Highlights from the Midwifery Skills Workshop in Gauteng, South Africa

“Thank goodness there are some Black women here!” Those were the first words I heard Marianne Littlejohn say as Zee and I found seats. We all giggled at the remark. I told them I am accustomed to being one of the few or the only Black person at birth workshops and conferences I attend in the U.S. and asked if they usually have more Black women in attendance? Several of the women replied: No… It is the same way here… There are mainly white women at these workshops.

This slideshow requires JavaScript.

Zee had told me that the situation in South Africa was similar to that the U.S. where few Black women were involved in birth work, but I didn’t believe her. She said that even among African midwives there were cultural changes that did not allow African women to benefit from more recent practices that promote gentle birth. How is it possible in a place where 80% of the population is Black African?

It is shameful that Black midwives have played such a prominent and sustaining role in childbirth historically (only 50-60 years ago) yet they are almost non-existent in the 21st century. It is sad that for many Black women, should they desire to birth with someone who looks like them, that option would not be available. How does that happen in only half a century?

I have always believed that in a different life… Under different circumstances and in simpler times, I would have been a midwife. When my children were younger, I considered disregarding my B.S. in Mathematics and my Masters in Education and beginning my education all over again to become a midwife. At a cellular level, I know that I have been called and purposed to connect with women and girls in this way.

In my real life current situation, however, I know the bureaucracy that surrounds birth and that is not for me. Birth is considered a medical emergency by many. Women are treated as if they have an illness for which the only cure is the birth of the baby. So women may be rushed and their births medicalized to the point where many women no longer believe they can experience childbirth as more than a passive observer. While infant and maternal mortality rates have definitely decreased over the past 100 years with the medical advancements, one would be hard pressed to find a balanced and holistic approach to childbirth in many areas of broader society.

I was grateful to be in attendance at Marianne’s workshop with the other midwives and doulas. Resolving a shoulder dystocia is primarily the responsibility of the medical professional tending to the mother, still I am grateful for the additional knowledge that will allow me to be a better support for mothers. I was appreciative of the opportunity to learn with other individuals who are persevering beyond the obstacles to help women birth in hospitals, in birth centers and (if they choose) in their own homes.

Here are some highlights from the workshop:



DOULA QUADS - Analysis (2)

Anyone who has been a doula for any amount of time knows that “DOULA” can mean different things to different people.

Most agree that a doula provides educational, emotional, and physical non-medical support for women during pregnancy, labor/birth and postpartum. There is also a general consensus that doulas help women feel EMPOWERED in birth. Still, the motivations behind why doulas commit to birth support and the ways that support is carried out are vast and diverse.

We draw our perspectives from our backgrounds which are made up of our “experiences, exposure, education and expertise.” That means that no two doulas are likely to perceive doula work in exactly the same way. We are each as unique as our fingerprints, with diverse beliefs about what is most important to focus on in our doula work.

After observing the differences in the ways that doulas refer to their work, I have noticed four primary paradigms that involve:

  • Provoking change through ACTIVISM in birth awareness and proactivity against unnecessary practices
  • Reviving the SISTERHOOD by sharing information, and passing along traditions, practices, and beliefs about birth
  • Supporting through SERVICE that meets a need that women have to be supported during childbirth.
  • Preserving the PROFESSION by emphasizing qualifications, accountability, and relationship to medical professionals

The image above is called DOULA QUADS and is used to consider each paradigm or model independently. The boxes suggest, as some doulas do, that doulas can only model a single behavior with regards to their doula work. Still, others resist the notion that they should be confined to any description, while acknowledging that their actions are most likely to mirror the needs of individuals they are supporting.

Doula Venn Diagram  - Gradient (2)The Venn diagram shows these perspectives in their complex realities. Seldom does any individual doula operate from a perspective that does not involve more than one single paradigm or model. While we may have a strong preference toward a single paradigm, there may be other areas we overlap into that create our individual and unique DOULA PERSPECTIVES.

I have become more and more intrigued about the motivations that people express for their doula work, but have found little research that investigates it. While there are sure to be other doula perspectives, these are very prominent in doula culture. I have decided study this area of DOULA PERSPECTIVES more closely and I would appreciate your input.

If you have 5 – 10 minutes, complete the DOULA PERSPECTIVES Survey and add your perspective about this topic. And if you have any additional thoughts about this topic or the survey, please share them in the comment section below.


This is a survey about DOULA PERSPECTIVES. It should take no longer than 5 – 10 minutes to complete. For additional background on this topic see What’s Your Doula Perspective. Please share this survey with other doulas so they can also share their views on this topic. THANKS!