You’re like a Midwife … You help with Natural Birth, Right?

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As a birth doula this is the statement I most often hear when introducing myself to new people.  My response is: Well … not really, no.  So what exactly is a birth doula?  I recently conducted an interview with Dreaming of Baby in which I answered this exact question.  I explained the different types of doulas, exactly what a birth doula is and what they are not, what they do throughout each stage of the birth process and how they work with partners.  This was my first time being interviewed via a chat service instead of in person.  I found that chat interviewing allowed me to spend more time thinking about the questions that I was being asked.  I also got a chance to edit this Dreaming of Baby interview before we posted it online.  In this blog post I wish to go over some more aspects of being a doula than those that I mentioned in the interview.

Doulas are Not Midwives

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First of all midwives are very similar to an obstetrics gynecology (obgyns or “doctors” as they’re often known by laypeople).  They both help deliver the baby.  Historically midwives had more association with home births and obgyn were related to hospital births but this is no longer true.  Many hospitals employ midwives (though there are very few obgyns who attend home births).  The primary difference between a midwife and an obgyn is that an obgyn is a surgeon.  Midwives are not trained as surgeons so they can not perform c-sections.  If one is giving birth in Europe one is automatically assigned a midwife, no matter where they decide to give birth.  It is then up to the midwife to determine the risk of the pregnancy.  If the pregnancy is of very high risk then the midwife will transfer the patient to an obgyn.  Otherwise patients don’t ever see obgyns.  This wonderful chart by Penny Simkin is a wonderful visual explanation on the difference between all the individuals involved in a given birth: midwives, doulas, partners, and obgyns.

Some midwives may quit their profession to become doulas.  And some doulas continue their education to become midwives.  Just as an architect may quit and decide to become a lawyer. 

Doulas Can Be Certified

So how does one become a doula?  Unlike many professions (architects, lawyers, surgeons), there are no accredited doula schools.  You can’t go to a university and get a degree as a doula.  Because of this there are also some doulas who never received their certification.  Instead there are a variety of different organizations that certify doulas.  Each organization has its different certification process.  With some organizations all a doula needs to become certified is to take a class.  In my case I am looking to become a DONA certified doula.  DONA (Doulas of North America) is the largest organization of doulas in the country.  In order to become certified through DONA one has to take a workshop, write several essays, read particular books, get evaluated on a certain number of births by both the birthing individual and a member of the medical staff and turn in a lot of paperwork.  Because this process is much longer than that of other organizations, it tends to take a doula longer to become certified with DONA.

Doulas Can Help with More Than Just Natural Births

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There are some doulas that prefer to focus on natural births.  These doulas attempt to weed out families who discuss epidurals and c-sections from the beginning.  Most doulas claim to work with all types of births.  However, some doulas clearly prefer to work with natural births over medicated births or c-sections.  Personally I have worked both with individuals getting natural births as well as individuals getting c-sections, epidurals, nitrous oxide, fentanyl, foley balloons, pitocin, and many other things.  In my opinion a doulas job is to ensure that the birthing individual gets the birth they want no matter what.  Birthing individuals may go in to their births hoping for an epidural and the birth happens so quick that they don’t ever get any medication.  Or they might want a vaginal birth and their baby ends up being breech so they have to have a c-section.  Any number of things can happen.  No matter the situation I do not get frustrated with my families for not having one kind of birth over another.  I do not walk away from a family who is getting an epidural.  I stay with that family and make sure they understand exactly what to do while getting the epidural and afterwards ensure that they know that certain positions will progress labor faster even while they’re resting in bed.  I stay and help an individual with an epidural push a baby out just like I’d help anyone else.  Not all doulas share these ideas.

As I mentioned in the interview, it is extremely important to me that I can help my families no matter what happens.  This is why I am training to become a full spectrum doula.  If a family loses their baby or if the baby ends up coming early I don’t want to have to tell them “well, I’m not trained in this so I can’t help you”.  These families are going through extremely trying times and need my help even more.  I want to be able to give them everything I possibly can so I will be going through training to become a bereavement doula (one who helps with stillbirths) in addition to a birth doula.