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What It Means to Have Cultural Competency as a Doula

Writer's picture: Kicki HansardKicki Hansard
Pregnant woman with henna tattooed belly.

Cultural competency is a phrase that gets used a lot, but what does it actually mean when it comes to being a doula? In a country like the UK, where people come from every corner of the world, it’s impossible to know everything about every culture. But that’s not really the point. Being a culturally competent doula isn’t about memorising customs or getting everything right. It’s about stepping into every birth space and home with an open mind, a willingness to listen, and the ability to adapt to each family’s unique way of doing things.


As an immigrant myself, coming from Sweden, I know first-hand that culture isn’t just about race or language. Although I come from a European background, I am not British, and I have experienced differences in communication and social norms compared to those who grew up here. In Sweden, there’s a strong emphasis on directness and honesty—if something doesn’t make sense, people tend to challenge it openly. That’s very different from the British approach, which can sometimes be more indirect, with an emphasis on politeness and avoiding confrontation.


I’ve had to adjust to this over the years, learning when to soften my words and when to hold back rather than speaking my mind immediately. But I’ve also noticed how this cultural difference plays out in birth spaces. In Sweden, it’s not uncommon for people to challenge medical advice if they don’t agree with it, whereas in the UK, many people have been raised to trust the system and follow recommendations without question.


Neither approach is necessarily right or wrong, but as a doula, recognising these subtle cultural differences can make a big difference in how you support a client. It also helps us understand our colleagues and everyone we work with, fostering better communication and collaboration in birth spaces.


Birth Culture vs Family Culture

One of the biggest misconceptions about cultural competency is assuming that all people from a particular background will think and act the same way. That couldn’t be further from the truth. Two people from the same racial or ethnic group can have entirely different expectations when it comes to birth, parenting, and the role of a doula.


Take, for example, a second-generation British woman whose parents immigrated from a different country. The traditions and expectations that shaped her parents’ views on birth may not align with how she sees things. She may feel torn between wanting to honour her cultural roots and also wanting to make her own decisions, especially if family members assume she will follow certain customs. These expectations might involve how she should give birth, who should be present, how she should recover, or even how she should feed her baby.


This is where the balancing act begins. As a doula, you may be the first person she confides in about her struggles—wanting to respect her heritage while also needing space to do things her own way. Some women feel the weight of their family’s expectations, but that doesn’t necessarily mean they want to reject their culture altogether. Instead, they may be looking for a way to merge their personal choices with their cultural identity in a way that feels right for them.


The role of a doula here isn’t to take sides or assume you know what’s best, but to help her find her own voice. She may need support navigating difficult conversations with family members or reassurance that she has the right to make choices that feel good for her. That support has to be led by her, not by your personal views on what is “best”.


Cultural Competency is Ongoing Work

It’s important to understand that cultural competency isn’t something you can master by attending a single workshop or reading a few books. While training sessions and courses can provide valuable insight, they shouldn’t be treated as tick-box exercises—something to do once and then assume the work is done. Being a culturally competent doula is about ongoing reflection, learning, and personal growth.


Each birth experience you attend gives you an opportunity to recognise your own biases, reflect on what you’ve learned, and adjust how you approach things in the future. It’s about being open to learning from the families you support, from other doulas, and from the broader cultural conversations happening around you.


Sometimes, you may realise that something you believed to be supportive was not helpful at all. Instead of feeling defensive, the best thing you can do is acknowledge, learn, and do better next time. For example, if a client shares that they felt uncomfortable with a comment or action, rather than explaining your intent, simply listening and acknowledging their perspective can build trust. A doula who once assumed all clients from a specific culture preferred a certain birthing method might realise the importance of asking open-ended questions instead. Small shifts like these can make a significant impact on the level of support provided.


Cultural competency is something you live and practice every day as a doula, not just something you learn about in theory. It’s about truly listening to the experiences of others and recognising that the way you see the world isn’t the only way.


Developing Cultural Competency Over Time

Since cultural competency is ongoing work, doulas need to approach it with curiosity, humility, and a willingness to grow. It’s not something you learn once and then “know”—it evolves with every client you support, every conversation you have, and every mistake you reflect on.


A good place to start is by actively listening. It’s easy to think we’re listening, but often, we’re just waiting for our turn to speak. True listening means taking in what someone is saying without filtering it through your own perspective first. Instead of assuming you understand what they mean, ask follow-up questions.


For example, if a client mentions that they feel pressure from their family to do something in a certain way, don’t jump in with solutions. Instead, ask, “How do you feel about that? What would feel right for you?” This opens the door for them to share more, rather than being put in a position where they have to justify their choices.


When to Advocate and When to Listen

One of the more complex aspects of cultural competency is knowing when and how to advocate for a client without overstepping. Doulas often witness bias in medical settings, such as healthcare professionals dismissing pain levels, making assumptions based on ethnicity, or not providing equal access to information. This is especially true when supporting people from marginalised backgrounds.


A culturally competent doula understands that advocacy doesn’t always mean speaking for someone—it often means empowering them to speak for themselves. Different cultural backgrounds may shape a client’s comfort level with advocacy, as some may come from traditions where medical professionals are unquestioned authorities, while others may be more accustomed to challenging decisions. Being aware of these variations allows doulas to tailor their support in a way that feels empowering rather than imposing.


For example, a client might feel that they aren’t being heard during labour, but instead of assuming they want you to jump in and challenge the medical team, you can ask, “Would you like me to support you in voicing your concerns, or would you like me to speak up for you? I also understand that in some cultures, advocating for oneself may not be encouraged or may feel uncomfortable. If that’s the case, I’m happy to take a more active role in ensuring your needs and preferences are heard and respected.” This simple question gives them control while still ensuring they are fully supported.


However, this is exactly why antenatal meetings and preparation for birth are so important. These conversations should happen well before labour begins, not in the middle of birth when emotions are high and decisions need to be made quickly. Asking these questions ahead of time ensures that both the doula and the client are on the same page, allowing for a more seamless and supportive birth experience.


Misunderstandings and Repairing Mistakes

Even with the best intentions, misunderstandings will happen. Doulas work with families during incredibly emotional and vulnerable times, so it’s natural that tensions might arise or that you might unintentionally say or do something that doesn’t sit right with a client. The key is to handle these situations with humility and a willingness to repair.


If a client expresses discomfort with something you’ve said or done, the best response is simple: “Thank you for letting me know. I really appreciate you sharing that with me.” You don’t need to explain yourself or justify why you meant well—just listen and learn.


Similarly, if you realise in hindsight that you may have misstepped, don’t ignore it. A simple, “I realise I assumed something earlier, and I just want to check in with you. How do you feel about that?” can go a long way in showing that you respect their experience and want to do better.


Cultural Competency is Just Being a Good Doula

At its core, cultural competency is about respect, awareness, and deep listening. It’s not about knowing everything—it’s about being willing to ask, to learn, and to adjust based on what each individual client needs.


A truly culturally competent doula understands that birth is not a medical event—it’s an experience shaped by identity, history, family, and personal belief systems. For instance, in some cultures, specific postpartum rituals are essential, such as a designated confinement period where the mother is cared for by family members, while in others, a more independent recovery is encouraged. Understanding these variations allows doulas to offer support that aligns with a family's unique needs and values. And the best doulas? They make space for all of it, without assumption, without judgment, and with an open heart.


So, if you’re wondering where to start, start with listening. Start with curiosity. Start with humility. And most importantly, start with the understanding that cultural competency isn’t something separate from being a good doula—it is being a good doula.


And like everything else in birth work, it’s not about getting it perfect. It’s about staying open, listening deeply, and always being willing to learn.

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