People generally know what a doctor is, and what a doctor’s job would be during delivery and birth, but the other titles for people who can be a part of the birthing process aren’t always as understood. The fact that the cast of characters in any given labor isn’t standard doesn’t help, either – some births may be attended by just a midwife, while others might have the full complement of obstetrician, midwife, doula, and labor nurses, all moving in and out of the same little hospital room. Both types can be perfectly healthy, safe, and supportive.
The term “midwife” covers a range of different care providers, from certified nurse midwives, who are registered nurses (and usually possess a graduate degree like a Masters of Science in Nursing, or a Doctorate of Nursing Practice) who have also completed special training specifically in midwifery, all the way to lay midwives, who enter practice directly following apprenticeship to an established midwife.
No matter what their level of certification, midwives have one thing in common: they’re trained in women’s reproductive health. While obstetricians focus mainly on delivery day, midwives focus more on a woman and baby’s “birth year”, or labor and then their first year together. After all, birth is a major life event and affects women in a variety of ways – mentally, physically, socially. Midwives educate women and their families on how to maintain wellness before and after they give birth. Basically, midwives look at pregnancies and births that don’t have serious risk factors as natural life events, rather than medical ones.
This doesn’t mean midwives don’t monitor pregnant women carefully for signs that could turn into medical complications. In fact, midwives who detect medical issues often have the ability and authority to treat them, but they also often have established relationships and protocols for transferring the care of pregnant women with health conditions to obstetricians, or have established protocols for working alongside doctors.
So why go to a midwife for care when it’s possible to end up under the care of an obstetrician anyway? Midwives provide continuity of care, both by attending all prenatal appointments, and by staying with women throughout labor, straight through to early infant care. Women who feel strongly about natural birth or alternative birthing methods often feel more supported in that preference by midwives too.
Beyond that, certified nurse midwives are medical professionals who are qualified to provide most prenatal monitoring and care, and to make recommendations for further care. In the US, depending on state regulations, many certified midwives can write prescriptions for medications, and outside of the US, certified midwives are often qualified to give all types of prenatal care and care during birth except for C-sections.
Doulas are not medical professionals unless they have independent medical training in another area. Instead of providing medical care, doulas provide physical and emotional support before, during, and after labor. Doulas can share information about pregnancy, the process of birth, and newborn care with new parents, and help to make sure moms-to-be know their options as they’re going into labor.
Doulas can help new parents feel a sense of stability during labor, since they often arrive either before the midwife or before new parents are recommended to head towards the hospital. Doulas also generally stay with parents throughout labor, which can be especially valuable in a hospital setting, when shift changes may mean that your doula is the only face that stays constant throughout the process.
Labor nurses are entirely different figures from either midwives or doulas, though in some ways, their function can overlap with both. In hospital settings, labor nurses can take on some of the monitoring that a midwife would do in a birth outside of a hospital setting. They can also give some of the support and education before, during, and after the birth, such as what a doula might provide.
This overlap doesn’t mean that labor nurses are equivalent to either, though. Labor nurses don’t attend to each stage of birth in the way that either a doula or a midwife would. Unlike midwives, labor nurses do not generally deliver babies, and unlike doulas, though labor nurses may provide some emotional support and education, their jobs are not defined by that.
Also, unlike either a midwife or a doula, labor nurses often have multiple patients at a time and may move from room to room during labor. Their shifts are independent of any individual woman’s labor, and may change mid-way through, or even multiple times, depending on the length of labor.
Different medical needs, availability, and the preferences of new parents mean that no labor team is exactly the same, but they are all teams – every member plays a part. Having a good idea of what each team member brings to the field is the best way to make sure you’re choosing right when you’re picking your team.
- Jessica Austin. “The Difference Between Midwife and Doula Explained.” BirthTakesaVillage. Birth Takes a Village, Dec 2011. Web.
- Yvonne Butler Tobah, MD. “Doula: Do you need a doula?” MayoClinic. Mayo Foundation for Medical Education and Research, Jan 15 2016. Web.
- “Differences between a Doula and a Midwife.” AllNursingSchools. All Star Directories, Inc., nd. Web.