Professional ambivalence among care workers: The case of doula practice

Abstract

Doulas are non-medical, privately paid caregivers to women during pregnancy and childbirth, who have entered the maternity care field in recent decades. In a hospital setting, doulas offer women emotional and physical support that supplements clinical care. Drawing on focus groups and interviews with eight doulas working in one Atlantic Canadian city, along with Abbott and Merrabeau’s analysis of the professionalization of ‘caring’ occupations, I consider how doulas navigate the uncertain terrain of their emerging occupation. In general, the work performed by care workers is viewed as an extension of the work women perform in the domestic sphere, for which they are understood to be ‘naturally’ talented. As a result, ‘caring’ occupations need to find ways to emphasize the value of their role and justify the need for adequate pay. While traditional processes of professionalization appear to offer a solution, the credentials associated with being a ‘profession’ – a monopoly over a field and a distinct body of (scientific) knowledge – may not be relevant when evaluating the quality of care provision. I argue that doulas hold ambivalent perspectives towards the nature of their training, the requirements of certification and ‘appropriate’ interactions with clients due to the broader tension between care work and professional ideology.