Whether it’s your first or your fourth, planning for a baby is always an exciting time filled with many decisions. One of the first decisions to make is choosing what kind of care you would like during your pregnancy, delivery, and postpartum days. If you’re thinking about a midwife or a doula, here’s what you need to know about each.
The Role of a Midwife
Midwives are medically trained professionals who attend your pregnancy and birth instead of an obstetrician. To practice in the province we operate in; Ontario, midwives must complete a four-year degree through the Ontario Midwifery Education Program. Upon completion, midwives will obtain a license and then must complete a one-year mentorship with an experienced midwife. There are currently more than 800 registered midwives in Ontario who deliver more than 130,000 babies every year.
Pregnancy with a Midwife
If you choose a midwife, she will be your primary health care provider for the duration of your pregnancy and the first several weeks after delivery. You will meet with your midwife throughout pregnancy for physical examinations and discussions. She will monitor baby’s progress while also providing support and guidance, and answer any questions you may have.
Your midwife can arrange the same routine prenatal tests as doctors, including ultrasounds, genetic screenings, and lab tests as well as receive and discuss the results of each test. Midwives can also prescribe necessary medications such as morning sickness relief and antibiotics. You will receive information about available tests and medications, including associated risks. She will make recommendations, but ultimately the decision will be yours to make and your midwife will support your choices.
If you choose a home birth, your midwife will provide you with all the information and support you need for success. She is trained to provide care and support for a home birth and brings the necessary equipment including sterile instruments, oxygen, and medication to stop bleeding if it becomes necessary after delivery.
Staffed by midwives, birth centers are another option for a safe, comfortable environment for delivery. The instruments and equipment at a birth center are similar to what would be found in a hospital delivery room for a typical delivery, but no surgical procedures are performed in a birth center. Several hours after giving birth, you will be transported home for recovery.
Epidurals and narcotics can only be administered in a hospital. If these are part of your pain management plans, you must arrange for a hospital birth. All midwives in Ontario can attend a hospital birth; check with your midwife to find out in which hospital she holds privileges as that’s where your delivery will take place. Your midwife works with all other medical staff, and just like a physician, will admit and discharge you when the time comes.
After giving birth, your midwife will provide care in your home for the first 24 hours. Over the next six weeks, you and baby will meet with your midwife about once per week. She will monitor your recovery and help you establish good breastfeeding habits. She will also examine baby at each visit to check overall development including weight, height, heart, lungs, and healing of the umbilical cord.
Midwives are highly trained to handle complications during pregnancy and birth. In the event of a development that exceeds your midwife’s abilities, she will consult with an expert such as an obstetrician or neonatologist and transfer care if necessary. During birth, your midwife is capable of handling a number of difficult situations. If needed, transportation to the hospital where she has privileges will be arranged. In the event of an urgent situation, emergency ambulance transfer to the nearest hospital will be made. Your midwife will remain with you as your primary care provider throughout, even if you are transported to a hospital.
The Role of a Doula
A doula plays a very different role in the pregnancy and birthing process. She is someone you may choose in addition to an obstetrician or midwife, but she will not replace a primary healthcare provider.
The doula’s job is to provide personal care, support, and assistance to a birthing mom, both physically and emotionally. She’s there to be an advocate for you and your personal needs during a time when you may not be the best advocate for yourself. An experienced doula has attended many births and can answer all your questions about pregnancy, including all those “is this normal?” questions that come up.
You’ll also spend time talking with your doula about your birthing goals, such as a desire for an unmedicated birth, and go over what steps to take when medical intervention may be required. When it is time to give birth, a doula will stay with you for the duration of the delivery and offer comfort, help with positioning during labor, and help you interact with your medical support team. Once the baby is born, your doula will help you recover from delivery and provide breastfeeding support.
Many people compare a doula to a birthing companion or a good friend (with tons of experience!) who will be by your side. She is someone who will give your partner a break–especially during delivery–so you both are calmer and more prepared for what’s coming. A doula will help you feel safe and comfortable while also making sure you meet as many of your birthing goals as possible.
The Best Decision for You
While you will need to choose whether you prefer a midwife or an obstetrician, a doula is an optional companion. Making the right decision comes down to finding the right fit for your needs. Don’t be afraid to talk to a few different providers as soon as you find out you’re pregnant–or even while you’re still trying to get pregnant–and ask as many questions as you need to feel comfortable.