Part of the pregnancy journey is developing a birthing plan that parents feel comfortable with, so when it's time to deliver, there are no big (or small) questions left unanswered. Although a majority of people you know may have had their child delivered by an ob-gyn in a hospital, it's important to explore all of your options. You never know what will make you feel most comfortable, so it's worth considering the options: a gynecologist, a doula, or a midwife. It's worth noting that there has been an increase in mothers using doulas and midwives over the past three decades. Moms who used certified nurse-midwives increased from 3.2% in 1989 to 7.5% in 2008, while mothers using doulas doubled from 3% in 2005 to 6% from July 2011 to June 2012.
What Is a Doula? What Is a Midwife?
A doula is a trained companion to provide birth and postpartum support but does not have a medical license and is not considered a healthcare professional. By contrast, a midwife is a trained medical professional that cares for mothers and newborns during labor and postpartum, and can also deliver babies.
And in case you were wondering, doulas can also accompany you if you're in a doctor's care—they're not just for home or water births like you see in the movies. Even though they can't prescribe you medicine and don't need a license, most doulas receive certification and basically act as your go-to person during your pregnancy and childbirth (and sometimes even after). On the other hand, a midwife has extensive medical training and can deliver your baby, whether at home, a birthing center, or a hospital. "We realize that every aspect of our lives impacts how and when we birth our children," says Chanél L. Porchia-Albert, the founder of Ancient Song Doula Services. "Everyone should feel empowered around their birthing options." Keep reading to learn everything you've ever wanted to know about doulas, midwives—and beyond.
The word doula comes from a Greek word for "female servant," but the modern-day doula is more half-friend, half-coach. And when we say coach, we mean it in a holistic way, seeing as most doulas will start with you while you are still pregnant and stay with you even after you give birth. "When I was afraid during labor and delivery, [my doula] reminded me of my power," says mom Lehna Huie. "That really helped. She was my advocate. The relationship we built is sacred and something I'll never forget."
Doulas are known for their more natural methods during the birthing period (hence why they often get a reputation for being more crunchy granola). They usually rely on massage, different positions to relieve pain, as well as essential oils to keep moms comfortable. These professionals are also often skilled in bath births, although all doulas have their own specialties. After pregnancy, doulas can be extremely helpful in breastfeeding instruction and can act as a support system for new moms.
The Nitty Gritty
Doulas are not medically trained, but often have a license through a respected organization like DONA International. If you know ahead of time you are going to have a complicated pregnancy, it's best to use a doula alongside a medical professional since a doula cannot administer drugs or perform a C-section, if needed.
Since doulas are not usually covered by insurance, their fees can range from $500 to $3000.
A 2013 study found that when women had a doula, they were 40% less likely to need a Cesarean, and the labor period was shorter.
According to a 2009 study, new moms are more likely to have breast milk within 72 hours after giving birth when they use a doula.
Findings from a 1999 study show that birthing with a doula gives new moms a reduced chance of postpartum depression.
When I hear the word "midwife," it's hard for me not to think of the TV series Call the Midwife set in the 1950s. If you're familiar with the show, then you know that midwives are medical professionals with extensive experience who see you through from pregnancy to postpartum. (And you can continue to see them for annual well visits and contraception long after giving birth.)
Typically, midwives are more hands-off than gynecologists when it comes to intervening with the birth. They most often help with labor in a hospital or birthing center but do in-home labors as well. Their birthing technique is different from a doula in that their focus is simply on safety for mom and baby and less about making the experience as comfortable as posible.
The Nitty Gritty
If you are expecting twins, a breech birth, or are giving birth post-cesarean, most states won't allow a midwife to handle the delivery. Although another option is that you may want to use a midwife for added support with an ob-gyn on call. The biggest difference between a doctor and a midwife is that a midwife cannot perform surgery.
Midwives are like doctors in that some take insurance and some don't. Therefore, the cost can vary (and that's not including the hospital costs if you go that route). One mom in Brooklyn, New York, reported that she paid $2000 for a midwife who didn't take insurance.
A review published by The Cochrane Library found that when women consistently saw a midwife throughout their pregnancy, they had fewer interventions and chances of having a premature child. According to studies, nurse-midwife attended births only report 13% of those being casareans, while the national average is 21%. (It's important to mention that typically midwives don't take on high-risk patients.)
If you have any further questions related to the doula vs. midwife dilemma, ask your doctor or some of your close friends who have already given birth.