There are a lot of myths about doulas. Many people who aren’t familiar with midwives and doulas mistakenly think they are interchangeable terms. Some think that doulas are just for home births, or even that a doula would not be helpful if you are having a home birth. Other people think that doulas are only for people wanting an un-medicated or natural birth.
Let us define these roles and address each myth one by one.
Doula
A doula is someone who is trained to assist the pregnant woman and her husband or partner emotionally, physically, and informationally during pregnancy, birth, and postpartum. Unless the doula has additional training, she is NOT a medical professional and will not perform medical procedures on the laboring woman or deliver the baby. Doulas do NOT provide medical care or advice. Doulas can provide you with benefits, risks, and alternatives to the advice offered by your care provider, but those alternatives should always be discussed with your care provider as doulas are not medical professionals.
Your doula is the only constant during labor. She will be with you as soon as you feel like you need her until after you deliver the baby. She does not change shifts and only supports one client at a time. She will help you labor at home and help you to know when it is time to move to your birth place, if you are not birthing at home.
Midwife
A midwife is a trained health professional who is provides medical care to women during pregnancy, labor, and postpartum. They can also do “well woman” yearly exams throughout a woman’s life. Midwives typically operate from the Midwifery Model of Care and statistically have lower rates of interventions. They can provide counseling, prenatal care and postpartum support as well as assistance during labor and delivery. There are different types of midwives: Direct Entry Midwifes (DEM), Certified Professional Midwives (CPM), and Certified Nurse Midwives (CNM). In Utah, Certified Nurse Midwives are the only midwives allowed to work in hospitals.
Aren’t doulas just for home births?
Doulas most often work in hospitals, however they are not just for hospital, birth center, or home births. Many people hire doulas thinking they will fend off the bad doctors or nurses. This is not the case. We are not duel-as. We will, however, empower you to help you get the things you want, know your options, and stick as closely to your birth plan as possible.
If you feel like it will be a fight with your doctor, midwife, or nurses, you should switch care providers and/or birth places. There are many wonderful doctors, midwives, and nurses who will help you achieve your ideal birth. We can refer you to those wonderful care providers if you feel like yours isn’t willing to work with you.
How can a doula help me at my home birth?
Midwives can offer emotional, physical, and informational support during pregnancy, labor, and postpartum. However, they are unable to check the well-being of you and your baby at the same time. Midwives have a lot of charting and need to take care of you and your baby medically, so it is best when there is also a doula who can take care of you emotionally, physically, and informationally while they take care of you and your baby. Doulas help midwives and doctors do their job better because they can focus on doing there job while we focus on doing ours.
How can a doula help me if I am planning on getting an epidural?
Let’s be honest, sometimes epidurals just don’t work right. Sometimes you are able to still feel one half of your body, sometimes you can’t feel anything, and you may have a bad reaction to the medication. Getting an epidural too early can slow down progress and require more intervention, therefore a lot of hospitals now are not admitting patients until they are in active labor, usually around 6 centimeters dilated. That means if you are planning to get an epidural, you will likely have to cope until you are 6 cm. A doula can help keep you comfortable and labor without an epidural until you are able to get one.
Once the epidural is placed and you are comfortable, the hospital staff usually leaves you alone besides the occasional cervical checks. Your doula, however, will stay with you and provide you and your husband or partner with emotional, physical, and informational support. Maybe you need a nice relaxing massage, music, a cool cloth, help turning in bed, non-chemical ideas to help with cervical dilation, help while your husband or partner is resting, what ever it may be your doula can help you.
How can a doula help me if I am planning on a cesarean or c-section?
Your doula can help you prepare for your cesarean by helping you to create a birth plan that will allow you to have all of the important things you want out of your birth. They can also help you find a provider who will be supportive of your ideal birth. For example, if you want skin-to-skin immediately after birth, if you want to have a clear drape so that you can see your baby being born, not having your arms strapped down, delayed cord clamping, etc. Your doula can keep you or your husband/partner calm during the experience. They can also stay by your head during surgery while your husband/partner is over with your baby so that you are not alone. Your doula can also help you after delivery with breastfeeding and your post-surgical needs.
Really, doulas are magical for what ever way you want to give birth. They are your go to for questions during pregnancy, information regarding nutrition and exercises, and can serve as your birth coach, confidant, and friend. They will help you to achieve what ever birth goals you have. Their only agenda is to help you have a positive birthing experience.
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