Is Gatekeeping Helping or Hurting the Birth Community & Mothers?

Unlock the Gates & Remove the Scope, Mothers are the Experts Here

The Triangle of Gatekeeping and the Loss of the Village: Reclaiming God-Given Wisdom

The birth community, composed of obstetricians (OBs), midwives, & doulas, has long been viewed as a crucial network of support for expectant mothers.

However, the gatekeeping evolving within this systematic industry has inadvertently contributed to the erosion of a vital cultural tradition: the village.

The communal wisdom, passed down from grandmothers, mothers, sisters, cousins & neighbors, has been overshadowed by a system that prioritizes professional training & outsourcing over autonomous, God-given wisdom.

The phenomenon of gatekeeping within this industry raises important questions about its impact on mothers and their ability to take personal agency over their health and choices.

Gatekeeping in the birth industry often involves placing experts on pedestals, creating a hierarchy that can inadvertently uphold systematic agendas focused on financial gain and control. This structure can force expectant mothers to outsource their care to professionals rather than empowering them to make informed decisions about their own bodies and birthing experiences.

Unlocking Knowledge: Empowering Mothers to Take Radical Responsibility for Their Health

"First, it takes about 4-12 weeks on average to get this appointment, causing a delay to care with your midwife. Those weeks are crucial to nutrition, emotional support, and common concerns… women are left alone." – Devotion Midwifery

The Problem: Delayed Care & Dependency on a Broken System

In certain states, policies require mothers to see an OBGYN before they can access midwifery care, leading to:

- Weeks to months of delayed prenatal education

- Lack of early nutritional and lifestyle guidance

- Medical coercion and loss of bodily autonomy

Restricting access to midwifery and home birth options under the guise of "safety." In reality, they create more harm by delaying critical care and placing obstacles between mothers and the providers they trust.

For example, Louisiana now requires an OB assessment before a mother can see a midwife, even though midwives are fully trained to assess risk and refer out if needed. This wasn’t always the case—but new regulations have forced women into unnecessary medical appointments, creating delays and increasing their exposure to coercion and unwanted procedures.

A mother should never be put in a position where she is forced into procedures she does not want just to access care.

But this is the reality for many women, leading to stories like the one shared by Devotion Midwifery:

"Today a mother called me in tears after her initial visit where she did NOT desire a Pap smear as part of the initial visit. She was adamant many times that she understood the risks and benefits of a Pap smear in the first trimester and declined. When the OB stated that they would refuse to complete this prenatal and began shaming ‘her kind,’ she accepted… to be done, so she could have her midwife. During the pelvic exam, the OB said, ‘and you won’t even remember all this once you have your baby’ as she cried.”

This is not how care should look. No woman should be made to feel powerless in her own healthcare decisions.

Mothers are the first caretakers, the first teachers, and the first line of defense in the well-being of their families. Yet, in many states, they are systematically denied access to crucial prenatal education, leaving them dependent on a healthcare system that dictates their choices rather than supports them.

The truth is, knowledge should never be gatekept—especially when it comes to pregnancy and birth. Every woman deserves the tools to understand her body, assess her own health, and make informed decisions without unnecessary barriers.

The Solution: Unlocking Education & Radical Responsibility

The most powerful thing a mother can do is educate herself.

When knowledge is no longer gatekept, women can:

- Assess their own health early instead of waiting for a provider to tell them what’s happening with their body.

- Order their own blood work and ultrasounds through direct-to-consumer labs, bypassing unnecessary gatekeeping.

- Understand proper prenatal nutrition and make adjustments before complications arise.

- Recognize the warning signs of complications and take proactive steps to prevent issues rather than reacting after they’ve progressed.

A Faith Driven Doula & Childbirth Educator can provide this education from the very start—before a mother ever steps foot in a doctor’s office. No delays. No coercion. Just informed decision-making.

Taking Back the Power

It is time for mothers to reclaim autonomy over their health and bodies by seeking knowledge outside of the system that profits from their ignorance.

We live in a time where information is more accessible than ever. Yet, policies and regulations still try to keep women dependent. The answer is simple: stop waiting for permission to take charge of your own health.

Education is the key to freedom in birth, confidence in choices, and true self-advocacy. Mothers are not passive participants in their care—they are the first and most important decision-makers.

And when they are equipped with knowledge, they will be equipped to make the best decision for themselves and their baby, navigating the system with self agency as needed.

Consider the triangle that represents the pedestal of gatekeeping in childbirth education, where mothers are required to hire experts:

Each point of this triangle—OBs, midwives, and doulas—plays a crucial role in the childbirth process.

Gatekeeping practices within these roles can sometimes lead to:

1. Outsourcing Care: Expectant mothers often have to rely on their providers to get permission or referrals for testing and blood work. This dependency extends to interpreting the results based on their perception, leaving women reliant on external validation rather than empowering them to order and interpret their own labs.

2. Trauma and Transition: When OBs cause trauma or fail to meet the emotional and holistic needs of mothers, many turn to midwives as an alternative. While midwives can provide valuable support, this can still represent another branch of the system that takes control of the birthing process, often shifting dependency from the hospital to outside its walls.

3. Limited Doula Scope: Doulas, while offering crucial emotional and physical support, are often restricted in their scope of practice. They are trained to avoid providing certain types of childbirth education unless they advance to become midwife assistants or midwives themselves. This limitation perpetuates a system where mothers must continually outsource aspects of their care and remain reliant on various experts.

4. Financial Burden: Expectant mothers may feel pressured to hire multiple experts to ensure comprehensive care, leading to significant financial costs. This can create an economic barrier, limiting access to holistic and individualized care for many families.

5. Loss of Personal Agency: When the emphasis is placed on professional expertise over personal knowledge, mothers may feel disempowered and less confident in their own ability to understand and navigate their birthing process. This can lead to a reliance on external validation and approval for their choices.

6. Systematic Control: The hierarchical structure can perpetuate a systematic agenda where the primary goal shifts from mother-centered care to maintaining control and financial gain. This control can manifest in routine interventions, standardized protocols, and limited options that do not necessarily align with the mother's preferences or best interests.

The Lost Wisdom

Grandmothers and mothers, once the primary sources of birthing knowledge, are now often sidelined. Their God-given wisdom & touch, which includes practical advice, emotional support, and spiritual guidance, is undervalued in a system that emphasizes professional credentials over lived experience. Over the last 100 years, mothers and grandmothers have faced systematic medical oppression through practices like twilight birth and the rise of 21st-century hospitals. As birth became more institutionalized, the industry grew, and birth was increasingly mandated within the medical system. As a result, mothers did not have a chance to redeem or pass down the God-given wisdom that had been central to childbirth for generations.

Twilight Birth and Medical Oppression: Twilight birth, a practice used in the mid-20th century where women were heavily sedated during labor, exemplifies the systematic oppression that removed women from active participation in their birthing processes. This not only disempowered women but also disrupted the transmission of birthing knowledge from one generation to the next.
Institutionalization of Birth: The rise of hospitals and the medicalization of birth throughout the 21st century further eroded the village. As birth became increasingly managed by medical professionals, the role of grandmothers and mothers as primary sources of wisdom was diminished. This shift prioritized medical intervention over the natural, intuitive practices that had been handed down through generations.
Disconnection from Tradition: The emphasis on professional credentials and medical intervention has led to a disconnection from traditional birthing practices. Mothers are often made to feel that they lack the knowledge and capability to navigate pregnancy and childbirth without professional intervention, leading to increased reliance on the medical system and a loss of personal agency.

Reclaiming God-Given Wisdom

To counteract the negative effects of this gatekeeping, it is essential to reclaim and honor the wisdom that has been passed down through generations. Here are some steps to reintegrate this valuable knowledge into the birthing process:

Empowering Mothers and Families: Encouraging mothers to trust their instincts and seek knowledge from their family and community can restore a sense of autonomy and confidence. This empowerment can help mothers make informed decisions that align with their values and beliefs.
Valuing Traditional Wisdom: Recognizing the importance of the wisdom shared by grandmothers and mothers can help to reintegrate this knowledge into modern birthing practices. This involves creating spaces where their voices can be heard and respected. Becoming the storytelling mothers & grandmothers.
Balancing Professional and Personal Support: While professional support is valuable, it should not replace the guidance and wisdom provided by the village. Finding a balance between professional care and community support can lead to more holistic and fulfilling birthing experiences.

The Role of Doulas and Birth Workers

The evolving role of doulas and birth workers should focus on bridging the gap between professional support and traditional wisdom. Rather than positioning themselves as advocates who fight against the system, doulas can serve as educators who empower mothers to take charge of their birthing experiences. By providing both practical support and education, doulas can help to restore the balance between professional care and personal agency.

Education and Empowerment: Doulas can focus on educating expectant parents about the birthing process, pain management techniques, and the importance of choosing a supportive team and environment. This education can help parents feel more confident and capable of making informed decisions.
Supporting Autonomous Choices: By respecting and valuing the wisdom of grandmothers and mothers, doulas can help to reintegrate this knowledge into the birthing process. This involves encouraging mothers to trust their instincts and seek guidance from their community.
Creating a Supportive Network: Doulas can work to create a supportive network that includes both professional and personal support. This network can provide a holistic approach to pregnancy and childbirth, ensuring that mothers receive the care and guidance they need from a variety of sources.

What Education Does the Pedestal Triangle Gatekeep?

The gatekeeping within the pedestal triangle of OBs, midwives, and doulas often restricts access to comprehensive education on various aspects of prenatal care, physiology, and true understanding of one’s health, including:

1. Holistic Prenatal Care: Understanding nutrition, exercise, and lifestyle choices that support a healthy pregnancy beyond just medical interventions.

2. Physiology of Birth: Detailed knowledge of how the body works during pregnancy and childbirth, including the hormonal processes, the stages of labor, and the role of the baby in navigating the birth canal

3. Informed Consent and Birth Choices: Education on the importance of informed consent, understanding medical procedures, and having the ability to make choices that align with personal values and preferences.

4. Emotional and Mental Well-Being: Recognizing the importance of mental and emotional health during pregnancy and how to manage stress, anxiety, and other emotional challenges.

5. Natural Pain Management Techniques: Techniques such as breathing exercises, hydrotherapy, massage, and other non-medical pain relief options that can empower mothers to manage labor pain naturally.

6. Postpartum Care: Comprehensive information on what to expect after birth, including physical recovery, emotional adjustments, breastfeeding support, and newborn care.

7. Civil Birth Rights: Knowledge of one's rights within the healthcare system, how to advocate for oneself, and understanding the legal aspects of childbirth options.

Doula's & Midwives made out to be Saviors

Women are often promoted the idea that doulas & midwives can lower the statistics of birth trauma and intervention in their pregnancy and birth. However, these statistics should focus on how choosing a team and environment that respects the mother as the leader and authority is where the true reduction in trauma and unnecessary interventions occur. By educating both parents to take charge & advocate for their own birth rights, regardless of whether a doula or midwife is present, they are empowered to make informed decisions. Hiring a doula who is also a childbirth educator is crucial for these reasons. This dual role not only provides emotional and physical support but also equips parents with the knowledge and confidence to take charge of their birth experience.

Reclaiming Personal Agency in Childbirth

To address these challenges, it is essential to shift the focus towards empowering expectant mothers with knowledge and confidence.

Here are some strategies to mitigate the negative effects of gatekeeping:

Education and Awareness: Provide comprehensive childbirth education that emphasizes the mother’s role and capabilities. This includes understanding physiological processes, exploring natural birth options, and highlighting the importance of informed consent.
Community Support: Encourage peer support groups and community-based initiatives where mothers can share experiences, resources, and support without the pressure of professional gatekeeping.
Holistic and Integrative Care: Promote care models that integrate the expertise of OBs, midwives, and doulas while centering the mother's preferences and choices. This collaborative approach can help ensure that mothers receive well-rounded care without feeling disempowered.
Navigating the System: Educate mothers on their civil birth rights and how to navigate the healthcare system effectively. Understanding one's rights and advocating for oneself within the system can help ensure that care aligns with personal values and preferences.

While experts in the birth community play a vital role in supporting expectant mothers, the gatekeeping practices that elevate these roles can sometimes hinder rather than help. By promoting education, community support, holistic care, and navigating the system through personal civil birth rights, we can empower mothers to reclaim their personal agency and make informed choices about their birthing experiences. This shift towards a more inclusive and supportive birth community ultimately benefits both mothers and the broader healthcare system.

The Truth About Doula Support: Breaking Misconceptions and Restoring the Role

For too long, large doula trainings have failed doulas by prioritizing advocacy over education—reducing their role to hospital birth activists rather than birth educators and emotional support providers. This has led to widespread misconceptions about what doulas truly offer, from pregnant mothers to medical professionals and even aspiring doulas themselves.

Common Misconceptions About Doulas

Pregnant Mothers:

“A doula replaces my partner.” – No, doulas enhance partner involvement, not replace it.

“Doulas are only for home births.” – Many mothers assume doulas are only for out-of-hospital births, but doulas provide essential support in hospitals too. As one mother put it, “I thought doulas were just for home births, but mine made all the difference in my hospital birth. She helped me understand my choices, stay calm, and feel in control.”

“Doulas make decisions for me.” – Doulas provide education and support, but mothers make their own choices.

“If I have a midwife, I don’t need a doula.” – Midwives focus on clinical care; doulas provide continuous emotional and physical support.

“Doulas only support unmedicated births.” – Doulas support all birth choices, including epidurals and C-sections.

“A doula is only helpful in a hospital to fight for my rights.” – This is one of the biggest misconceptions fueled by large doula trainings that frame doulas as birth advocates rather than support professionals. Many doulas are being hired under the expectation that they will challenge hospital staff and policies rather than focus on emotional and physical support. This has led to unnecessary conflict and has overshadowed the true value doulas bring to all birth settings, including home births and birth centers.

Fathers/Partners:

“A doula will take my place.” – Doulas guide and empower partners to be involved in meaningful ways.

“Birth is a private experience—we don’t need an extra person.” – A doula provides calm guidance without taking over.

“We can just rely on the nurses.” – Nurses have multiple patients; a doula offers continuous, one-on-one support.

“A doula means my partner doesn’t trust me to support her.” – A doula complements a partner’s support, not replaces it.

Midwives:

“Doulas overstep and act like midwives.” – Professional doulas stay within their non-medical scope.

“Clients rely on doulas more than their midwives.” – Doulas and midwives serve different but complementary roles.

“Doulas create unnecessary tension between providers and families.” – A well-trained doula fosters teamwork and communication.

“Doulas are only needed in hospital births.” – Doulas play a vital role in home births by supporting labor flow, relief, positioning, and emotional connection.

“Doulas push confrontation with midwives.” – The overemphasis on doulas as "advocates" in hospital births has led to an adversarial mindset, creating tension not just with OBs and nurses but also with midwives in home birth settings. Instead of working together, doulas trained under this model sometimes challenge midwives.

Nurses:

“Doulas interfere with medical decisions.” – Doulas support informed decision-making but do not advise medically.

“Doulas are anti-hospital.” – Many doulas work within hospitals and collaborate with staff.

“Doulas encourage risky birth choices.” – Doulas provide balanced, evidence-based education to help families make informed choices.

“Doulas make my job harder.” – Doulas often make it easier by keeping moms calm and lowering intervention rates.

“Doulas push back against hospital policies.” – Some training organizations have promoted medical advocacy over evidence based support, causing unnecessary conflict. However, doulas are meant to work to teach navigating the system to serve the mother’s best interests. There is a time and place for legal activism, where doulas can leverage their legal power to change policy and promote respect, but this is not during the sacred moments of labor and birth.

OBs:

“Doulas promote unscientific methods.” – Many doulas are trained in evidence-based birth support.

“Doulas only work with those who refuse interventions.” – Doulas support all birth plans, including those with interventions.

“Doulas discourage hospital births.” – Doulas work in all settings and respect each family's choice.

“Doulas cause unnecessary conflict with medical staff.” – The push for doulas to act as birth advocates rather than support professionals has led to increasing tension with hospitals, leading to the regulation of doulas in some states.

Aspiring Doulas:

“I have to attend a certain number of births before I can be a doula.” – Many programs, like Faith Driven Doula, certify without birth attendance requirements.

“I must be an expert on everything birth-related.” – A doula’s role is support in continued perinatal research, not expertise in all aspects.

“Advocacy is my primary job as a doula.” – Many large doula trainings push advocacy as the core of birthwork, teaching doulas to challenge hospital staff and policies. While empowerment and informed choice are vital, this confrontational approach has led to distrust, exclusion from hospitals, and even doula regulation in some states. Instead of advocacy, doulas should focus on education, emotional support, and fostering collaboration.

“If I don’t work in hospitals, I won’t have enough clients.” – There is a growing demand for doulas in home birth, postpartum care, and virtual coaching.

How the Push for "Advocacy" Led to Doula Regulation

Many mainstream doula trainings have emphasized advocacy in hospital births—framing doulas as warriors against the system rather than supportive guides for families. This has caused unnecessary confrontations with nurses, midwives, and OBs, creating tension instead of collaboration.

As a result, some hospitals and states have pushed for regulations on doulas, limiting their access to birthing spaces and requiring specific certification/training.

This shift has reduced options for families by placing unnecessary restrictions on doulas, ultimately undermining the autonomy that doulas were meant to support. Instead of bridging the gap between families and providers, doulas are now facing increasing barriers to practice, making it harder for mothers to access the support they deserve.

The Truth About Doula Support: Restoring the Role

Doulas are not there to fight for a mother’s rights but to empower her with education, comfort, and emotional grounding so she can confidently advocate for herself. When doulas return to this heart-centered approach, they become valued partners in birth, no matter the setting—hospital, home, or birth center.

Many doulas are being failed by large training organizations that strip away a crucial part of their role—childbirth education. Instead of equipping doulas with the knowledge to truly inform and empower families, these programs focus primarily on advocacy and hospital navigation, leaving doulas unprepared to teach and guide mothers through their own decision-making. This omission is not accidental—it’s part of a larger cycle of outsourcing education, keeping both doulas and mothers dependent on the system rather than fostering true autonomy.

This is why the Faith Driven Doula Program takes a different approach. We believe that doulas should be educators first, restoring birth knowledge to the hands of mothers rather than placing it solely in the medical system. The modern shift has turned doulas into hospital birth advocates rather than true birth guides, creating unnecessary conflicts with medical staff and leading to government regulation that limits doulas' ability to serve freely. The result? A misunderstanding of the doula’s role and a growing belief that doulas are only needed for hospital births—when in reality, they are essential in every setting.

But the real answer isn’t more advocacy—it’s education.

By prioritizing education over reactive advocacy, we equip doulas to inform, guide, and support families from the very start. This approach doesn’t just change birth experiences—it transforms the system itself. When mothers have a deep understanding of their bodies and birth options before labor begins, they make empowered choices with confidence. This shift reduces unnecessary trauma, decreases intervention rates, and prevents doula burnout.

Doulas were never meant to be warriors in hospital battles. They were meant to be guides, teachers, and unwavering support. When we return education to where it belongs—with doulas and the families they serve—we don’t just create better doulas. We create a movement that truly honors birth.

The Faith Driven Doula & Childbirth Educator ONLINE Training is designed to equip you with the tools, wisdom, strength and spiritual foundation to serve confidently, protect your heart, and create a sustainable practice.

This training focuses on:

🌿 Serving with Purpose – Rooting your birthwork in Avodah, where every action becomes both worship and service, reflecting God's love in the sacred work of birth.

💨 Walking in the Spirit – Learning to invite and rely on Ruach, allowing God’s strength, peace, and discernment to guide you as you support families through birth and beyond.

✨ Empowering Families – Equipping you with faith-centered, evidence-based knowledge to educate and uplift families, helping them step into birth with confidence and authority.

🕊 Sustaining Your Calling – Guarding against burnout by integrating spiritual renewal, prayer, and intentional rest, ensuring that your work is both sustainable and spirit-filled.

🏡 Creating Holy Ground – Cultivating birth spaces where God’s presence is tangible, inviting peace, faith, and divine connection into each moment of labor and birth.

🤲 Loving with Chesed – Embodying steadfast, covenantal love that does not waver, reflecting God’s unwavering faithfulness in every birth space.

⏳ Waiting with Qavah – Learning the sacred rhythm of waiting on the Lord, trusting in His perfect timing, and embracing the tension between preparation and surrender in birthwork.

Learn more about the training that transforms passion into a fulfilling, lifelong calling.

Join us for a FREE 5-Day Faith Driven Doula Discovery Challenge and explore whether becoming a doula, childbirth educator, or hands-on skills practitioner aligns with your calling!

✨ What to Expect:

✅ Daily lessons to uncover your gifts & strengths

✅ Faith-centered reflections & journaling prompts

✅ Action steps to gain clarity on your birthwork journey

✅ A supportive community of like-minded women

God may be calling you to serve in the sacred space of birth. Will you answer?

📅 Challenge Begins Now– Sign Up Today!