What's the Difference between Doulas and Midwives?
Many of us hold great passion for the well-being of women and their babies! Whatever our role, it’s a delight to empower them in their journey of becoming a family, as well as being powerful work in itself. The work of doulas and midwives share some common ground, and yet they are vastly different roles in the year of pregnancy and birth. Both doulas and midwives attend women in childbirth. They both trust the power of a woman’s body to birth, and hopefully are devoted to supporting the birthing woman in the labor and birth process she desires. Exactly what they might do, and especially the responsibility that they carry, though, is very different.
Doulas and Holistic Doulas
The word ‘doula’ is said to be from the Greek, meaning ‘with woman.’ Doulas are professional, sensitive, labor-support persons; they are privately hired by families to be with them during the labor and birth of their babies in a supportive way. The exact nature of what skills and ideas doulas might bring to the birth depend on:
Birthing location – Hospital, birth center, or home?
Birthing environment – A relaxed, supportive birth center; friendly home; intense, high-risk medical center, or something in-between?
Birthing circumstances – Are the intentions to 'go natural', use pain meds, or a planned C-section?
Birth attendant – An obstetrician, family practice doc, nurse-midwife, or traditional midwife?
Overall, well-trained doulas will be capable medical advocates, knowledgeable on the normal process of labor and birth, and full of ideas to ease and facilitate the mother/baby’s birth process. Doulas aspire to be uplifting and positive presences for mother and partner, and provide continuity of care. Generally, doulas are interviewed, hired and paid for by parents independent of their maternity care.
In addition to being supportive of both mother and father/partner at the birth, the doula relationship will generally include at least a few meetings prenatally, to get to know each other and the family’s priorities, and 1-2 meetings during postpartum to debrief from the birth and answer questions about the baby and recovery. There are doulas who also provide in-home postpartum assistance and support as separate work.
Holistic doulas bring additional resources to their birth families. In addition to the basic doula information such as positive positions for helping the labor progress, holistic doulas will also have education in a range of naturopathic support that may include nutrition, homeopathy, herbology, flower remedies, therapeutic use of essential oils, and much more. There is growing interest in natural health, and in the benefits of blending natural approaches to increase safety and satisfaction in the birth process. Thoughtful and educated use of natural remedies will compliment medical approaches when they are needed or desired, it does not have to just be an either/or approach. Holistic doulas have a wide range of helpful ideas when a client is experiencing severe pain, fear, or even when they are throwing up!
Midwives
Midwives are primary healthcare providers, responsible for the health and well-being of the mother and unborn child throughout pregnancy, labor and birth. They could be a certified nurse midwife (CNM), who most commonly works in medical settings such as hospitals with or under the OB/GYN physicians who are in charge. On the other end of the spectrum, she could be a traditional lay midwife or certified professional midwife (CPM), who independently attends births in families’ homes.
All of these primary care providers are providing maternity care in the form of monthly prenatal visits in which they check the health, vital signs, and overall well-being of the mother and baby. Midwife prenatal appointments are likely to run 20-60 minutes each, with plenty of time to answer questions and offer information as well. This is compared to OB visits, which are generally much shorter, due to the mandates of insurance guidelines and medical scheduling. Because of their shared, women-centered maternity health perspectives, midwives and doulas often appreciate each other’s work and may be at births together. Doulas assist mothers in positioning, provide emotional support and encouragement and act as an advocate for their individual birth plans, regardless of who is their health care provider. Midwives may also do these things, but are actually delivering (or "catching") the babies, and are responsible for the health care and safety of the mother/baby dyad in labor and birth. Keep asking lots of questions until you find a good understanding of your choices, and good match for your birth and parenting journey!
Thanks to Anna Civolani,for her photo on Unsplash