Why You Need a Midwife and a Doula During Your Delivery

Both have their roles during your delivery.
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Illustration by Valéry Goulet

Something about the word midwifery sounds dated, sort of ye olde tyme, but the care midwives provide is hardly archaic.

A midwife is a pregnancy care provider. They’re registered nurses—so they have a master’s degree in nursing—and can do many of the things doctors can do: admit patients to the hospital, prescribe medication, deliver babies, perform prenatal and postpartum care, conduct gynecological exams, prescribe narcotics, and more.

“Just like an OB-GYN, we are their prenatal care,” says Susan Wenn, a midwife with TriHealth Nurse Midwives, based in Clifton with satellite offices in Western Ridge. “We follow the same safety standards doctors do and order the same tests.”

The primary difference between a midwife and a doctor is about education, and oftentimes, midwives’ patients are lower-risk. That means midwives can spend more time on a patient’s individualized care, Wenn says. Midwives can care for high-risk pregnancies—where the mother has had a previous miscarriage, for example, or smoked, or had some cardiac conditions, or diabetes—but not all midwife practices are set up to handle those patients.

Midwives often work in tandem with doulas, complementarily, though they have different roles. Instead of providing healthcare, a doula is an advocate for the patient. A birth doula is a mother’s support during labor, and a postpartum doula is for everything that comes after a mother gets home, says Nena Reed, founder of Mommy N Me Professional Maternity Services and a Dayton-based doula, who sees patients in Cincinnati and Columbus.

“I think of a postpartum doula as that extra friend that comes over and does all your chores, watches the baby while you get in the shower, and can cook for you,” Reed says. “Some stay overnight so you can sleep. It’s mostly running errands that Mom can’t do at the moment because she’s bonding with the new baby.”

The Essentials of Making a Birth Plan

It’s a common misconception that doctors and nurses run the show during a birth. In truth, says Nena Reed, it’s the mother’s show.

“You do have a say,” says Reed, a registered nurse and Dayton-based doula with patients in Cincinnati and Columbus.

A good way for mothers to assure they get that say-so is to have a birth plan, which essentially spells out a mother’s wishes for before, during, and after labor. A plan can cover everything from what music to play in the delivery room to how she feels about having a C-section. Reed has seen birth plans that were 40 pages long, but there are a few areas she recommends focusing on.

Stage one: What do you want to do at the very beginning of birth, when contractions aren’t so painful? Do you want to stay home and cook or go for a walk? Watch a movie? How long do you want to stay home?

Stage two: What do you want to do once you’re at the hospital? Some offer mobile monitors so mothers can walk around. Or would you rather stay in bed? If you need to be induced, do you want Pitocin, a drug to induce labor? Or do you want labor to progress naturally?

Stage three: Who do you want around during the birth? If you’re at a teaching hospital, can students be in the room?

“I always say, keep it simple,” so your caregivers can read the plan quickly, Reed says. “When you’re having a birth in a hospital, there’s a lot going on. You’re not the only patient they’re taking care of.”

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