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Midwife vs. Doula
By Wild Oak Birth LLC: Film, Photo, & Doula | wildoakbirth.com
[Doula face-to-face with laboring person, Midwife charting in background]
Midwife vs. Doula... wait, aren't they the same thing?
This is something I get asked a lot, and the answer is... nope! A Midwife and a Doula each have different roles and scopes of practice. Simply put...
Midwife = Clinical Role | Doula = Support Role
Both birth professionals have value and importance as members of your birth team. Do you need both for the birth of your baby? That's up to you! Let's breakdown their scopes of practice and the impact they have on your experience.
[This post is largely painting a picture of community birth, some of this information will remain the same in a hospital setting and some will differ/won't apply]
Prenatal Period
During your pregnancy, your Midwife will monitor you and your baby's health, provide education, nutritional guidance, answer questions regarding prenatal care and birth, and take the time to get to know you personally, your preferences, and your wishes. Within their clinical role, at your prenatal appointments some of the things they will do include: check your blood pressure, measure fundal height, palpate for baby's position, listen to baby's heart tones (heart rate) with a Fetal Doppler, draw blood for lab work, offer routine prenatal testing if desired, screen your urine, and can refer for ultrasound if desired.
During your pregnancy, your Doula will provide education, emotional support, and take the time to get to know you personally, your preferences, and your wishes. Within their support role, at your prenatal visit (and Childbirth Ed classes) some of the things they will do include: assisting in creating a birth plan, providing information on topics related to pregnancy/labor/postpartum, offer referrals to other prenatal professionals, and build a rapport with you and your partner to ensure you feel comfortable with their support during your labor and birth.
Shown above are the Midwife's supplies for a home birth | Why Choose Home Birth?
Labor and Birth - the Midwife's Role
During labor and birth is where most people 'see' both a Midwife and Doula together. As your body begins to prepare for labor, a Midwife will continue risk assessment and monitoring you and your baby's health. They will offer suggestions for early labor and check in on you, but typically will not see you in person until active labor has begun.
Once your rushes are consistently 4-5 minutes apart, lasting at least 60 seconds, for at least an hour, they will advise you to request they come to you (or you to them if birthing in a. birth center or hospital). Upon arriving, they will take your vital signs (blood pressure, temperature) and listen to baby with the doppler. They can perform cervical exams if you request. As your labor progresses, they will remain with you to monitor how baby is tolerating labor through intermittent monitoring, offer suggestions for labor coping, position changes, and chart your labor for records. When birth is imminent, they will monitor baby closer with the doppler, coach you through pushing if you request, provide encouragement, assess baby once they're born, assist with the birth of the placenta, and monitor and control your bleeding if needed. Midwives, and their assistants, are specially trained to handle emergency birth scenarios (shoulder dystocia, unplanned breech, resuscitation, etc.) and will act quickly if they sense intervention is necessary at birth.
Midwives keep you and your baby safe and healthy!
By Renee Mason Photography: Indiana Birth Photographer | reneemason.com
[Midwife listening to baby with fetal doppler. Doula can be seen behind her, holding space and remaining present to support her client]
By Alexandria Mooney Photography | alexandriamooneyphotography.com
[Doula holding hands with Mom, Midwife catching baby]
By Renee Mason - Indiana Birth Photographer | reneemason.com
[Doula in bottom left corner, both Midwives assessing baby after birth]
Labor and Birth - the Doula's Role
As your body begins to prepare for labor, your Doula will be in communication and available to you as well. Some Doulas are requested in early labor, they will help you time contractions, release any fears/anxieties surrounding the birth, communicate with your Midwife if needed, ensure you're eating and drinking well, remind you of labor coping methods, and guide your partner in how they can best support you, too. The most powerful tool a Doula can bring to your birth is themselves. Their confidence, knowledge, and unwavering support will make the process feel less overwhelming. They can suggest exercises or positions to progress labor or engage your baby, they can perform massage and counter pressure techniques to ease the sensations of labor. Above all, their continuous praise and encouragement will help to make you and your partner feel comfortable with the process of welcoming your baby.
Doulas keep you informed and in control!
By Salt City Birth & Newborn Photography | saltcitybirth.com
[Doula massaging the hips of her client and talking with the partner, Midwife and team are in the background charting and fueling]
By Renee Mason - Indiana Birth Photographer | reneemason.com
[Doula's hands applying counter pressure to sacrum, Midwife's gloved hand reaching underneath]
Postpartum Period
The time immediately following the birth of your baby, until up to 12 months after, is considered the postpartum period (also known as the fourth trimester).
Before leaving your birthing space, your Midwife will continue to monitor you and your baby. This will include vital signs (blood pressure, temperature), performing the newborn exam (weight, length, head-to-toe health assessment etc.), administering any medications (or herbs) that are needed/requested to you or your baby, assess bleeding, assisting you to the bathroom to empty your bladder, repairing any tears if needed, assist with breastfeeding, explaining normal limits of newborn behavior, and comprehensive postpartum instructions to keep you feeling strong and healthy after they leave. You will continue regular care with your Midwife until at least 6 weeks postpartum, where they will monitor your baby's growth and your recovery.
Before leaving, your Doula will continue to support you and your family. This may include preparing a meal, feeding it to you while you nurse your baby (Yes! We totally do this!), starting a load of laundry, assist with breastfeeding, prepare postpartum supplies such as pads, herb sitz baths, and tend to your older children if needed. You will see your Doula at least once more within the 7-10 days following birth, even longer if you have hired them for postpartum support.
During this sensitive period of healing and bonding, your Midwife and Doula will continue to support you!
By Renee Mason - Indiana Birth Photographer | reneemason.com
[Midwife observing baby latching, available if help is needed]
By Renee Mason - Indiana Birth Photographer | reneemason.com
[Doula chatting with big sister]
By Megan Nicole Photography, LLC | megannicolephotographyllc.com
[Midwife measuring length of baby during newborn exam]