Midwife or Doula?

Midwife or Doula? That is the million dollar question.. As a Midwife, I get this question all of the time.. “What's the difference?” In the past I just never understood why people didn't know, but obviously because I knew and everyone around me knew too. The problem is a good majority of people don’t really know and this includes some health care professionals. Well, let me break it down in easy terms. Here is what Google says, A midwife is a health care provider while a doula is more of a childbirth coach. You might choose to have a midwife instead of an OB for prenatal care and to deliver your baby —midwives can deliver babies in hospitals, birthing centers or even in your home. Thank you Google, that clears it up! Even then people still don't understand why they need one over the other.. It’s not that difficult to understand when you know our backgrounds and what we can do. As a midwife, we specialize in prenatal care, childbirth education, labor birth and postpartum care. We are the health care provider for mom and baby. We do support and comfort mothers throughout the process and of course we will rub your back in labor but, we at some point need to take a step back to make important health related decisions. Imagine this, you're in labor and your midwife is coaching you through every contraction, rubbing your back, taking your vital signs, listening to baby's heart tones, charting and making sure not only you but your family is doing well throughout the process too. Let's say this goes on for 20 hours. Lets also say something unplanned starts to present, like your blood pressure starts to rise or you're running a temperature. If we are managing all of those other things and we need to make a medical decision it may be very difficult to do while also being emotionally in the moment. I always tell moms, at some point we need to step away so that we can look at the scenario from the outside and make a clear  responsible decision. If you’ve ever been to a birth in the hospital, the Doctors are usually making decisions from everywhere else but there. The nurses are reporting everything and they are giving orders based on that. Now, we are not like doctors and do not like to be compared in no way, but it’s just an example. Now on the other hand, A doula, also known as a birth companion and post-birth supporter, is a non-medical person who assists a person before, during, and/or after childbirth, as well as her spouse and/or family, by providing physical assistance and emotional support. The word doula is a Greek word meaning women's servant. Women have been serving others in childbirth for many centuries and have proven that support from another woman has a positive impact during the process .This means, they will rub your back, breathe with you through every contraction, make sure your family is doing well through the process and the list goes on. When Midwives work with Doulas, it’s like the mom has her own Justice League! Defenders of Natural Childbirth!! ( I have boys so I think in Superhero terms)  The Doula is comforting her while we are using our Midwife skills to encourage a smoother and hopefully faster delivery. If the Doula needs a break, we are there to take over so that mom always has her team supporting and encouraging her. It’s what we like to call “a win win”!! Evidence shows that having both a Midwife and a Doula present at a birth GREATLY reduces the need of unnecessary interventions and c sections.  When the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) released their groundbreaking "Safe Prevention of the Primary Cesarean Delivery" Obstetric Care Consensus Statement in February 2014, one of their key recommendations to reduce the primary cesarean rate in the USA was the continuous presence of a doula at a birth. (Caughey, 2014) Having a doula present at a home birth often means that two heads are better than one when it comes to suggesting coping techniques and offering comfort  that allow the labor to progress. So, now that we’ve cleared that up, I hope you’ll have your own Justice League at your birth.. We’ll be here waiting for the call to defend Natural Childbirth!!!