(Content Warning: Miscarriage, Stillborn, Abortion, Fertility) 

When I discuss my study and practice, I often use the language, “full spectrum doula,” or “full spectrum perinatal care.” 

 Miriam Zoila Perez offers some insight in their pamphlet The Radical Doula Guide, “A full spectrum doula refers to a doula who provides support to people during the full spectrum of pregnancy – from birth to abortion to miscarriage to adoption.” And I would add, conception and contraception. “While the terminology of full spectrum doula and the programs that support that work might be new, the concept of full spectrum care is certainly not. Midwives have always served as abortion providers and fertility counselors. It is only in the most recent incarnation of midwifery, under the watchful eye of the medical establishment and the government, that the ability to provide these services has been removed from most sanctioned midwifery care. Doulas, similarly, have been providing support across the full pregnancy spectrum for as long as doulas have been around.” 

Often times when people imagine doulas, or even engage with them, they are overwhelmed or immediately turned off by their perceived crunchy, toxic-positivity approach to pregnancy and childbirth. Not every story related to our reproductive health is a happy one with a fairytale ending. I would be so bold as to say that most, if not all, reproductive health stories have challenging elements. In part, the role of a doula is to normalize what transpires physically, emotionally, socially, and spiritually during the perinatal period, but we have to be mindful that the ways in which we choose to normalize don’t blindly alienate other people, situations, and stories.

 As a full spectrum doula, this is why… 

 ..it is as important to me to hold space for the person who birthed a stillborn, as it is the person who birthed a perfectly healthy baby. ..it is as important for me to hold space for the person who has had multiple miscarriages, as it is the person who is pregnant with multiple babies. 

…it is as important for me to hold space for the pregnant person who is trans or non-binary, as it is the pregnant cis woman. 

…it is as important to me to hold space for the person who sought out an abortion, as it is the person who is undergoing fertility treatments. 

…it is as important to me to hold space for the person who is going through the adoption process, as it is the person who is electing to undergo a sterilization procedure. 

…it is as important to me to hold space for the single parent who is experiencing pregnancy without the support of a partner, as it is the co-parents who have hired a surrogate to carry their baby. 

…it is as important for me to hold space for someone who is exclusively nursing, as it for someone whom lactation wasn’t an option. 

…it is as important for me to hold space for someone who thrives in the postpartum period, as it is someone who struggles. 

…it is as important for me to hold space for someone who lays-in for 60 days postpartum, as it is for someone who returns to work after 10 days. 

And more. All of these people matter. All of these stories matter. 

 There is another element of full spectrum doula care that is vital – the ability to support individuals regardless of their care choices. I know that there are doulas out there who will only serve particular individuals/communities, or might not have the desire, capacity, training, or skill sets to comfortably serve a diverse client base. To me, a full spectrum doula is also comfortable serving anyone in need of service – regardless of gender identity, relationship status or dynamic, religious beliefs, history of personal traumas, preferences in regards to a no, low, or high-intervention labor, preferences in regards to infant feeding, approach to parenting, and so on. 

This work is deeply personal, which means it becomes even more important to maintain boundaried and intentional "professionalism." 

This work requires that we are constantly learning, growing, adapting, and adjusting. 

This work isn’t always easy. It is definitely not always rainbows and unicorns. But, it is so very important.