the ancient trinitarian thought that If Jesus is the embodied divine, then this divinity was a part of Mary’s body, too. Mary was not merely a container for holiness; divinity is flesh of her flesh, blood of her blood. Holiness is not only reflected in the newborn child, but in the body of the one who bears her.

Recognizing the spark of the divine that is so palpable in newborn babies, I know that every client I see is theotokos. When I massage her hands and feet, I massage the hands and feet of God. When I wipe the sweat from his brow, I am tending to the needs of divinity. When I hear her painful groans and groan along beside her, I participate in the strenuous work of divine creation.

Lindsey MullenLindsey Mullen
Third Year

Lindsey Mullen is a third year divinity school student and a DONA trained birth doula. She is currently working on her DONA birth doula certification. Lindsey is also a feminist, a children’s minister, and a sucker for any and all Christmas music (even in October).