Though birth is universal, the context given to the event by the culture in which a woman births, as well as the culture in which she was raised, can have a profound effect on birth. In order to function within this framework, a doula should:

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Cultural competence is a core standard of work as a doula, and is an ever-changing process. The doula can best individualize her care for a client by learning as much as she can about the client's cultural understanding of pregnancy, birth, breastfeeding, parenting, etc. Judging a client by the precepts of a dominant culture, as well as stereotyping based on assumptions, can marginalize the woman, and can create antagonism between doula and client. The helping relationship should be focused on the client's needs. The doula will have her own cultural beliefs and values, but should not impose them on the woman she is supporting.

Though Birth Is Universal, the Context Given to the Event