At a time when there are two ways of understanding the birth process, it is not surprising that there are two kinds of doulas (and two kinds of midwives, etc.).
Image by Elena Heatherwick-Lammers
One group is representative of the dominant cultural conditioning, as the aftermath of thousands of years of interferences through beliefs and rituals. The basis of this deep-rooted conditioning is that a woman does not have the power to give birth by herself. It is the "helping-supporting-coaching-managing paradigm". Within this dominant paradigm doulas need training. This paradigm has obviously reached its limits, since we are at the bottom of the abyss - where the history of childbirth is concerned.
The other group is characterised by an understanding of the birth process inspired by modern physiology. The birth process is considered an involuntary process, under the control of archaic brain structures. In general, one cannot help an involuntary process. However it can be disturbed by inhibitory situations easily identified through well-established physiological concepts, such as the concept of adrenaline-oxytocin antagonism and the concept of neocortical inhibition. Within this emerging paradigm the keyword is "protection" (of an involuntary process from inhibitory factors): the birth process needs to be protected in particular from the effects of language, light, and attention enhancing situations such as feeling observed or feeling insecure.
The physiological perspective is suddenly offering an opportunity to reconsider the basis of our cultural conditioning. It can help to interpret the doula phenomenon. It seems that ideally the doula phenomenon would be a transitory historical episode paving the way to the rediscovery of authentic midwifery. One just needs to recall that the mother is the prototype of the protective person. Originally the midwife was the mother or a substitute for the mother.
There is no paradigm shift without language shift. There are reasons to avoid certain terms. The term "training", for example, suggests that what the doula does is more important than who she is. However modern doulas need some basic information. This is the reason for the "paramanadoula information sessions" (see: www.paramanadoula.com). These three day sessions are provided by Liliana Lammers and Michel Odent. Liliana gave birth to four children and has four grandchildren. She has been a busy doula for 15 years. Michel is considered a pioneer in the field of midwifery/obstetrics (see: wikipedia.org). He is in particular the author of the first articles about the initiation of breastfeeding during the hour following birth.