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

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

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 – 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!!!

– ask the doctor: dr. corinne brown, ND –

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LIVE: HRSB Meeting – December 14 2011