Community-Based Doulas in Nova Scotia: Defining the Meaning of Care at the Intersection of Reproductive Justice and Biomedicine

Abstract

Institutional support for community-based doula programs appears to be growing in response to persistent maternal health disparities in North America. Yet little is known about how community-based doulas view these new demands, and what motivates them to do their work, which is frequently unpaid. Fifteen people who identify as community-based doulas working in Nova Scotia participated in semi-structured interviews for this study. Participants frame their work first and foremost, as political. Their focus is not fetal and maternal health, or on limiting medical interventions in birth. Rather, community-based doulas seek to support birthing people to feel empowered, and “bear witness” to people navigating intersecting systems of oppression, including capitalism, colonialism, carcerality and heteropatriarchy. Participants were not interested in working within the mainstream health care system. They valued autonomy from systems and institutions, as this separation better aligns with their values, and enables practices of radical care.