Midwives and Birth Doulas

Defining the professions

It’s safe to say that Alberta is booming, as many couples start or expand their families! However, not all women know how midwives and birth doulas can care for and support them in their birthing experience. As a birth doula, I have realized that the roles of these professionals need defining.

Both the midwifery and the doula models of care trust in and promote birth as normal. Registered midwives and birth doulas are experienced, trained professionals. However, the specific roles they play differ.

Midwives, considered experts in normal pregnancy and birth, provide care to mothers and babies during the prenatal, birth and postpartum periods. Midwifery care has been fully funded by Alberta Health Services since 2009. In addition to delivering babies, midwives can perform other clinical tasks, including screening their patients’ physical and emotional health, ordering tests and making referrals to specialists when needed. Their care is based on evidence and is woman centred. Midwives collaborate with each other, often working in teams, and with other health professionals.

In contrast, birth doulas do not undertake medical tasks or deliver babies. As part of a woman’s birthing team, which may include a midwife, doctor and nurses, birth doulas offer continuity of care to the mother and her partner by providing information and emotional and physical support before, during and just after the birth. The unbiased information they give enables women to make informed choices about their care.

A birth doula stays with the mother throughout her labour, providing nonmedical physical and emotional comfort, and, if needed, facilitates communication with her other care providers. The fact that the doula focuses on the needs of the mother can be especially helpful in a busy hospital environment. The doula can also encourage the woman’s partner to be as involved in the birth experience as desired. Some partners report enjoying the birth experience more because they don’t feel solely responsible for coaching and supporting the mother.

Studies have shown that having a professional birth doula present during labour and birth provides the following benefits:
• 50% reduction in the cesarean rate
• 25% shorter labour times
• 60% reduction in epidural requests
• 40% reduction in Pitocin use
• 30% reduction in pain medication use
• 40% reduction in forceps deliveries

In addition, research has shown that parents who receive care from a doula can have fewer negative feelings about their birth experience; feel more cared for, secure and self-confident; experience greater success in adapting after the birth and in breastfeeding; and have lower incidences of postpartum depression and abuse. Their babies tend to require shorter hospital stays.

As support professionals, doulas recognize that birth is a transformative experience for women, as well as for their families. They aim to provide compassion, support and informed guidance to help their clients through this transformation. Because each situation is different, they tailor their care to the unique needs of each woman and her family.

As a professional birth doula and prenatal childbirth educator, I strive to promote and preserve maternal and infant safety during childbirth. I recognize that in areas without a practicing registered midwife, the safest option is hospital birth. I am hopeful that the Alberta Association of Midwives will grow and that an increase in registered midwives, in both urban and rural settings, will offer families safe alternatives for prenatal care and birth.

Editor's Note: This piece was originally written for Guided Synergy Magazine in 2014