the difference between doulas and midwives
I hear you’re planning to give birth with a midwife…
So, have you hired a doula yet??
“Nah”, you think. “Doulas are great for hospital births, but I’m birthing with a midwife! My partner’s very supportive, too. A doula won’t really be necessary.”
While it’s true that birthing with a midwife is likely to be pretty different than birthing with an OB, a midwife’s role still has more in common with an obstetrician’s than a doula’s.
Simply put, a doula is trained in providing physical and emotional care, while a midwife is a medical care provider.
Midwives provide clinical care, akin to the role of an obstetrician. While midwives do have a general reputation for being more involved, hands-on, and emotionally attuned to their patients than OBs, they’re still responsible for the clinical aspects of your care, which means a lot of checking, charting and paperwork.
Doulas do not offer medical care, but what people don’t really realize is that birth is NOT, in fact, a medical event.
We have allowed birth to be dressed up as a medical procedure - and the truth is that both midwives and doctors alike must adhere to regulatory protocols that have more to do with preserving their state license than with the finer aspects of your birth experience.
A doula will be there to provide nearly continuous, hands-on emotional and physical support during your entire labor – from the moment she arrives until after the birth of your baby.
A clinical care provider does not specialize in helping you to cope with the waves of contractions as they come. They’re there to ensure you have a clinically-defined-as-’safe’ outcome – and not terribly focused on your personal experience of the labor journey.
The consistent, heart-centered, moment-by-moment support that a doula offers simply can’t be done as well or as thoroughly by a care provider whose role is also tied up with clinical tasks, nor by a husband or partner who is emotionally invested in the birth themselves.
Even though your midwife may be an amazingly nurturing care provider, it’s highly unlikely that she’ll be able to hold your hand or rub your back the entire time you’re in labor - and it’s important to recognize the limitations of her care.
Your partner may be eager and willing to help, but he/she isn’t professionally equipped with the skill set that a great, experienced doula is – and he or she may also be feeling overwhelmed or fearful about your labor.
A doula, however, is there specifically to do just that – and much more. She attends to all aspects of your emotional, mental, and physical well-being – and your partner’s, too!
As both the mother’s romantic partner and as the other parent of the baby, partners are usually a key support person for a laboring woman.
There’s already a deep and intimate bond in place, and a high degree of trust between the two of them.
However, birth is a significantly emotional event in the life of a father, too.
It’s difficult for dads to become overnight experts on all-things-childbirth, keep calm and stay positive on little to no sleep, and be the sole support person through the course of a labor that may take a very long time. A typical labor is usually exhausting, both mentally and physically, for moms as well as dads. Read more on why dads love doulas.
Furthermore, even the best childbirth class can’t give a partner all the skills and knowledge that an experienced doula has at her disposal. It’s all too easy to forget everything you’ve learned once you’re actually expected to use those skills!
A doula’s calm, confident presence can reassure both mom and dad as labor progresses.
Instead of relegating dad to the back of the room, a doula will gently suggest ways in which he can be helpful to his partner, that feel good to both of them.
Most doulas are quite well-versed in “reading the room” and intuiting the feelings and needs of everyone present, even if it’s something as simple as adding ice to mom’s water bottle. Your doula will also be able to take over caring for the mother when her partner needs a moment to eat, go to the restroom, make a phonecall, or take a short nap.
During labor, there are so many little things that, alone, don’t sound like they have a big impact on the way a birth unfolds.
For example – needing to apply consistent pressure on just the right part of mom’s back; having the lights dimmed for you instead of having to leave your partner’s side to do it; or even just hearing that everything is normal and you’re doing great. However, it’s precisely these things, cumulatively, that make a massive difference in the way you feel about your birth once you are able to look back on it.
Ask any new mom what she remembers most about her labor – it’s likely to be the little things.
Interestingly, in a normal, low-intervention labor, there’s really not much for a clinical care provider to do…but wait.
In uncomplicated hospital births, you won’t often see your OB’s face until you’re nearly ready to push! Likewise, it’s not at all uncommon for a midwife to check in with her patient fairly infrequently – although it may be for a different reason: she knows that her presence is likely to contribute to a sort of “watched-pot” phenomenon and may disrupt your labor progress.
If you want a natural, unhindered birth, the best thing a clinical care provider can do is, stay out of your way!
One homebirth midwife I know likes to joke that her main job is to sit in the corner and knit – and her clients love her for her unobtrusive, unwavering, calm presence.
However - not all midwives are created or trained equally - and there’s been a sharp rise in the “med-wife” phenomenon…meaning, those who are trained in out-of-hospital birth, but still approach labor and birth as something to be feared, controlled, and managed.
If giving birth is like a journey, then you can think of a doula as your seasoned, reliable tour guide.
She knows the territory well, and can reassure you that you’re on the right path even when you’re feeling nervous.
She can help you learn and use coping skills that will boost your confidence in each other, and ensure that your journey is more pleasant and less stressful – for both parents! She even has a bag of tools to help you both through some of the rough patches.
Choosing a midwife instead of an OB gives you a greater chance at having a low-intervention, natural birth.
However – regardless of where or how you give birth, a doula will be with you for every single step of the way.
So, do you need a doula if you have a midwife? The answer is a resounding YES!
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