Should you use a doula or midwife?
Every new mom needs a helping hand. Fortunately, there are two types of experts who can help an expectant mom make the transition from pregnancy to motherhood: doulas and midwives.
While most people think they have similar functions, doulas and midwives actually have different training, duties, and certifications. Read on to learn what the major differences are between the two.
Think of a doula as an expecting mother’s BFF. The word doula is actually Greek for woman’s servant. Your bond develops long before the due date, as you both plan how you’d like the birthing process to go, and learn the answers to the many questions you likely have.
There are two types of doulas: birth and postpartum.
Birth doula
The main job of the birth doula (or labor doula) is to be by your side offering nonmedical techniques during labor, such as breathing, massage, and helping you move into different body positions.
They can also provide emotional support and act as an advocate on your behalf. No matter what type of birth you have, a doula will be there to help you feel safe and empowered. A doula will support you in your decision to use medications or have a “natural” or unmedicated birth.
In the event of an unplanned C-section, a doula can help comfort you and give you extra attention to help alleviate fears and anxieties. A doula can be a helpful part of your birthing team.
According to a 2017 Cochrane Review, many mothers report the need for less medical intervention and increased satisfaction with the birthing process when using a doula.
However, it’s important to note that a doula is not a substitute for a doctor or midwife since they do not have the same in-depth medical training.
Postpartum doula
After birth, postpartum doulas help a new mother as she recovers from the birthing process. This includes caring for the infant and guiding a mother through the breastfeeding process.
Doulas can also play an important role in your home life, especially if there are older siblings in the home.
Certification
Not all doulas go through a certification process. If a doula seeks certification training, it usually includes didactic training and assisting during live births.
Certification is typically not required but may vary by state. Lawmakers in a few states are working to allow doulas to be reimbursed by Medicaid. This may increase certification and regulation.
Formal training can be obtained through the International Childbirth Education Association, Doulas of North America, or Childbirth International.
A mother’s friend, who is not certified, can also use the title of doula, but their duties are controversial within the medical community. Untrained doulas are considered labor support and their role is different. They should not be part of any medical aspects of the birthing process.
A midwife is a trained medical professional, and can be a woman or man. They play a key role during the birthing process. Midwives have various levels of training.
Some midwives are registered nurses, while others have a bachelor degree with specialized training. Graduate school and certification is the normal path in the United States.
Certified nurse-midwives can do many of the same things as doctors, including:
- perform gynecological exams
- provide prenatal care
- administer pain medications
- give labor-inducing drugs
- monitor the fetus using electronic equipment
- order an epidural
- perform an episiotomy
- deliver a baby vaginally
- resuscitate a baby
- stitch tears
Midwives can manage postpartum hemorrhage and more complications than a labor and delivery nurse.
Midwife care centers focus on promoting unmedicated birth, detecting complications, and using emergency measures when needed. A credentialed midwife is authorized to work in any setting, including health clinics, hospitals, or the home.
Certification
Like doulas, laws on midwife certification vary by state. According to the International Confederation of Midwives, a midwife must be registered or licensed by a program recognized in the country they practice in.
All midwives must undergo specific education, training, and supervised clinical experience, and complete the certification requirements set forth by the Midwifery Education Accreditation Council.
In the United States, midwives are certified through the North American Registry of Midwives and the American Midwifery Certification Board.
Many midwives in the United States are also registered nurses. They’re called Certified Nurse-Midwives (CNM) and have a bachelor’s degree from an accredited institution as well as a certification from the American College of Nurse Midwives.
Midwives are commonly certified as International Board Certified Lactation Consultants, with advanced knowledge on the breastfeeding process.
The most important aspect of a midwife or doula is how they interact with the expectant mother. Find someone who advocates strongly for you, and who respects your opinions and viewpoints on pregnancy and the birthing process. This is key when you’re forming a bond.
Experience is another important factor. Doulas and midwives with more years of experience and births under their belts are usually the best. Getting a recommendation from a friend or family member who has used a midwife or doula can help you find a capable and experienced person.
Should you find a midwife or doula from an online service, ask for references from other mothers and do your own research. Also, ask to see the certificates they received at the end of their training and their license to practice if they’re nurses.
Since the two professions both offer benefits to expectant moms, you can have both a midwife and a doula to help you during the birthing process.
If you’re having a home birth, you’ll want to at least have a midwife, as their medical training and expertise is crucial if problems arise. Midwives can anticipate problems and do continual assessment on the mother and baby.
Also, doulas can’t prescribe painkillers, nor order an epidural, so if you want to keep such options open, having a midwife there will give you more flexibility. Doulas are not healthcare practitioners: they’re trained individuals who can provide support to the mother and the childbearing family.
Speak with your delivery team, including your doctor, to see who would best fit your specific birthing needs.
