Do you need a doula if you have a midwife?

need a doulaI hear you’re planning to give birth with a midwife? Great!

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.”

Actually…you might be surprised to learn that a doula has been statistically proven to be an excellent addition to your birth team, no matter where or with whom you’re birthing.

While it’s true that birthing with a midwife is going 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 much, much more than just a medical event.

Your doula will be there to provide nearly continuous, hands-on 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 safe outcome – and not terribly focused on your personal experience of the labor journey.

The consistent, professional, 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 him- or herself.

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. 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 not really fair to expect 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 classes can’t give a partner the type of 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.

That’s why even in uncomplicated hospital births, you won’t often see your OB’s face until you’re getting close to pushing! 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 might disrupt your labor progress.

If you’re planning a low-intervention birth, and labor is progressing normally, the best thing your clinical care provider can do is to stay out of your way!  One excellent homebirth midwife I know jokes that her main job is to sit in the corner and knit – and her clients love her for her unobtrusive, unwavering, calm presence.

Policies in the UK are already changing to reflect the latest evidence-based care recommendations, which state that giving birth under the care of midwives, rather than obstetricians, is a safe and sensible option for most healthy women.

Clearly, there’s a specific role for doulas in any type of birth – not just hospital births, and not just low-intervention births, either.

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 for your care provider is an excellent choice if you’re seeking a low-intervention, natural birth.

However – regardless of where or how you give birth, your primary care provider isn’t likely to be with you for every single step of the way – like a doula will.

So, do you need a doula if you have a midwife?  The answer is a resounding YES!


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