Midwives and Doulas: working in partnership

Can Midwives and Doulas work together? How and why we should, plus find out the differences and similarities between our roles

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I work as a community midwife and have worked with a few doulas in the past and they have all been pleasurable working partnerships.  This article aims to explain the differences between the two job roles and explore the ways in which we can work together to provide holistic care for the woman and her family.

So, what are the differences between a Midwife and a Doula?

Doulas

Can

Cannot

Provide emotional and physical support during pregnancy, birth and postnatally

Physically deliver the baby

Help with coaching, birth planning, hypnobirthing

Provide any medical advice or suggestions

Use massage and complementary therapies

Physically examine, diagnose, or treat any medical issues or complications

Be with the woman and family without needing to document or adhere to policies

Stay with the family for the duration of the labour

Make any decisions regar
ding the woman’s care

Help with non labour/pregnancy reated issues such as housework and childcare

 

Midwives

Do

Do Not

Physically examine, diagnose, or treat any medical issues or complications

Help
with non labour/pregnancy reated issues such as housework and childcare

Provide care and support during pregnancy, birth and postnatal care of mother and baby up until baby is 28 days old

Stay with the family for the duration of the labour unless they choose to do so

Perform minor procedures such as suturing (stitching), episiotomies, emergency procedures

Provide complementary therapies within hospital guidelines


As you can see, they overlap in certain areas, but basically a midwife is more responsible for the woman’s medical care during pregnancy as well as supporting them in their birth choices and signposting them to any social care they may need.  A Doula is hired privately by the woman and can tailor their package as it suits them, they may want a birth partner and advocate with background knowledge to support their birth plan or just some extra support around their life changing event!

doula-role-midwife

How can we work together?

There’s no reason why we can’t work together.  During pregnancy they help prepare the woman for birth, which makes a midwife’s job easier when they know what to expect.  Some midwives may feel ‘pushed out’ (excuse the pun) by the presence of a doula at a birth, but I for one see them as an added bonus.  It means I can confidently perform my necessary tasks such as record keeping, checking equipment, noting the history (particularly if I haven’t met the lady before), performing check ups and dealing with any deviations from the norm whilst someone she knows and trust can support her physically and emotionally.  I can also be of added support when needed.  Having a Doula present at a birth also means there’s an additional pair if hands!  Invaluable.  If there are any complications or slight changes in the plan, the Doula can help to explain the rationale for this and help the family come to terms with it.  Afterwards they can help with any de-briefing, and provide extra support that a midwife just can’t do due to workload.

Tips for working together:

  • Respect each other’s roles
  • Co-ordinate postnatal visits so that they are separate, the woman gets twice as many visits and therefore more support
  • Work together not against each other
  • Doulas can improve birth outcomes and breastfeeding rates so a good working partnership is essential.

I personally think Doulas are a great idea, and should be more available to women, not just privately. What do you think?

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7 Comments

  • Reply Sebnem Susam-Saraeva

    Many thanks for this brief but extremely positive piece! I am a doula and have worked with a variety of midwives up until now. Some, like yourself, find our presence invaluable and we immediately become a ‘team’. Others just don’t know what to expect from us and immediately go into a defensive mode. Please do spread the word amongst your colleagues, as you are doing now, and we can all achieve better outcomes 🙂

    September 2, 2015 at 10:04 am
  • Reply Nichole

    Exceptional post. Didn’t know this, appreciate it for letting me know.

    September 2, 2015 at 8:34 pm
  • Reply Catrin Archer

    It’s so great to see midwives being positive about Doulas! I hugely appreciate midwives who open up their minds and their practice to share with Doulas! I am in some disagreement over the Doula’s role in explaining the rationale for changes to a woman’s plan however. This is not how I understand my role as a Doula; I provide support to capture sufficient evidence and information for the woman to decide herself on what should happen to her during birth, this active, informed decision making ensures there is little need to ‘come to terms with it’. I would not explain why a midwife is doing something the woman didn’t plan on, I would ask the woman if she felt she had adequate information to make a fully informed decision.

    Sadly women are seeking Doula support to provide support and advocacy during birth yet this significant reason for seeking a Doula seems to be missing here. I am very hopeful midwives and Doulas can become support teams around women and families and I can gladly say is is often the case, let’s keep the conversation going without avoiding the elephant in the room. Thanks again for contributing to our discussions!

    November 17, 2015 at 1:01 pm
    • Reply Midwife and Life

      Thank you for your comment, it is much appreciated. I haven’t worked with as many doulas as I’d like to. I wish more women had access to one or that we were more free to provide the support that is lacking. I will consider updating the article when I review it.

      November 17, 2015 at 2:00 pm
  • Reply carrie

    Great post. I was checking continuously this blog and I’m inspired. Thanks for providing such information. There are trained doulas Oahu who offer postpartum for the new mommies. Check out more information http://www.shinebirthservices.com

    January 9, 2017 at 7:54 am
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