May 2016

Gold Coast Doulas is pleased to present a guest blog from Mandi Garvey  She is a certified birth doula, Masters trained health educator, and EMT serving families in West Michigan in both clinical and non-clinical labor support roles.  When she’s not at a birth in one capacity or another, she’s napping in preparation for the next one.

Doulas and Midwives

… but if I have a midwife, why would I want a doula?

Building the perfect care team to support your upcoming labor and delivery can feel daunting.  Do I choose a midwife or a physician?  Will my partner accompany me in labor?  Should my mom be in the room?  All of these questions race by while you try to sort out the best way to meet your needs, often without knowing exactly what the needs will even be once labor begins.  As doulas, we often hear the suggestion that those being attended by midwives or those laboring outside of a hospital would not benefit as much from the presence of a doula.  We think doula support can be beneficial in all scenarios from home birth to planned surgical delivery.  Here’s why:

 

1. The Research Says So

Twelve separate randomized trials comparing outcomes between labors supported by doulas and those that were not found doula support significantly reduced the length of labor and the odds of surgical or medical interventions like cesarean section, forceps delivery, oxytocin augmentation, and pharmaceutical pain relief.  People in the doula supported group also rated their labors as ‘less difficult’ and ‘less painful’ than those in the unsupported group.  Doulas were also found to reduce anxiety levels, increase positive feelings about the birth, decrease rates of postpartum depression, improve self-esteem, and increase rates of breastfeeding success.  Evaluations of partner-only or other non-doula support person labors did not see the same results.  (Scott, Klaus, & Klaus, 2009)

 

2. Doulas Have Only One Job

While midwife supported labors are awesome, and we adore their dedication to supporting safe and healthy labor experiences, their primary focus is not the same as a doula’s.  Your midwife is tasked with monitoring labor for complications, managing the physical aspects of delivery, and keeping the laboring person and the baby physically safe throughout that process.  This often means their hands, eyes, and attention are on things other than the continuous non-judgmental complete emotional support of the laboring family, and rightly so!  We love midwives for the excellent work they do, but in situations when you might need the most support, they are likely going to have to focus on your physical needs and those of the imminently arriving baby.  Doulas do not have this conflict.  We are there to devote 100% of our attention to you, your partner, and y our emotional needs.

 

3. Doulas Are Not Healthcare Providers

Your healthcare provider has a sense, from their experience and training, about how they think labor and delivery should go.  Based on the risks in a given situation, and always wanting to keep the health and safety of all involved in mind, even the most inclusive provider has a way s/he would like decisions made.  Your doula, by contrast, has no personal preference in what decisions you make.  We support you regardless of how you decide to proceed.  We will not try to persuade you in any particular direction.  Your provider is always motivated by safety first (as they should be!!).  Your doula is motivated by you, first and only.

 

4. Doulas Are All About Relationships

When you hire doula support from Gold Coast, you’re getting two doulas dedicated to getting to know you, your family, and your needs.  We work alongside you from that first meeting through the postpartum period.  You know our names and faces.  We make it our job to know your rhythms, preferences, and fears.  As a healthcare provider myself who works separately in both capacities, as a birth attendant and as a doula, I can say the experiences are vastly different.  When I’m working as a clinical provider, I often do not meet laboring families until the last hours of their adventure, sometimes skating into the birth space only moments before your baby arrives.  When I work as a doula, we spend weeks getting to know each other.  I know you really wanted to be the first to touch your baby when it emerges.  I know you prefer constant light touch for affirmation.  I know how scared you were a month ago, and how strong you feel right now.  While choosing a small practice of midwives often gets you a similar relationship to this, hiring a doula guarantees it.

 

5. Doulas Are Great Team Players

There is seriously nothing better than a having a whole team of people ready to support you through your labor and delivery.  Doulas love attending births with midwives.  We love knowing the kind of excellent care and attention our clients will receive in the midwife-led model.  We love providing a complementary service in supporting laboring families’ emotional and informational needs while the midwifery team handles the rest.  The question should not be, ‘do I hire a midwife OR a doula?’, but rather, ‘how do I get both?’.

 

We love midwives.  We love the work they do, the care they provide, and the positive force for change they are in the healthcare system.  We also love doulas.  Their presence improves labor outcomes, regardless of who the healthcare provider is, and creates space for positive experiences for laboring families.  We think midwives and doulas collaborating to provide the best in practice and support can be a perfect combination for laboring families.  There’s no need to choose one.  You really can have it all.

* Scott, K., Klaus, P., & Klaus, M. (2009). The obstetrical and postpartum benefits of continuous support during childbirth. Journal of Women’s Health & Gender-Based Medicine, 8(10), 1257-1264. doi: 10.1089/jwh.1.1999.8.1257.