We had a conversation in our community about what the roles of a midwife and doula are. This was hard to fully explain in a 20 minutes and I really felt it deserved further thought. These are my thoughts, they are certainly not comprehensive. Please feel free to comment if you feel something should be added.
What’s a midwife’s role?
A midwife is someone who works with women during the mothering years. No, I didn’t say pregnancy, because what I do is so much bigger than just pregnancy. I work with women who are trying to conceive, women who conceive but lose the baby to soon, women who are pregnant planning home birth, women who are high-risk and are going to birth in a hospital for safety. I am there for women who are laboring, women who are freshly postpartum, and women whose children are growing, including women whose children are grown and moved on to their own lives.
I don’t just show up to catch a baby! I’m invested in my clients and their families in a very unique way. Their babies become part of my life story, and each woman is part of a family. Each birth is important to me and a treasure I tuck away and cherish, even the harder ones.
As I walk with a mom through trying to conceive, I’m there with every two week wait, every period that comes and crushes hope, or for that beautiful moment when two lines are on the stick! I’m there for the next twelve weeks praying this baby sticks right alongside of the mom. Sometimes this can be a year or more before we get to a birth. Sometimes the heartbreak is overwhelming.
With some moms it’s not getting pregnant that’s hard. It’s the pregnancy itself. With the range of things we help with and the trouble-shooting to help ease the discomfort we are spending a lot of time with our clients and are very close emotionally, understanding how they work and what comforts them. Some do have an easier time of it and for those moms we talk more about postpartum concerns.
My hope in the ten months of pregnancy is that women will find their power of motherhood, and that through our time together she will find her mothering instinct and be willing and able to listen to it. This comes easy for some and for others it may take longer. I work very hard to help women find the tools and resources to make her decisions for HER family. I don’t always agree with them! But they are made with all the info on both sides and are very educated choices!
So by the time we get to a birth we are friends and a big part of each other’s lives. I’m not just a “so & so” that shows up for the catch. I’m the midwife — the one who sat with her as she opened up her soul and birthed a new life!
If it was a simple birth I may have not done much PHYSICALLY. I may have knitted the whole labor. This does not mean I wasn’t paying attention. I was hearing her sounds and her body; listening to the flow. I can hear when it has stopped moving and we need to change position. I can see as she struggles to move up in intensity, I can see her body ripen, and I don’t always step in because she has asked me to be there as her helper. This mom wants to learn this and do this on her own. AND SHE CAN! I am there for those moments when life forgets what it’s doing, to gently remind it to get on the path of birthing. If this labor has gone off the normal path, then I’m watching and asking and doing based on what this labor is showing me.
I don’t always catch the baby. Sometime its mom, dad or the water! I have no ego wrapped up in who catches. I just watch to make sure baby is responding. I don’t like showing up moments before baby. I like to know how the baby is doing well with labor and know if I can, that baby is doing well or may need my help. Sometimes babies do just come fast and I may miss the birth. This always leaves me a bit sad,it’s a feeling I still don’t know what to do with. If I have done a good job educating, then moms and dads will know what to do and feel comfortable letting it happen. Thankfully, this is not common.
The postpartum time is full of another set of questions and lessons. I’m not finished just because the baby is outside now. We have the placenta and bleeding and repairs if there was a tear. We watch baby’s adjustment, breastfeeding, and the general fear of caring for this new being.
For first time moms, this time is the hardest time — going from self to selfless. This begins the dawning of change to baby centered life. The excitement of the birth sometimes overshadows the reality of a new baby, especially with first time moms. So I’m there for the 2 am phone calls and the tears that come with the milk and for the mini freak outs. I watch my moms grow into sweet, confident mommas and beam with pride when they come see me at three weeks postpartum and share all the issues they dealt with on their own. All the worry has left them, and they radiate motherhood.
Over the next weeks it’s just the odd question or worry and then at six weeks we are officially done with care, and my heart saddens knowing that life will take over, and I won’t see them as frequently. Now with Facebook I get to see them grow. I watch for struggles. I may see them at the store or at playgroups. It makes my heart happy to know they are doing so great. For some, that will be the end as they move out of birthing and into the new era of parenting, and for others we will see them again for another baby or two or five. Some will continue to call for common ailments, as I may be able to help with a quick tried and true answer to natural health. I don’t feel this is a job as much as it is my life’s work. Each of these moms and families and I walk together for a time and then are forever friends. Some move away, some hire other midwifes, some divorce, some lose children; life is chaotic and continues to change. I flow with the changes and each woman’s need of me. I am comfort for some andprotection for others, and for many I’m there for their husband’s comfort. I am a midwife — a constant changing women for the need of the mother.
Things to think about when hiring a midwife:
Ask for references! Ask what a normal birth looks like to the midwife. When do they come? What do they do? How do they respond to your questions? Do they work to answer them, and do you feel heard? Are your concerns fully addressed? What does postpartum care look like? Do they really do the postpartum visits? Are you needing her to be present for you emotionally? Can she be the person you need her to be? Do you need her to be in and out without a lot of fuss? Knowing yourself and how you handle pain is helpful in choosing a midwife and getting the care you are really wanting.
Does she repair tears? Does she check heart tones during labor? How often? Can you refuse? Does she require the newborn screen? What other tests do they require for newborn? Can you refuse?
What is a doula’s role?
Doulas started after we moved birth out of the home and into the hospital, and women felt they were not being heard or respected. They have gained huge popularity since the 80’s and the rise in C-sections. They bring the traditional comfort measures that midwives have been using for years to the hospital. They fill in the gaps of education that OBs and CNMs no longer have time to do. She is an educator and comforter. She provides emotional support, holds the mother’s space in labor, and some also help with postpartum care. Some do not. Doulas are a woman with helpful knowledge during labor and birth, she is there as your base and comfort during a this period. She may help get into better positions or just sweet talk you. She will reflect with you later about your birth.
Doulas are not trained to see or know if labor is off track. They are not trained in physiologic life-saving techniques of the newborn or moms.
Things to think about when hiring a doula:
Doulas are a huge value if you are going to the hospital or if your midwife is not one to come earlier in labor. This may help the parents feel comforted. Most doulas feel that it is not their job to call your midwife so please clarify this with your doula before your labor. Knowing what your doula brings to your labor is a good idea. Sometimes they set the tone with your other care provider. Think about what you will really need. For example, do you need Essential Oils? Do you need Bible verses? Do you need music or chanting? Do you need hands on (massage,gentle touch) or someone who is hands off and just talks? Doulas come in many styles and really knowing their style can help you when labor comes. Asking your care provider if they have and will work with the doulas is a good idea as well.