Reclaiming Birthwork: Why Language, Liberation, and Lineage Matter
Why We Don’t Use The Word Doula
We hope the following article helps to clarify an important linguistic and cultural choice regarding our services and writings. At BA NIA, we intentionally use the term "Birthing Assistant" to describe the vital care and support that individuals provide to women and birthing people. Using language correctly and maintaining cultural congruence is extremely important to us, and we reflect this commitment through our work, and we approach this one birth at a time.
The Historical Definition for Doula
The original Greek word “doúla” (δοῦλα) did literally mean “female slave” or “bondwoman.” It was the feminine form of “doûlos” (δοῦλος), which meant slave or servant. So in its ancient Greek context, the word carried the connotation of enslavement — a woman bound to serve a household or mistress.
Over time, however, the meaning shifted — especially in modern usage:
When anthropologist Dana Raphael revived the term in the 1970s, she was aware of its linguistic roots but used it symbolically to mean “a woman who serves another woman during childbirth.”
Modern doulas explicitly reject the notion of servitude; the term today represents empowerment through service, not bondage. It’s about supporting women in their agency, not submission.
Still, the etymology raises real cultural and ethical questions, particularly for people of African descent and others whose histories are tied to slavery. Many birth workers have criticized the uncritical use of the word doula because of that origin, preferring terms like “birth companion,” “maternal support specialist,” or “community birth worker.”
By choosing “Birthing Assistant,” BA NIA affirms that birthwork is sacred service, not servitude — a continuation of ancestral care, not a rebranding of colonial language.
1. Before “doula,” there were traditional birth attendants and community mothers
Long before the Greek word doula was ever spoken, African, Indigenous, and diasporic cultures had women who served as:
Birth attendants, granny midwives, aunties, and community healers.
They passed down generational wisdom — herbs, massage, song, prayer, and ritual — to guide women safely through childbirth.
Their authority came from experience, spiritual calling, and community trust, not from formal certification.
In these traditions, serving women in birth wasn’t servitude — it was sacred stewardship. Birth was understood as both a biological and spiritual event that connected the mother, baby, ancestors, and community.
2. Enslavement disrupted but didn’t destroy this lineage
During enslavement in the Americas, Black women carried this sacred role under brutal conditions.
Enslaved midwives — often called “granny midwives” — were responsible for delivering both Black and white babies on plantations.
They maintained herbal and spiritual practices brought from Africa, even while being denied freedom and recognition.
These women were keepers of life in a system built on death — healers, witnesses, and preservers of culture.
Despite being enslaved, their work was not slavery in spirit — it was resistance, survival, and care work rooted in ancestral power.
3. The 20th century brought erasure and rebranding
By the early 1900s, medical institutions — led by white male doctors — began to:
Criminalize or discredit traditional midwives through licensing laws.
Push childbirth into hospitals, excluding community-based birth workers.
Appropriate the labor of care once done by Black women and label it with sanitized or academic terms like “nursing,” “public health,” and later “doula.”
When Dana Raphael revived the word doula in the 1970s, she didn’t create the role — she rebranded an ancient, cross-cultural practice that had survived despite oppression.
4. Reclaiming the role, questioning the word
Modern Black and Indigenous birth workers have revived this legacy by:
Restoring traditional language — using titles like birth keeper, community midwife, village auntie, or sacred birth worker.
Reclaiming ancestral wisdom that predates Western medicalization.
Challenging the class and racial divide in modern doula training, which too often centers white, middle-class models of care.
Their focus is not just on comfort during labor — but on birth justice, healing generational trauma, and rebuilding community trust around childbirth.
Reclaiming the Doula: From Servitude to Sacred Service
The word doula comes from ancient Greece, where it meant “female slave” or “woman who serves.” That origin cannot be ignored. The word itself was born in a world where women’s labor — physical, emotional, and spiritual — was owned and controlled. But the role of the doula, the act of serving another woman through childbirth, is far older, far deeper, and far holier than any system of bondage.
Before the Greeks gave it a name, African and Indigenous women had already been serving as birthkeepers, midwives, and community mothers. They carried ancestral wisdom — herbs, songs, prayer, and healing — passed down through generations. In their hands, birth was not just a biological act; it was a sacred ceremony, a joining of mother, child, spirit, and community.
During enslavement, that sacred duty continued in defiance of cruelty. Black women on plantations became midwives and healers, delivering babies of both the enslaved and the enslavers. They preserved knowledge that white medicine could not replicate — knowledge born of love, experience, and ancestral power. Their work was never servitude in spirit; it was resistance, survival, and care made holy.
By the 20th century, medical institutions stripped away that power. Laws and licensing pushed traditional midwives aside. Birth moved from home to hospital, from women’s hands to sterile rooms. When the word doula resurfaced in the 1970s, it reintroduced the idea of woman-centered care — but it often ignored the roots and the resilience of those who had lived this role for centuries.
Today, Black and Indigenous birth workers are reclaiming both the role and the narrative. Some reject the term doula altogether, choosing names that honor their lineage: birthkeeper, community midwife, village auntie, sacred birth worker. Others keep the word but redefine it — stripping it of its slave past and filling it with strength, dignity, and spiritual service.
To serve in this tradition is not to be owned or silenced. It is to stand in a long line of women who have guarded life itself — through oppression, through erasure, through every generation.