The experience described in this article could not be more remote from my own experience with a doula, or stories I’ve heard of others’ experiences. My understanding, supported by my own experience and those of others in my circle, is that a doula supports a mother through the labor process and advocates (to the extent it is possible) for the choices made by the mother–whatever those choices may be. The article mentions doulas who limit their practice at the outset to women who seek to have a natural birth. This seems wholly legitimate to me, and seems completely distinct from the example given at the beginning of the article of a doula who walked out because the woman chose the epidural. I suspect that example was either (1) an anomaly, or (2) a more complex a story than what was relayed by the mother. At any rate, I think the article could have done more to distinguish between those doulas who would "walk out" because medical interventions had been chosen, and those who make a professional and ideological commitment to natural birth for very important and well-supported reasons. The article exploited the idea that doulas pursue their commitment in a manner that is "doctrinaire," without doing much to examine the doctrines doulas and midwives challenge by definition. By this I mean long-established doctrines announcing generally that babies are "delivered" by people other than the mother, and that such "delivery" always or typically requires medical interventions.
One more point: As a Southern woman, I am highly suspicious of the article’s conclusion–based, it seems, on statistics drawn from medical communities in ALABAMA and VIRGINIA–that doulas are routinely in conflict with health care professionals and hospital staff. This seems to lay the blame for the conflict at the feet of doulas in these places, with no consideration of whether the medical communities at issue have grown to accept doula practice and natural birth as legitimate approaches to a shared end. Without drawing a whole lot of baseless conclusions about Alabama and Virginia, I would say that based on my own experience researching the natural birth resources in Tennessee (where I might have given birth to my son had he come two weeks earlier than he did), there was a whole different set of expectations than we have here in New Mexico. Unfortunately, I think the Times article does more to undermine the stature of doula practice in those places, where doulas and natural birth are struggling to achieve acceptance, where a more even-handed approach might have celebrated the progress that doulas have made in bridging the gap between natural birth and the conventional medical approach. By my own choice, I had an unmedicated birth in the hospital setting, and was struck by the harmony achieved by the various participants in that experience, including my doula, nurse midwife, nurses, pediatric staff, and other hospital staff. With ever-increasing doula involvement nationwide (stats referenced in the article), I can only imagine that the "conflicts" described in the article will decrease as the idea takes root.