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Selecting Your Birth Team

Written by Sarah, IBCLC, CD, CBE

Doula, Midwife, Obstetrician – Getting to know your birthing team options

You’re expecting – congratulations! Ah, but now you are conflicted with selecting your birth team, your birth plan, and probably a million other things that pop into your head once that pregnancy test came back positive. When navigating the labyrinth of pregnancy, labor, birth, postpartum, and breastfeeding, it can be rather complex on your own. Hiring the right professionals with the appropriate education, experience, and passion for your birth, should be of paramount importance. Deciding where to birth your baby, with whom as the professional, which classes to take, who will be your rock through labor, what labor looks like to you, how your partner fits in and how private the event will be, can be all-encompassing.

Let us help you break down the options when selecting your birthing team -

Doula

A doula can be hired for birth or the postpartum journey. They are a non-medical person who can assist the mother before, during, and after childbirth by providing emotional support, education, and physical help as needed. A doula is someone you’ve hand-picked to be your rock, your shoulder, and your sounding board at any time, day or night. They have gone through special training and apprenticeship to better assist you, but their craft truly comes from the heart. While their main goal is to be there for the goddess growing the baby (that’s you), they will make every effort to support the partner, parents, other children and or friends, as needed. Their goal will be to keep everyone updated on the facts while coaching you through this maze of wonderment. However, doulas do not replace the partner. There is a special connection between the goddess and the doula. The doula will bring love, adoration, and an intimacy known by no other at your birth. Employing a doula when you find out you’re pregnant can dispel the uncertainty surrounding this complex journey.

Studies suggest that the benefits of a doula include a reduction of complications or adverse outcomes for both mother and baby.* Continuous support from a person not emotionally connected to the mother, who has some training and experience is very beneficial in several ways. Most significant are lower inductions, lower cesarean rates, less need for pain medication, and an increase in mothers reporting a positive birth experience.

Midwife

A midwife is a healthcare professional trained to assist expecting mothers during labor, birth, and the postpartum period. Midwives go through rigorous training, attend programs online and in classrooms, have written and clinical testing, and do an apprenticeship or hospital rotation. They do not have to be a nurse or physician to become a midwife, but some hospitals or birthing centers may require this in order to have privileges. They attend low-risk pregnancies and do not perform surgeries, although they can order medical testing. Midwives are trained to detect abnormal pregnancy deviation and will collaborate or transfer care with physicians to ensure the mother and baby are safe and healthy. A midwife always has a back-up obstetrician at his or her fingertips.

While midwives will primarily help you birth your baby without interventions such as induction, vacuum, forceps, episiotomy, cesarean section, and medications, they will support the birthing choices you make. Like a doula, the midwife may offer more personalized educational services.

Obstetrician

This is the physician trained to assist women in more complex health situations while pregnant, birthing and during the initial postpartum period. He or she will have had many years of schooling, residency, fellowship, and exams. They have special knowledge, skills and professional capabilities in the medical and surgical care of the female reproductive systems and mother’s associated disorders. The obstetrician is highly trained to use medicine and interventions like induction or episiotomy and statistically may have higher usage rates, rightfully so. This is the doctor who would perform a cesarean section if needed. The higher the risk you are, or the more health care issues you have, the better the reason to have an obstetrician as your primary doctor. An obstetric office will likely refer you for childbirth education at the hospital they have privileges at, although you can always hire a private educator as well.

In the end, when that pregnancy test comes back positive and you’re in the market to hire highly educated birth attendants, take your time. These people are on your payroll and will be honored to serve you during this extraordinary journey. Keep in mind a doula can be your new pregnancy BFF and give you the ins and outs of other team members. There is never a time a doula is not an asset to the squad, but by choosing the model of care that’s right for you (medical or midwifery) you can decide on the correct birth attendant (midwife or obstetrician) that fits your needs.

*   For more information, reference https://www.cochrane.org/CD003766/PREG_continuous-support-women-during-childbirth