Friday, May 31, 2013

Let's get the facts straight. Midwives and doulas are totally different.

So I'm a doula. Not a midwife. I plan on becoming a midwife eventually, but I don't see doulas as inferior (or superior) to midwives. Just different. Like, not the same thing at all.

Most people I have conversations with about birth-related things don't fully understand the difference between a doula and a midwife. Many don't realize that there is a difference (and there's a big one). I've had people confidently tell me that doulas are like PA's (um - NO), that they can't have a doula because they're having a hospital birth, and a whole list of other falsehoods. This is understandable I guess, but it does get frustrating having to explain myself over and over again. So let's break it down.
Midwives draw blood, listen to mommy and baby hearts and lungs, take blood pressures, hold appointments at their office or home office, make recommendations that they expect their clients to at least consider, deal with insurance payments, prescribe and administer medications and herbs, make life-or-death decisions, palpate uteri, perform newborn exams, diagnose complications and diseases of the reproductive system, measure cervices with their fingers, own (and regularly use) dozens of vag specs, are sometimes employed by hospitals and OBs, work alongside doulas and are backed up by OBs, break water bags, swab vaginas for GBS, arrive at births when the mothers are in active labor or transition, have the education similar to that of a physician's assistant or nurse practitioner, meet clients at the hospital or birth center if that's the way they're going, chart chart and chart some more, see women even when they're not pregnant, and, of course, they catch babies.

Doulas don't.

Doulas spend hours helping their clients plan their births, meet with their clients in their clients' homes over coffee (decaf of course for the mama), work with women only if they're pregnant or in the 6-week postpartum period, make breast and belly casts if they know how to, encapsulate placentas if they know how to, show up at births when the mommies are still in early labor, refer clients to their pregnancy care providers for medical advice, are self-employed or work in a group practice, have extensive training in non-medical childbearing-period support, work alongside midwives, labor nurses and OBs, act as Medicalese to English interpreters, facilitate pow-wows when moms and dads don't know what to do, watch other kids while mom is laboring if needed, let clients borrow their birth balls, go to the hospital or birth center with clients if they are birthing there, hold legs back on epidural'd pushing mamas, and do everything else you can think of that is not medical.

Midwives don't.

But there is some overlap. Midwives AND doulas give frequent back and foot rubs, text and call their clients for updates, assist in home, hospital, and birth center births or all or some of the above, hug their clients whenever they see them and say "Look at you, you're the most beautiful pregnant/postpartum woman I've ever seen!" (and really mean it every time), drive around a lot, offer birth tubs for rental, have lending libraries, get pooped, sweated, bled and cried on, say things like "You can do this, I know you can. You know how I know? Because you ARE doing this, and the contractions can't be stronger than you, because they ARE you. Besides, you have no other choice!" often, educate their clients, eat their clients' food and share food with their clients, tearfully exclaim "Happy birthday!" whenever they witness a child emerge from a woman's body, encourage their clients to make their own decisions, but aid in those decision-making processes, suggest position changes and other coping mechanisms, laugh, weep and say "I'm so sorry" when there's nothing else to say, offer breastfeeding support, admire new squishy babies, get scared, pray with their clients if they so desire, rub pregnant bellies lovingly, help clients figure out where they are in labor, look at screenshots of contraction timer apps, take lots of pictures, and pour their hearts and souls into the mothers they serve. Both midwives and doulas want what is best for their clients, and do everything they can to make sure that happens.

Midwives and doulas do different things. They have different roles. Doulas aren't pre-midwives and midwives aren't advanced doulas. But they are entirely different. And women should have both. Get it? Got it? Good.