When Gabriela’s water broke, she rushed to her phone. At the end of the line, neither ambulance nor midwife. Just the reassuring voice of Alix, her “doula”. A handywoman, found on Instagram, hired to support her during her pregnancy. Like her, many “companions” offer their services, to “give birth better”. It was Alix who brought Gabriela to the Grenoble University Hospital, where she had planned to give birth. It was also Alix who made her complete her “birth plan”, in which she details her conditions: no epidural, and the “nature” room, the least medicalized in the maternity ward. It’s Alix again who holds her hand as she screams. Officially, she’s just a friend. Otherwise, the maternity would not have accepted it: too much risk of interference with the caregivers.
Appeared in France in the 2000s, the practice of “birthing support” is enjoying a new lease of life with the hospital crisis and the development of social networks. Faced with the lack of time, the over-medicalization and the media coverage of cases of obstetrical violence, the doulas sell “additional” listening, feedback from mother to future mother, and some personal assistance tasks. The guarantee of a “luxurious” and “timeless” gestation, for around sixty euros per hour. A mirage, for the Order of Midwives. “The doulas take advantage of dysfunctions to interfere in the system, but many of their promises are at least unrealistic”, affirms Anne-Marie Curat, its treasurer. Behind the innocuous appearance of the services offered, health professionals fear that these improvised “accompanying persons”, devoid of medical or psychosocial training, will keep future mothers away from care.
Far from these criticisms, the customers are at the rendezvous. Faced with increasing demand, training to become a doula is now full four months in advance. “Some have even multiplied their capacities by ten in two years”, notes Flora Jimenez, co-founder of the Directory of doulas, which records 137 French-speaking practitioners. A figure far from being exhaustive, even if there are no official statistics on this unrecognized profession. With a friend, Flora Jimenez launched doula week in early May. On the program: conferences on the “feminine cycle”, karaoke “connect to your power”, or discussions on the practice abroad, very popular in Anglo-Saxon countries.
“Big anything slips in too often”
Elise, 36, was tempted for her second pregnancy: “I wanted to save time, and comfort.” When the support remains pragmatic, it can be useful to those who can afford it, assures this marketing manager in the Paris region. Except that in the absence of regulation, all kinds of practices coexist. “On Instagram, a lot of doulas distribute esoteric advice or recipes for eating your placenta. It was not at all what I was looking for”, laments Elise. It’s a bit of a lottery. Here, an accompanying person confines herself to making tea, laundry and telling what she has seen of other deliveries. There, another offers rites and spiritual exercises to make pregnancy more “natural”.
“Big anyone slips in too often,” summarizes Cyril Vidal, from the No Fake Med collective, who denounces the excesses linked to alternative therapies. “A lot of doulas offer massages with essential oils. How many know that some contain neurotoxic compounds that promote miscarriage and harm the fetus?” he wonders. In 2008, the Academy of Medicine had already issued a vitriolic opinion on these practices. The institution considered the “interference” of these “insufficiently trained” people as a “danger” for the pregnant woman. Anne-Marie Curat, of the Order of Midwives, remembers a complaint she filed in 2008 against a doula who carried out home births without authorization. A baby had died, and the case had fueled a parliamentary committee. The Regional Health Agency of Nouvelle-Aquitaine tells L’Express that it has recently been seized of similar facts.
In the viewfinder of Miviludes
Health professionals are also concerned about the spiritual orientations of certain sessions. “Often, it is an opportunity to transmit new age precepts, antivax trend, according to which we would be in better health far from traditional medicine”, laments Pascale Mathieu, president of the National Council of the Order of Masseurs-Physiotherapists. If beliefs, religions and rites are a matter of individual freedom, doulas include controversial services in their offer. Like to “reconnect with the sacred feminine”. A trend in the sights of the Interministerial Mission for Vigilance and the Fight against Sectarian Aberrations (Miviludes), which warns of the particular vulnerability of pregnant women. “These are just ancient rites, which allow you to regain power over your body, by reconciling with your part of femininity”, is surprised a doula.
Problem: according to this precept, carrying out a pregnancy would be a matter of will and mood. Misconceptions and guilt, especially in the event of an incident. Also in the viewfinder of Miviludes, the “blessing of the uterus”: a “care” that would harmonize the organ, “physically and energetically”. “It helps resolve infertility disorders, premenstrual pain, endometriosis and other uterine conditions,” details a doula on her site. The therapeutic drift is then not very far.
Among the doulas offering such rites, many brandish a “Quantik doula” certification. A sesame awarded by the “school” of the same name, founded by Quebecer Karine Laseva. One of the headliners of the French-speaking community, which charges its training 3,450 euros for 120 hours mainly in the form of video, to which must be added 1,200 euros to reserve its place. The course, neither qualifying nor recognized, certainly provides for a session of “evidence-based medicine”. But most of the sessions turn out to be very esoteric. A chapter is dedicated to “sacred sexuality”. The course promises to explore “the anatomy of pleasure” and help find its “vibrational signature”. Another explains the “alchemical preconception”. The idea? Awaken the conscience of the pregnant woman, so that she can “call her child” and that her arrival on Earth goes well…
Knowledge that Karine Laseva claims to draw from her multiple pregnancies, and from her involvement in a community of women who give birth alone. On YouTube, she says that a doula practicing childbirth without authorization would have “opened her eyes”: “She introduced me to quantik […], the dimension of the invisible. The quantik is the way our thoughts have an impact on the visible”. And to describe how his mentor “felt” the state of health of the babies, “thanks to the particles, the odors which float”…
Faced with criticism, the associations that federate the doulas put forward numerous scientific references. Their support would reduce the risk of cesarean section by 50%, the duration of labor by 25%, and the use of epidurals by 60%. Serious studies, but on countries where doulas replace midwives, too rare or too expensive, like the United States. Any extrapolation to France, where midwives are supported, is therefore impossible.
Recipes for placenta, the sacred feminine and the dimension of the invisible… Juliette has had enough. Doula in the Paris region, the young woman has created an Instagram account to slay the pseudoscientific or eccentric advice of certain colleagues. “I also love pebbles and burning sage, but what does that have to do with the organization of a pregnancy?” strikes the one who calls herself We Can Doula on the networks. What to glean from the audience, and a lot of enemies. She takes on and defends a down-to-earth profession: “I’m like a wedding planner, except that I help plan births”. Rainy birth, happy birth?