The conclusion summarizes the reflections elaborated throughout the book. The development of doulas in Italy started in the first decade of the 2000s, and at this time of writing (September 2021), around 1000 Italian doulas have been trained. In their activities, doulas embody a pluralism of symbols, meanings, and systems of knowledge; they are legitimizing their jurisdiction through their various practices and techniques. The doula is a social care profession that I have named doulaing, which can be described with the metaphor of “patchwork.” What gives coherence to this patchwork are the particular texture and designs into which the differing elements are assembled. Doula work is designed around a specific relational style and a set of skills that work to facilitate and enhance the perinatal experience. This expertise and relational style give consistency to the patchwork. To understand the doula profession in Italy, I find it useful to imagine a large patchwork quilt of many colors, in which each small quilt piece is sewn by an individual doula. Together these quilting pieces, when sewn together, create a larger, recognizably coherent pattern. And I like to think of this quilt as a blanket available to all childbearers to warm, comfort, protect, and empower them in the multiple, patchwork ways that doulas employ.

Furthermore, I see the Italian doula profession as engaged in the creation of a social structure able to guarantee its effectiveness toward crucial audiences: the state/legal system, public opinion, and the workplace. Despite the different meanings that doulas attribute to their practices, and holding different values and perspectives, the professional group maintains compactness, thanks to the embodiment of a shared rhetoric of sisterhood and solidarity that is able to provide cohesion and consistency. Although a large group of Italian midwives opposes doula development, a smaller group does not, thereby opening up the possibility of collaboration between Italian midwives and doulas, which would greatly benefit mothers. The presence and growth of the doula in Italy also urges the biomedical field toward the adoption of a social–humanistic paradigm that encompasses substantial autonomy for midwives and welcomes the presence of doulas throughout the perinatal period.