ask the doctor: expecting : doulas & midwives & homebirth, oh my!


Most moms, especially natural mommies have heard of Midwives and Doulas and a portion of you have even used them! But just in case there’s one or two who are unclear, I thought it was a good idea to reiterate their roles, how they’re different, and their individual benefits to childbirth. Being a Doula myself, being over seven months pregnant {yay!}, and planning to have both a Doula and a Midwife attend my birth, I have encountered many varied reactions {fear, shock, ignorance, judgment} on the subject from friends, family, and even some complete strangers. So let’s clear the air!

What’s a Doula?

The Greek word Doula roughly translates into “woman who serves“. A Doula is a labor coach; her only role is to help mom labor. She provides physical support, emotional support, partner support, pain relief, and most often education. It usually comes very naturally to women to nurture and encourage other women throughout labor and birth. In terms of the birthing mom, I always say, the Doula takes the top half, meaning the Doula is concerned with mom’s emotional state, her well being, her overall birth experience. Sometimes, a Doula can take the form of a mom, sister, friend, or an incredibly supportive husband or partner. Anyone can be a Doula so long as they are committed to mom’s wellbeing; being a Doula is more about instinct, encouragement, and love rather than education. That being said, any couple who has had a trained and/or certified Doula attend their birth – in addition to supportive friends, family, and partner – will tell you they found her indispensable.

With a trained Doula, you can be assured a standard level of education and experience, tricks of the trade to help mom manage contractions in a powerful and empowering way, and an individual who finds true joy and pleasure in helping women labor. A Doula can absolutely be used with or without a Midwife, with or without a home birth, and with or without a partner. Current research is exploding with the benefits to both mom and baby of having continuous, dedicated labor support, which reiterates the importance of having a Doula present throughout labor and birth:

1) Continuous labor support throughout and between contractions – help mom to focus, pain management, and emotional encouragement.

2) Relief for partner – tag in/out for mom’s support. Both Doula and partner need to eat, pee, get coffee, so this way she never goes without support.

3) Statistically, the difference a Doula can make on a woman’s birth experience is significant:

– 26% less likely to give birth by cesarean section

– 41% less likely to give birth with vacuum extraction or forceps

– 28% less likely to use any analgesia or anesthesia

– 33% less likely to be dissatisfied with or negatively rate their birth experience

4) Someone dedicated to advocating for your wishes and birth plan so you/your partner can focus on the birth

5) Overall more positive birth experience for the mom

What’s a Midwife?

Compare that with the Midwife, who takes the bottom half. The Midwife is essentially the physician, the one who has undergone years of intense education to make all the real decisions, and catches the baby. A Midwife is essentially a naturopathic obstetrician “ an alternative highly qualified, educated, regulated practitioner who is trained in delivering babies. So why choose a Midwife over an OB? Midwives view pregnancy of a healthy pregnant woman as a normal physiological process. They trust that body of a healthy pregnant woman knows to do what it has done for centuries, and as a result, medical interventions {pitocin, epidural, vacuum/forceps, cesarean} are significantly lower than in obstetrician-attended births. A Midwife offers patients all standard medical testing throughout pregnancy and birth, but gives the patient informed choice, the option to comply or deny, essentially allowing the parents to take more control over their prenatal care, labor and birth. The postpartum care with a midwife is exceptional as well she will visit your house (you don’t even have to get out of bed!) on day 1, 3, 5, 7, and 10 to weigh the baby, assess mom’s recovery, ensure proper breastfeeding latch, etc. Then the 2-and-3 week appointments you go to the clinic. Midwives were the way women delivered babies years ago before doctors and drugs and technology was invented. We made it this far, so they must have been doing something right!

Midwives do have hospital privileges to deliver babies in a medical setting if that’s where mom is more comfortable. However, because they do not see the woman as sick or birth as dangerous, they are also very comfortable delivering babies in a home setting. The birthing woman and her partner are given the option to choose their birth location and some couples don’t even know they have a choice! A Midwife is not an anesthesiologist, though, and so a homebirth would also include no epidural, a true natural birth. However midwives have faith in the female body and in women’s inborn, innate, instinctive ability to birth without medication. In a healthy, low-risk pregnancy, statistically, there are rarely complications and a homebirth is a very safe {some would argue safer} and comfortable option for those women. Of course, because Midwifery is a government-regulated profession, there are strict safety standards which must be upheld, and mom and baby’s safety is always of the utmost importance. Midwives never hesitate to transfer moms from home to hospital {in a car, not an ambulance} the moment any aspect of birth becomes non-normal {blood pressure increases, fever, etc, which is usually long before it is considered an emergency or mom or baby’s health is compromised in any way.

I highly recommend all you moms out there who are curious about your options for your next birth to explore the idea of a Doula, Midwife, or both! I am currently reading the book Birthing From Within by Pam England, which is – of all the pregnancy and birthing books I have read {a lot} – already my absolute favorite and I’m only halfway through. I highly recommend it, it is very informative and interesting and the information is all very clear and well researched. Another great thing about this book: most chapters are only 2-3 pages! So if you have kids running around or dinner to make or whatever the case may be, you can feel like you’ve accomplished a chapter or two whenever you can grab a free minute. {So far I have found sections I and III most informative and helpful, so if you’re short on time, maybe skip section II and come back to it later.}

Even if you are not considering a Doula or Midwife for your next birth and have decided to have an OB-attended birth in a hospital, I still highly recommend reading this book. Labor and birth are something all women should be educated in, perhaps especially if having a hospital birth, where oftentimes informed choice is not offered and women agree to doctors decisions out of fear, pressure, or simply because they don’t know. In these situations, women find it empowering to have information in their back pocket which can give them comfort and confidence in their bodies and the process of birth, allowing them to make sound, informed decisions about their birth.

I feel like I could talk about labor and birth all day long! If any of you have any other questions on this topic – or any naturopathic topic! – please don’t hesitate to drop me a line at drcorinne@naturalmommie.com or visit my website at www.brownrootswellness.com.

Did you have a midwife? A homebirth? A doula? Please share your experience!!!

Have a question for Dr. Corinne? Send her an email at drcorinne@naturalmommie.com and your question will be answered here. These suggestions are not intended to provide diagnosis or substitute a private consultation with your healthcare practitioner.

 

About Amanda

Amanda Robinson is the eco-chic, green living, fitness loving mom behind Natural Mommie. Since 2009, Amanda Robinson has been the source for moms to learn how to bring more balanced green beauty, eco-friendly, sustainable, organic products into their homes without being too “crunchy” or “granola”. Amanda is passionate about design, wellness and inspiring moms to make more eco-friendly and healthy choices without having to trade in their stilettos for Birkenstocks. In addition to Natural Mommie, Amanda is also the owner and designer behind Top Knot Style - a beautiful collection of handmade oversized luxury knitwear.

18 thoughts on “ask the doctor: expecting : doulas & midwives & homebirth, oh my!

  1. I had a doula attend both of my hospital births. I was able to have the medication-free births I desired and the doula provided awesome support not only for me but for my husband! He said he wouldn’t know how to meet my needs if the doula wasn’t there. He was my support but she coached him on how to help and assist me more. It was awesome.

    I also love that I have detailed birth stories and beautiful pictures from both my babies’ births. I treasure those keepsakes!

    1. Jennifer that sounds like a wonderful experience! I don’t know anyone who has used a doula so thank you for sharing your experience with the role she played during another during your labor and delivery!

  2. The books by Ina May Gaskin are also amazing reads. I am almost done Spiritual Midwifery and let me tell you its amazing how one those women have become with their bodies when in labour and giving birth. This book is mainly all birth stories but its wonderful to read the experiences of these women.

  3. We used a doula with #1 and would highly recommend it to anyone! DD was sunnyside up and had a head circumference in the 99 percentile and I was still able to deliver without an epidural or any pain meds of any sort. Even though it was all back labor, she still managed to have me sleeping between contractions that were 2 minutes apart, simply by managing my breathing. Now that we are pregnant with #2 we are once again searching for a doula. This is probably the first time I’ve said it since we moved, but I wish we were still in Peace River so that we could use her again, she was that great!

  4. I had a homebirth for our daughter (and first baby) last October. She will be 1 on Sunday! tear Her birth was the most empowering and awe inspiring experience of my life. It has changed me profoundly.

    Our midwives were absolutely fantastic. From our prenatal care to my birth experience and, critically, our post partum care and breastfeeding help they were excellent. I can’t wait to be pregnant again just so I can go back to see them.

    I ended up with a non emergency transfer to hospital after birth for a delayed placenta. The situation was handled professionally, carefully, and gently (which was so important). Everything ended up being fine and we returned home within a couple of hours. The relationship the midwives had with the hospital staff and their care for me during a situation I obviously didn’t want was superb.

    My daughter weighed in at 8lbs 9oz and I credit my midwives for helping me to make it through without tearing. Their excellent knowledge helped me to labour and move in ways that would help the baby get into the best position and make labour as efficient as possible. They were able to assess my anatomy and recommend pushing positions that would help me get the baby around my, apparently, angled and tight pubic bone.

    During labour they were there when I needed them and invisible when I needed my space.

    It was great – that’s all there is to it.

    As for books… I highly recommend Sarah Buckley’s Gentle Birth, Gentle Mothering

  5. Amanda, you’re 7 months pregnant?! Is this the first mention of it on your blog? Or is Dr. Corinne the pregnant one? I am confused! Anyways, I delivered naturally in a hospital using an OB, but have since switched to a naturopath/midwife for all my health needs. Next time around I will be using her instead of an OB (for so many reasons that I won’t go into) and I hope to give birth at home! I did have a doula, and she was amazing. I recommend a doula to all pregnant moms. In fact, my doula and I have since become friends.

    I love the book, Birthing from Within. Great information in this post. Thanks!

    1. Hi Lucy! Dr. Corinne is 7 months along. I just realized her post is authored under my, instead of her own name – sorry for the confusion!! Thanks so much for sharing your experience – I especially love hearing the difference in care from OB to midwife from mamas who have been there done that!

  6. I would love to have a midwife or doula for my next pregnancy. Or maybe give birth at a birth center. With the baby we just had, my husband and I took a natural birth class and studied and practiced a lot on our own. I labored at home for 5 hours, went to the hospital and had my (breech!) baby completely naturally a little over an hour later. I’m so glad I was able to labor at home with my husband as long as I was able to, but I would love to avoid the hospital experience next time.

  7. I had a doula with my 2nd and I loved her being there. Wish I had one for my 1st as well! She helped me stand up for what I believed in and it was nice to have someone calm and loving through the birth process.

  8. I hired a doula for the birth of my son, and I will never do it without her! My husband and I were both thrilled with our birthing experience thanks to our doula, Roseanne! He wasn’t sure we needed her, but once the day came, he was so thankful. I could not have made it through a drug free labor with a posterior 9 lb. 8 oz baby without her. She kept us calm, focused, and motivated every step of the way. She was amazing, and she helped both of us be amazing.

    1. Thanks for sharing Joanna! My baby was the same size (9lbs 7oz) so I know how difficult the labor of a big baby is!!!! Sounds like you had a great experience!

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