Navigating Birth in Spain: Insights from a Doula and Therapist
We are well into the year now, and hopefully, spring will arrive soon, bringing new hopes, new projects, and fresh perspectives.
After six years of working as a counselor providing psychotherapy to women in the perinatal period and as a doula supporting couples through pregnancy and birth in various settings alongside midwives and OBGYNs, my time in Spain has given me valuable insights into the differences in how birth is approached and supported compared to the Netherlands; deepening my appreciation for my years of training and experience there.
Doula Training in the Netherlands vs. Spain
In the Netherlands, the doula profession is regulated, ensuring high training standards. Our education includes extensive theoretical and practical training, self-study, research, and internships in hospitals and midwifery practices. This holistic approach prepares us for a variety of birthing scenarios and allows us to advocate for women using non-violent communication and evidence-based information. Collaboration is a key aspect of our work, ensuring doulas are respected and valued in medical settings.
Despite this standardized training, doulas in the Netherlands develop their skills in different directions. Some specialize in home births, while others focus on clinical settings or mental well-being. My personal focus has always been on supporting women in achieving their birthing goals, regardless of the setting.
My Journey into Doula Work
Many doulas enter the profession for many reasons: they have either experienced a transformative birth that inspired them, or they have endured a difficult birth and seek healing through supporting others, and have a deep-rooted passion for birth advocacy, a desire to support women in vulnerable moments, and a commitment to improving maternity care. My path was the latter.
After the traumatic birth of my twins, I struggled with PTSD while caring for newborns. My healing journey led me to study birth trauma, understand why my experience unfolded the way it did, and explore what could have been done differently. Over the years, supporting numerous births has been both a learning and healing process for me.
However, working in Spain has reawakened some of those emotions. Being a doula requires constant self-reflection and personal growth. Every birth we attend teaches us new lessons, sometimes in unexpected ways.
The Reality of Being a Doula in Spain
The need for doulas in Spain is undeniable, but awareness of the profession remains low. Unlike in the Netherlands, doulas in Spain operate in an unregulated field with no formal certification process. This allows anyone to adopt the title of 'doula,' leading to inconsistencies in training and practice. As a result, many healthcare professionals misunderstand or mistrust the role of doulas, which may contribute to their exclusion from hospitals.
Additionally, outdated hospital procedures in Spain—many of which increase the risk of birth trauma—further complicate the acceptance of doulas. Through my work as a counselor, I have heard numerous accounts from women who have experienced traumatic births due to unnecessary interventions or lack of informed consent.
For immigrant women, navigating the Spanish birth system can be even more challenging. Language barriers often make it difficult to access crucial information, and cultural differences can lead to misunderstandings about birth preferences and rights. Many hospitals prioritize a medicalized approach, leaving little room for holistic or patient-centered care, while home birth options may lack clear guidance on emergency transfers. Without a clear, accessible system, immigrant women may struggle to advocate for themselves and make informed decisions about their births.
A Glimpse of Hope
Despite these challenges, I have also encountered compassionate and open-minded healthcare professionals in Spain who are eager to improve birthing experiences. There is potential for positive change, and I remain hopeful that the role of doulas will gain recognition and acceptance over time.
While I will continue to support a limited number of doula clients each year, my primary commitment remains providing a safe space and guidance for women recovering from birth trauma through one-on-one therapy. By offering personalized care and evidence-based strategies, I aim to empower women on their healing journey and help them regain confidence in themselves and their birthing experiences. Every woman deserves to feel heard, supported, and empowered in her birthing journey.
Whatever the next chapter brings, I welcome it with open arms, renewed purpose, and unwavering dedication to this important work.
Join the Conversation
If you’ve given birth in Spain, what was your experience like? Were you aware of doula support options? I’d love to hear your thoughts in the comments!