Midwives, Doulas and Lactation Support
Women deserve choices when crafting a birth and postpartum plan
A midwife is a health care professional. Depending upon the laws of the US state in which the midwife practices, a midwife may perform gynecological examinations (for example, Pap smears, pelvic exams, and breast exams), write prescriptions, care for a woman during labor and delivery, perform fetal monitoring, and provide information about contraception. A midwife usually seeks to eliminate or minimize unnecessary technological interventions, believing that pregnancy and birth are normal life processes. However, a midwife also is skilled at identifying and referring women who need the services of an obstetrician during the birth. A midwife is medically trained and qualified to deliver babies. Some midwives also are trained as nurses. A nurse-midwife usually can offer the greatest variety of health-care services to women.
The American Midwifery Certification Board (AMCB) is the US national certifying body for certified nurse-midwives (CNMs) and certified midwives (CMs). Midwifery education programs involve graduate study and usually require a Bachelors Degree for entry. Some programs will accept applicants with a Bachelor’s degree in a field other than nursing, while others require a Bachelor’s degree in nursing. Midwifery education programs in the United States are accredited by the Accreditation Commission for Midwifery Education (ACME). According to the AMCB, legal recognition for CNMs and CMs varies among states. Find out what guides midwife practice in California, here.
A midwife is trained to recognize an emergency or situation that requires medical care from a doctor. Midwives are trained to handle normal pregnancies, but obstetrical care is required for certain situations, and for pregnancies deemed to be at high risk. Many doctors have nurse-midwives in their practices that work alongside your doctor’s team, and may manage normal pregnancies if the woman wishes.
Obstetricians (OB-GYN physicians) can manage high-risk pregnancies and can perform surgeries, including C-sections, when necessary. Midwives are prohibited from performing C-sections or using forceps and vacuums during the delivery process. The midwife will seek obstetrical care by a doctor should a birth complication arise that requires one of these interventions, or an emergency that threatens the mother or baby.
A doula provides physical, emotional, and informational support to an expectant mother before, during, and after childbirth. A doula focuses on an expectant mother’s own needs, which enables her to have a memorable and empowering experience while giving birth. While in most cases the term “doula,” implies a professional who is present during the birth, there also are doulas who specialize in antepartum (before birth) care and postpartum care. A birth doula remains with the mother during birth, offering relaxation and breathing technique support, as well as comforting services like massage, and assistance with labor positions; however, doulas are not medically trained, and cannot deliver babies. A doula is not a substitute for having a woman’s partner at the birth. Doulas encourage participation from the partner, and offer support and reassurance to the partner as well.
A doula does not necessarily have medical training, and there is no formal licensing required. However, many doulas choose training and certification by organizations that oversee doula training programs, such as DONA International™ and the Childbirth and Postpartum Professional Association (CAPPA).
Info taken from
North American Registry of Midwives