UC Press Blog

By Andrea Ford, author of Near Birth: Contested Values and the Work of Doulas

Doula-supported births have increased dramatically in recent years. A doula is a birth attendant who provides emotional, physical, and informational support but does not carry medical liability. Doulas do many useful things, but they don’t fit well into existing categories – they work in the borderlands between the medical and the domestic, the passionate and the professional, the spiritual and the bodily. Doulas, like anthropologists, like birth, show us how things could be otherwise. 

In my book Near Birth: Contested Values and the Work of Doulas I draw on years of ethnographic work as a doula in the California Bay Area to explore these cultural ambiguities. Yet it wasn’t doula work that originally drew me to this research — it was bodies. Childbearing struck me as one of the strangest things a body could do, and I wanted to know more. To conduct ethnographic research that was useful to people, and to be as involved as I could be without giving birth myself, I trained and practiced as a birth doula. During those ten years, I discovered that the strangeness of giving birth, and the strangeness of doula practice, were linked. They are both situations where the ideology of the individual breaks down and yet gets reinforced. They are paradoxes, problems, possibilities. 

Near Birth provides a window into American culture through seven values that grapple with what it means to be an individual. These values – progress, experience, autonomy, equality, authenticity, immunity, and redemption—are not the only American values or the most important ones, but they emerged clearly from my research. They are not cleanly divisible, because cultural stories are interwoven with one another. The chapters, and the stories within them, build on and reference each other. These seven values are current problems, sites of upheaval at this moment even as they reference longer struggles and instabilities.

The individual has come to be seen as synonymous with the human. Yet in childbearing the boundaries of the individual are necessarily blurred as one body becomes two. A new person’s material and social existence are formulated in conditions of utter dependence: the infant—and, increasingly, the fetus—is the quintessential object of social vulnerability. It is not yet an individual—and neither is a pregnant person. Rights and responsibilities that were conceived to apply to individuals with personal agency become very messy when applied to pregnant, birthing, nursing, fetal, infant, and child-age people. Doulas help navigate this messy terrain, themselves crossing cultural boundaries that have long established who gets to be an individual, and how. 

It is not a coincidence that this research took place in California. California occupies a particular place within the national imaginary. It is not representative, but dynamic: a bellwether, a lightning rod, a utopia and a dystopia simultaneously. Like birth, like doulas, it can help us see American culture differently, both in a more specific way and as a broader set of myths and ideals that are relevant beyond America itself. 

California is also where I grew up. Like many of the people who populate the book, I am middle-class, White, straight, cisgender. So, it is an anthropology of “home” in multiple senses. And as such, it makes what is taken for granted, “unmarked”, and normal into something strange. Near Birth does not give advice or take a political stance on how to birth. It is neither a breathless paean nor an outraged manifesto. It’s a window into how culture is made, and how it breaks down. It’s about gender, which is a set of foundational stories that shape what we think bodies are, what they (should) do, and how they (should) fit into society. It’s about how the past haunts us, and how sometimes our dearest aspirations don’t make sense. Values are what we take for granted as desirable – but as the book shows, how to actually live out values is not straightforward. It might not even be possible. 

People who haven’t given birth don’t necessarily think about it much. But we should. We were all born. Birth is like some kind of open secret, a fact of life, a miracle, a trauma, both too precious and too abject to confront frankly. A bit like death, in that respect. We tiptoe around it, although it affects us all. Near Birth follows in the venerated anthropological tradition of showing childbearing to be a microcosm of culture. Wonderful, horrifying, mind-blowingly powerful and utterly mundane, it doesn’t fit, yet we try to contain it anyway. It’s a site where our cultural stories break open.