Midwives & Doulas: Learning Your Options for Birthing Partners

It’s Black Maternal Health week, which is an incredibly important opportunity to inform Black women of the harsh realities of pregnancy and childbirth in the United States, and to equip us with the resources to protect ourselves and our families. Launched by the Black Mamas Matter Alliance in 2018, Black Maternal Health Week is a time to deepen the national conversation around Black Maternal Health.

FACT: The United States is the only wealthy country in which rates of illness and death during pregnancy are on the rise. The rates of maternal mortality and morbidity among Black women are especially alarming. Black women are three to four times more likely to die from pregnancy-related complications than white women. 

As such, deciding to start a family or even finding out you’re pregnant can actually be a source of anxiety or fear for many Black women and their partners. The complicated birth stories of prominent women like Beyonce, who experienced pre-eclampsia while pregnant resulting in an emergency c-section with her twin babies, and Serena Williams, who had to fight for her life after her doctors didn’t believe she had a potentially life-threatening blood clot in her lungs, despite her insistence, greatly contribute to many women’s concerns because we see just how exposed we are as Black women.

Growing up in a family of doctors, I had no problem always feeling taken care of. By the time I was pregnant with my first child, I lived thousands of miles away from all of my family MDs. Honestly, I didn’t even know about the Black Maternal Health Crisis. I just knew I didn’t trust a doctor I wasn’t related to, and that there may be a ton of decisions to make in childbirth. I pursued midwives because I’d read that they can do many of the same things as doctors but they spend significantly more time with patients, whereas visiting a doctor usually means spending most of your time with the nurse and a few minutes with the doctor. I also knew that doctors have a tendency to offer drugs and surgery to assist in childbirth and midwives place an emphasis on non-medicinal techniques for pain management. I was also fortunate enough to have friends who had experiences with midwives and doulas and home births, in addition to hospital births so what I knew for sure was that I had options. I started Googling to figure out the best care for me and my baby and I’m so glad I did. —BlackLove.com Editor in Chief Codie Elaine Oliver

At a time when it’s vitally important to maintain a space of peace, tranquility, and optimism, expecting moms need to know that being informed on your rights and resources is one way to set yourself up for the best possible pregnancy, which includes knowing that, when it comes to your prenatal care, there are choices beyond an Obstetrician (OB).

But what exactly does this mean? What is the difference between a midwife and a doula, and how may they assist you in having the best possible pregnancy and delivery experience?  

Midwife vs. Doula

For starters, what do midwives and doulas have in common? Both midwives and doulas lean into natural, drug-free birthing practices. Both also work toward the goal of helping a woman achieve a satisfying birth experience and provide support during labor and birth to attain this goal. Though, neither midwives or Doulas are Obstetricians (OBs) (medical physicians).  

In addition to midwives, there are certified nurse midwives, who, according to thebump.com, have a combination of training in modern obstetrics and gynecology, midwifery (the traditional birthing practice), and nursing. These medical practitioners also hold registered nursing licenses.  Many nurse-midwives work as maternity nurses and then return to graduate school to become a nurse-midwife.

This education and certification allow them to legally take the place of an obstetrician-gynecologist in a mother’s child birthing journey, which is becoming more and more common as women are turning toward natural and home childbirths. Also, according to FitPregancy.com, Certified Nurse Midwives, should be covered by your insurance as a primary-care provider or specialist. A woman may start looking for a midwife during the family planning process, before they are pregnant, as Certified Nurse Midwives handle well-woman care as well. Midwives typically lend a more personal touch to the pregnancy experience compared to OBs, emphasizing the physical, emotional, and social needs of their patients.

In addition, midwives typically have doctors and hospitals that they work closely with in the event of a transfer from a birth center or home birth, due to complications that may arise. There, a midwife can still be a source of comfort for the mother and an educated advocate.

Doulas, however, do not replace your healthcare provider but act as meaningful support to moms and dads-to-be. An expectant mother may choose to have an OB and a doula or a midwife and a doula.  Why opt for both? According to thebump.com, a doula can help you with techniques to manage pain during labor and even provide support and help during baby’s early days. A doula is a trained birth coach who offers physical, emotional, and educational support, especially for the mom, either during labor or the postpartum period. Though doulas are not medical professionals, they still go through rigorous training and certification, some of the larger courses including: DONA, Childbirth International, and the International Doula Institute.

The services doulas provide include: Pre-birth consultation — meeting with the couple to review expectations during childbirth, discussing the birth plan, and answering labor and delivery questions; Assistance during birth — moving the mother into optimal birthing positions, adhering to massages, and leading breathing exercises; Serve as Patient Advocate — the doula may intervene for the mother with the medical team to make sure mom’s wishes are known and adhered to; Breastfeeding support — some doulas are trained breastfeeding counselors and lactation consultants. Doulas can offer advice, answer questions about nursing, and help address any challenges you run into once baby is here. They also provide postpartum support — a doula can visit you in your home after the baby is born and assist by potentially performing light housework, preparing meals, or just being a voice of support as the new mother navigates the first few days of motherhood.

A woman’s birthing plan is a very personal part of her motherhood journey, and the professionals she chooses to surround herself with during this time are of utmost importance. Choosing to work with a midwife or doula to assist in this journey could be a huge step for Black moms to feel more supported and educated as we grow our families.