Join Embrace Birth Wellness Collective tonight at 7pm for Sip & Shop! Two great local shops, The Spotted Pocket and Green Baby Planet will be premiering new products while you shop and mingle with light refreshments! We hope to see you there!
Embrace Midwifery Care and Birth Center is dedicated to Encouraging, Educating and Empowering Women to embrace a healthy pregnancy, a safe, gentle birth, and a peaceful transition to confident mothering.
Monday, September 12, 2016
Friday, September 9, 2016
Eating Dates Reduces Chance of Augmented Labor
I have always been an advocate and continuing researcher of the best and most recent scientific studies when it comes to childbearing and pregnancy. Time after time, studies prove organic and holistic methods to be extremely beneficial, especially when it comes to prenatal nutrition. Here's one little tip I always share with my mamas and have experienced it's effectiveness first-hand! I recently found an article on thepeacefulbirthproject.org highlighting the statistics backing it up, so I thought I'd share! Enjoy!
The date fruit is the product of the date palm, a tree native to Northern Africa and the Middle East. There is a wide variety of dates including the better known Medjool and Deglet Noor. Each variety is unique in size, sweetness, flavor, and texture. Containing at least 15 minerals such as potassium, calcium, iron, magnesium and zinc, 23 types of amino acids, vitamins, carbohydrates, protein, 14 types of fatty acids, dietary fiber and a lot more, these sweet little fruits are a nutritional powerhouse. [International Journal of Food Sciences and Nutrition, 2003]
On the photo I quote a study published in the Journal of Obstetrics and Gynaecology which concludes that eating 6 dates daily during the last four weeks of pregnancy “significantly reduced the need for induction and augmentation of labor, and produced a more favorable, but non-significant, delivery outcome”. Some significant findings:
- Cervical dilation was significantly greater in the date-eating mamas upon arrival at the hospital
- 83% of mothers who consumed dates had their membranes intact upon admission at the hospital
- 96% of the women who ate dates went into labor on their own
- Use of Pitocin (synthetic Oxytocin) was significantly lower in women who consumed dates (28%), compared with the non-date fruit mothers (47%)
- The latent phase of the first stage of labor was almost 7 hours shorter in the date-eating mothers compared with the non-date fruit eaters (510 min vs 906 min). Not bad for eating a few dates!
I also came across a very interesting research comparing the use of dates and Pitocin in the management of postpartum hemorrhage. The study demonstrates a significant reduction in the amount of postpartum bleeding experienced by women who consumed date fruit compared to women who received synthetic oxytocin (Pitocin). The randomized clinical trial was done in two hospitals. Immediately after the delivery of the placenta one group was give 50 gram of dates. Another group received 10 units of synthetic oxytocin in an intramuscular injection. Blood loss mean in the end of first hour after delivery were significantly different in dates and oxytocin groups (104 ml vs 141.6 ml) The researchers suggest that dates are effective for management of postpartum hemorrhage because dates have Calcium, serotonin, tannin, linoleic acid, enzimes, iron and other nutrients beneficial to control bleeding and prevent anemia. Khadem, Sharaphy, Latifnejad (2007)
These studies are yet another confirmation of the priceless legacy of ancient wisdom. Since the beginning of time, women have been using food, teas, oils, poultices and herbs to ease the pains of labor, heal during postpartum and support breastfeeding. Eating dates has been emphasized during pregnancy and after delivery in many Islamic traditions.
The Quaran tells of Mary eating dates in labor: “The pains of labour drove her to the trunk of a date-palm. She [Mary] said, “Oh if only I had died before this time and was something discarded and forgotten!” A voice called out to her from under her, “Do not grieve! Your Lord has placed a small stream at your feet. Shake the trunk of the palm towards you and fresh, ripe dates will drop down onto you. Eat and drink and delight your eyes…” (Qur’an, 19:23-26)
Dates are also said to increase sexual stamina, help lower LDL (bad) cholesterol and lower blood pressure. Dates have been used for thousands of years by athletes to improve physical endurance, agility, and stamina. So start eating your dates and have them handy during labor!
Wednesday, September 7, 2016
12th Annual RVA Peace Festival!
Join the 12th Annual RVA Peace Festival! Where diversity is celebrated and community is embraced. Embrace Birth and Midwifery Care will have a table at this year's festival being held at St. Stephen's Episcopal Church! This has historically been a wonderful event with a great mission:
The mission of the annual RVA Peace Festival is to provide an opportunity for children, youth, and adults of the greater Richmond area to gather in celebration of peace and diversity. It is our hope that this will foster a growing sense of community.
Come by our table and sign up for our free drawing for our Embrace Botanicals, Balms for the Body, Salves for the Soul, Basket of Love!
Here is the schedule of events for all interesting in going, and you can find more information at their event page!
Schedule of Performances:
11:00 – 11:10: Opening Drumming Ceremony, Polly Lazaron
11:15 – 11:40: Sri Sai South Indian Dance Academy
11:45 – 12:10: Ebraheem Khabeer, Slam Poet
12:15 – 12:40: Prodigy Productions Music Group
12:45 – 1:00: Fire Ceremony, Greg Kelley
2:15 – 2:35: Interactive Dances of Universal Peace, Hayat Donna Bain
2:40 – 3:05: Drums No Guns, Ram Bhagat
3:10 – 3:35: Latin Ballet of Virginia
3:40 – 4:05: Falun Dafa Chinese Dancers
4:10 – 4:35: Cultural Libations Drama Production
4:45 – 5:00: Closing Ceremony
Exciting Exhibitions:
Mini Memoirs led by the Chrysalis Institute
Chalk for Peace, led by Art180
Healing Our Water
Meditation Labyrinth
Cooperative Games
Arts and Crafts
Wonderful Food:
La Milpa Mexican Cuisine – crafting in colorful Mexican food
Zainab’s – Middle Eastern Halal delicacy
Soul Ice -Premier Minority-owned and Certified Frozen Dessert Company
Ellwood Thompson’s – Locally-owned Market
Friday, September 2, 2016
The Role of Doulas in Reducing the Primary Cesarean
Coming up on September 14th, Embrace Midwifery Care & Birth Center will be hosting another Doula Meet and Greet! We believe in the power of a positive support team during your pregnancy. Our doulas specialize in everything from massage therapy to prenatal yoga, but they all specialize in meeting your needs. Yet another reason to bring a doula into your birthing plan comes this article, highlighting their role in reducing the primary cesarean.
The Role of Doulas in Reducing the Primary Cesarean
Article published on Donainternational.org
The rise in cesarean birth rates and the effects of cesarean birth on mother and baby have become common themes in articles about birth and medical care. It seems everyone from the American Congress of Obstetricians and Gynecologists (ACOG) to Consumer Reports to mommy blogs are talking about the need to reduce the number of cesarean births in the United States. Doula support as a way to help achieve a lower cesarean birth rate was first acknowledged by ACOG in 2014. Doulas have again received a strong endorsement for the role we play in supporting vaginal birth, this time from the California Maternal Quality Care Collaborative (CMQCC). Their evidence-based Toolkit to Support Vaginal Birth and Reduce Primary Cesareans for maternity care practitioners outlines seven strategies, one of which is to #4 Encourage the Use of Doulas and Work Collaboratively to Provide Labor Support. Their view of doulas can be summed up in one simple quote from the Toolkit:
— California Maternal Quality Care Collaborative, Toolkit to Support Vaginal Birth and Reduce Primary Cesareans (p. 46)
The Toolkit also addresses the role of doulas and how to promote stronger teamwork with nurses. That some providers may not understand the role of doulas and may have an “antagonistic or adversarial view of them” is not ignored (p. 40). Doulas are described as having a unique skillset, and it is noted that we can be both an advocate for the birthing woman and be an ally to care providers, including nurses, when we are allowed to “function appropriately” in our role. The authors are aware that doulas have not been fully accepted in all hospital settings and “there are still many misconceptions about doula care, and often there is a stigma surrounding the ‘type’ of woman who has a doula.” (p.46)
To address this, the Toolkit provides specific recommendations to better integrate and support doulas.
KEY STRATEGIES FOR SUPPORTING INTENDED VAGINAL BIRTH
— Toolkit to Support Vaginal Birth and Reduce Primary Cesareans, Table 9
In detailing this strategy, the Toolkit offers specific recommendations to promote stronger relationships between doulas and nurses to support vaginal birth including:
For hospitals, the Toolkit offers these “Innovative strategies to support the use of doulas”:
Many of the strategies outlined in the Toolkit speak to maternity care practices and hospital policies that support vaginal birth. The importance of education for birthing families is mentioned in more than one strategy with recommendations that practitioners educate families on what to expect in early labor, the safety of laboring at home in early labor, comfort measures partners or other family members can provide throughout labor, and the use of intermittent monitoring in labor. The importance of childbirth education is emphasized in a list of tools available to providers, hospitals and families in Appendix C of the toolkit as well.
The Toolkit is free to download from their website after registering with CMQCC and completing a short survey. As a follow-up, CMQCC will be releasing both a teaching slide set and an implementation guide.
— Adrianne Gordon, CD(DONA), MBA
References
Smith H, Peterson N, Lagrew D, Main E. 2016. Toolkit to Support Vaginal Birth and Reduce Primary Cesareans: A Quality Improvement Toolkit. Stanford, CA: California Maternal Quality Care Collaborative.
The Role of Doulas in Reducing the Primary Cesarean
Article published on Donainternational.org
The rise in cesarean birth rates and the effects of cesarean birth on mother and baby have become common themes in articles about birth and medical care. It seems everyone from the American Congress of Obstetricians and Gynecologists (ACOG) to Consumer Reports to mommy blogs are talking about the need to reduce the number of cesarean births in the United States. Doula support as a way to help achieve a lower cesarean birth rate was first acknowledged by ACOG in 2014. Doulas have again received a strong endorsement for the role we play in supporting vaginal birth, this time from the California Maternal Quality Care Collaborative (CMQCC). Their evidence-based Toolkit to Support Vaginal Birth and Reduce Primary Cesareans for maternity care practitioners outlines seven strategies, one of which is to #4 Encourage the Use of Doulas and Work Collaboratively to Provide Labor Support. Their view of doulas can be summed up in one simple quote from the Toolkit:
“Doulas should be considered an integral part of the birth team.”
— California Maternal Quality Care Collaborative, Toolkit to Support Vaginal Birth and Reduce Primary Cesareans (p. 46)
The Toolkit also addresses the role of doulas and how to promote stronger teamwork with nurses. That some providers may not understand the role of doulas and may have an “antagonistic or adversarial view of them” is not ignored (p. 40). Doulas are described as having a unique skillset, and it is noted that we can be both an advocate for the birthing woman and be an ally to care providers, including nurses, when we are allowed to “function appropriately” in our role. The authors are aware that doulas have not been fully accepted in all hospital settings and “there are still many misconceptions about doula care, and often there is a stigma surrounding the ‘type’ of woman who has a doula.” (p.46)
To address this, the Toolkit provides specific recommendations to better integrate and support doulas.
KEY STRATEGIES FOR SUPPORTING INTENDED VAGINAL BIRTH
— Toolkit to Support Vaginal Birth and Reduce Primary Cesareans, Table 9
In detailing this strategy, the Toolkit offers specific recommendations to promote stronger relationships between doulas and nurses to support vaginal birth including:
- Open communication between the doula and the nurse and a “mutual understanding of roles.” Unit guidelines may need to be developed to foster delineation of roles and expectations. Posting these guidelines at the bedside may be useful.
- Collegial rapport and joint understanding that the doula’s professional knowledge of labor support techniques complements the nurse’s extensive technical and medical skillset
- Two-way teaching. Doulas appreciate thoughtful and respectful guidance and feedback, especially those training for future medical or nursing professions. Likewise, nurses and nursing students can learn extensive labor support skills from doulas if willing to do so.
For hospitals, the Toolkit offers these “Innovative strategies to support the use of doulas”:
- Working with a local doula organization to provide information, support, and resources to families
- Connecting with community-based doula programs
- Considering the implementation of a hospital-based program
Many of the strategies outlined in the Toolkit speak to maternity care practices and hospital policies that support vaginal birth. The importance of education for birthing families is mentioned in more than one strategy with recommendations that practitioners educate families on what to expect in early labor, the safety of laboring at home in early labor, comfort measures partners or other family members can provide throughout labor, and the use of intermittent monitoring in labor. The importance of childbirth education is emphasized in a list of tools available to providers, hospitals and families in Appendix C of the toolkit as well.
The Toolkit is free to download from their website after registering with CMQCC and completing a short survey. As a follow-up, CMQCC will be releasing both a teaching slide set and an implementation guide.
— Adrianne Gordon, CD(DONA), MBA
References
Smith H, Peterson N, Lagrew D, Main E. 2016. Toolkit to Support Vaginal Birth and Reduce Primary Cesareans: A Quality Improvement Toolkit. Stanford, CA: California Maternal Quality Care Collaborative.
Wednesday, August 31, 2016
MyBirth Podcast
Listen as Corina Hossle, the Founder, Clinical Director and Midwife of Embrace Birth Midwifery Care & Birth Center talks to the lovely ladies of MyBirth in this insightful, entertaining and informative Podcast.
Saturday, August 20, 2016
Breastfeeding Tips That Work!
To finish off National Breast Feeding Month strong and to Celebrate our upcoming Black Breastfeeding Week Cookout, we are dedicating our blog to all things breastfeeding this next week!
Breastfeeding Tips That Really Work
By: Dana Holmes
August is National Breastfeeding Month and if you’re a nursing mom you know how breastfeeding can sometimes feel like the most frustrating and unnaturally difficult things you ever have to face as a parent. Well, I have some stellar advice for new moms from the people who are changing the way we do it. I spoke with the people who are helping new moms feel more confident about getting the most out of that precious nursing time with their little ones.
How do you keep your supply strong?
Helen Anderson- Creator of Milkies milk-savers that catch every last drop of your liquid gold says,
“Breastfeeding often keeps your milk supply strong on its own. If your baby is fussy, don’t reach for a pacifier - breastfeed instead. When your breasts are empty, your body says, “Make more milk - baby is hungry!” When your breasts are not emptied completely or infrequently, your body says. “Slow down production - baby doesn’t need this much.” It is normal to breastfeed ALL THE TIME in the first weeks - plan to focus on caring for yourself and your baby and ask for help if you need it.”
What if I just can’t do it?
Melanie Herschorn, creator of Udderly Hot Mama Nursing and Pumping Wear, says,
“Remember that even though breastfeeding may look easy if you watch other moms doing it, it can be really hard at the beginning. Don’t shy away from asking for help if it seems too hard for you to master on your own. There are lactation specialists everywhere who can help you through the tough times.”
What can I do to prepare for breastfeeding?
Kate Doti, co-founder of jay elle by J.L. Childress, a line of chic breastfeeding totes and accessories, says,
“Prepare and practice. I really benefited from reading The Womanly Art of Breastfeeding before my first baby.”
Kimberly Schram, VP of Marketing and Communications for UpSpring Baby, creators of Milkflow healthy milk supply tea, says,
“New moms can’t rely solely on the breastfeeding information you may, or may not, get in the hospital so take a breastfeeding class before baby arrives from a certified lactation consultant. A breastfeeding class will help you be better prepared and will provide you with a resource to reach out to if you have trouble once you start breastfeeding.”
Personally, I found that teas and oatmeal cookies, massage and pumping during nursing and in between feedings was all very helpful in increasing my milk supply. Also, the lactation consultant was a total lifesaver. I learned that the hospital hadn’t taught me the best positions for me and my baby and that there were lots of positions to try in different situations. Mastering the “dream feed” where you both are practically asleep and lying down is one of the greatest gifts a nursing mother can give herself.
And, register for a housekeeper for those first few weeks. In fact, a theme of not being afraid to ask for, and hire, help during the early breastfeeding days is the one thing that all of these ladies mentioned and rings true in my own personal experience. The lesson here is that nursing is a full-time job! Don’t make yourself crazier than you have to.
To read the original article, click here.
Breastfeeding Tips That Really Work
By: Dana Holmes
August is National Breastfeeding Month and if you’re a nursing mom you know how breastfeeding can sometimes feel like the most frustrating and unnaturally difficult things you ever have to face as a parent. Well, I have some stellar advice for new moms from the people who are changing the way we do it. I spoke with the people who are helping new moms feel more confident about getting the most out of that precious nursing time with their little ones.
How do you keep your supply strong?
Helen Anderson- Creator of Milkies milk-savers that catch every last drop of your liquid gold says,
“Breastfeeding often keeps your milk supply strong on its own. If your baby is fussy, don’t reach for a pacifier - breastfeed instead. When your breasts are empty, your body says, “Make more milk - baby is hungry!” When your breasts are not emptied completely or infrequently, your body says. “Slow down production - baby doesn’t need this much.” It is normal to breastfeed ALL THE TIME in the first weeks - plan to focus on caring for yourself and your baby and ask for help if you need it.”
What if I just can’t do it?
Melanie Herschorn, creator of Udderly Hot Mama Nursing and Pumping Wear, says,
“Remember that even though breastfeeding may look easy if you watch other moms doing it, it can be really hard at the beginning. Don’t shy away from asking for help if it seems too hard for you to master on your own. There are lactation specialists everywhere who can help you through the tough times.”
What can I do to prepare for breastfeeding?
Kate Doti, co-founder of jay elle by J.L. Childress, a line of chic breastfeeding totes and accessories, says,
“Prepare and practice. I really benefited from reading The Womanly Art of Breastfeeding before my first baby.”
Kimberly Schram, VP of Marketing and Communications for UpSpring Baby, creators of Milkflow healthy milk supply tea, says,
“New moms can’t rely solely on the breastfeeding information you may, or may not, get in the hospital so take a breastfeeding class before baby arrives from a certified lactation consultant. A breastfeeding class will help you be better prepared and will provide you with a resource to reach out to if you have trouble once you start breastfeeding.”
Personally, I found that teas and oatmeal cookies, massage and pumping during nursing and in between feedings was all very helpful in increasing my milk supply. Also, the lactation consultant was a total lifesaver. I learned that the hospital hadn’t taught me the best positions for me and my baby and that there were lots of positions to try in different situations. Mastering the “dream feed” where you both are practically asleep and lying down is one of the greatest gifts a nursing mother can give herself.
And, register for a housekeeper for those first few weeks. In fact, a theme of not being afraid to ask for, and hire, help during the early breastfeeding days is the one thing that all of these ladies mentioned and rings true in my own personal experience. The lesson here is that nursing is a full-time job! Don’t make yourself crazier than you have to.
To read the original article, click here.
Friday, August 19, 2016
The Doctor, The Midwife, The Nurse & The Doula
Addressing the most common questions and concerns of many expecting parents, but often times, their extended family. We have so many mothers who walk through our doors wanting to have a natural birth administered by a midwife, but are lacking support from their family members. It is understandable for parents, grandparents, aunts and uncles to be concerned for the well-being of you and your new family, but ultimately it is not their birth. We believe that good information and the best up to date research is a great tool to ease the minds of concerned parties when it comes to your pregnancy. Starting with the fundamentals....
The Doctor, The Midwife, The Nurse & The Doula
From The Prenatal Yoga Center
I wanted to share some questions with you that I am asked on a regular basis: “What is the difference between a midwife and a doula? “; “Does my doctor work with my midwife?”; “Why would I choose a midwife over a doctor?”; “Isn’t the nurse like a doula?” I figured the best way to answer all of these questions would be to finally sit down and map it out.
First, let’s understand the definitions of those terms and the job of each of the people mentioned.
Obstetrician: A physician who delivers babies and is in the practice of obstetrics, the art and science of managing pregnancy, labor and the puerperium, the time immediately after delivery.
You will see your OB/GYN or members of his/her practice throughout your pregnancy, although who your care provider will be at delivery depends on who is on call during your labor. During the labor, the doctor will come in and out to check on your progress and, as the definition above states, “manage” your labor. Obstetrics is also a surgical field, so in the case of a cesarean, it would be your OB that would perform the procedure.
Midwife: A midwife is a trained professional with special expertise in supporting women to maintain a healthy pregnancy birth, offering expert individualized care, education, counseling and support to a woman and her newborn throughout the childbearing cycle.
A midwife works with each woman and her family to identify their unique physical, social and emotional needs. When the care required is outside the midwife’s scope of practice or expertise, the woman is referred to other health care providers for additional consultation or care.
Midwives operate from The Midwives Model of Care which emphasizes the fact that pregnancy and birth are normal life processes. Midwives statistically have lower rates of interventions and provide the mother with individualized education, counseling, prenatal care and postpartum support as well as continuous hands-on assistance during labor and delivery.
Midwives, like doctors, may work in a group that rotates who is on call and who will see you for your prenatal visits. Some midwives work alongside doctors in their practices, while some work individually or outside the hospital setting. There are different types of midwives: Direct Entry Midwifes, Certified Professional Midwives, and Certified Nurse Midwives. Depending on their credentials and training, some midwives work in hospitals while others solely attend home births.
Labor and Delivery Nurses: Nurses in this field provide care to women who are in labor or who have recently delivered, or for those who may be having complications with labor. They also work with doctors to develop a plan to aid in the safe delivery of healthy babies.
Labor Support Doula: A trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.
Unless the doula has additional training, she is NOT a medical professional and will not perform medical procedures on the laboring mothering or deliver the baby. However, she most likely will be one of the most consistent elements of the labor experience. She does not change shifts and only deals with one client at a time. The doula will also labor with you at home and come with you to the hospital or birth center.
Now that there is an understanding of what each professions offers, it may be clearer how they might or might not work together. So, back to the original questions:
What is the difference between a doula and a midwife?
As described above, the doula acts as an emotional, physical and informational support for the mother. While the midwife may offer many of those same qualities, it is the midwife that will deliver the baby and perform the necessary medical examinations throughout pregnancy, labor, delivery and postpartum. Midwives are also available to do “well woman” yearly exams throughout a woman’s life, not just working with her while pregnant.
Does my doctor work with my midwife?
Yes, sometimes a practice has both doctors and midwives. But if your current doctor does not work with midwives you cannot have both as care providers. If a midwifery practice does not have a doctor as part of the group, there will be a doctor that backs up that group. However, if you choose a home birth, you will have just a midwife; should you need further medical assistance, you would be transferred to a hospital. Some midwives have privileges at a hospital, while others just have a relationship with a doctor and will no longer be your care provider should you be admitted.
Why would I choose a midwife over a doctor?
Choosing your care provider is a very personal choice. It requires a long, hard look at the model of care you would like for your pregnancy and delivery. While both professions try to offer the best care they can to women, the path in which that support is offered differs. The Model of Care that midwives subscribe to reflects the idea that pregnancy and birth is a natural physiological process that should be inherently trusted, while the medical model focuses on the pathologic potential of pregnancy and birth. They both have the same desired outcome, but use different routes to get there.
You should also consider the style of care you personally prefer. Midwives will tend to be more present during labor; moreover, they will be more holistically based and allow more space for the labor to unfold naturally before moving to medical interventions. Doctors are not as likely to give you as much personal care and time and may move to medical interventions more quickly.
Isn’t the nurse like a doula?
Many of the Labor and Delivery nurses (L & D nurses) I have worked with are wonderful and can offer a lot of helpful advice for the laboring mom. However, I would not advise depending on your L & D nurse to provide the same comfort and assistance as a labor support doula. The L & D nurse often has several women they are monitoring at the same time and cannot offer consistent support since they work in shifts and breaks. You may also find it appealing to choose your labor support doula and have the opportunity to previously discuss you birthing preferences with this person.
Now that the cast of characters has been laid out, I hope this makes it easier to make decisions about the model of support you will receive and who you would like at your birth.
The Doctor, The Midwife, The Nurse & The Doula
From The Prenatal Yoga Center
I wanted to share some questions with you that I am asked on a regular basis: “What is the difference between a midwife and a doula? “; “Does my doctor work with my midwife?”; “Why would I choose a midwife over a doctor?”; “Isn’t the nurse like a doula?” I figured the best way to answer all of these questions would be to finally sit down and map it out.
First, let’s understand the definitions of those terms and the job of each of the people mentioned.
Obstetrician: A physician who delivers babies and is in the practice of obstetrics, the art and science of managing pregnancy, labor and the puerperium, the time immediately after delivery.
You will see your OB/GYN or members of his/her practice throughout your pregnancy, although who your care provider will be at delivery depends on who is on call during your labor. During the labor, the doctor will come in and out to check on your progress and, as the definition above states, “manage” your labor. Obstetrics is also a surgical field, so in the case of a cesarean, it would be your OB that would perform the procedure.
Midwife: A midwife is a trained professional with special expertise in supporting women to maintain a healthy pregnancy birth, offering expert individualized care, education, counseling and support to a woman and her newborn throughout the childbearing cycle.
A midwife works with each woman and her family to identify their unique physical, social and emotional needs. When the care required is outside the midwife’s scope of practice or expertise, the woman is referred to other health care providers for additional consultation or care.
Midwives operate from The Midwives Model of Care which emphasizes the fact that pregnancy and birth are normal life processes. Midwives statistically have lower rates of interventions and provide the mother with individualized education, counseling, prenatal care and postpartum support as well as continuous hands-on assistance during labor and delivery.
Midwives, like doctors, may work in a group that rotates who is on call and who will see you for your prenatal visits. Some midwives work alongside doctors in their practices, while some work individually or outside the hospital setting. There are different types of midwives: Direct Entry Midwifes, Certified Professional Midwives, and Certified Nurse Midwives. Depending on their credentials and training, some midwives work in hospitals while others solely attend home births.
Labor and Delivery Nurses: Nurses in this field provide care to women who are in labor or who have recently delivered, or for those who may be having complications with labor. They also work with doctors to develop a plan to aid in the safe delivery of healthy babies.
Labor Support Doula: A trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.
Unless the doula has additional training, she is NOT a medical professional and will not perform medical procedures on the laboring mothering or deliver the baby. However, she most likely will be one of the most consistent elements of the labor experience. She does not change shifts and only deals with one client at a time. The doula will also labor with you at home and come with you to the hospital or birth center.
Now that there is an understanding of what each professions offers, it may be clearer how they might or might not work together. So, back to the original questions:
What is the difference between a doula and a midwife?
As described above, the doula acts as an emotional, physical and informational support for the mother. While the midwife may offer many of those same qualities, it is the midwife that will deliver the baby and perform the necessary medical examinations throughout pregnancy, labor, delivery and postpartum. Midwives are also available to do “well woman” yearly exams throughout a woman’s life, not just working with her while pregnant.
Does my doctor work with my midwife?
Yes, sometimes a practice has both doctors and midwives. But if your current doctor does not work with midwives you cannot have both as care providers. If a midwifery practice does not have a doctor as part of the group, there will be a doctor that backs up that group. However, if you choose a home birth, you will have just a midwife; should you need further medical assistance, you would be transferred to a hospital. Some midwives have privileges at a hospital, while others just have a relationship with a doctor and will no longer be your care provider should you be admitted.
Why would I choose a midwife over a doctor?
Choosing your care provider is a very personal choice. It requires a long, hard look at the model of care you would like for your pregnancy and delivery. While both professions try to offer the best care they can to women, the path in which that support is offered differs. The Model of Care that midwives subscribe to reflects the idea that pregnancy and birth is a natural physiological process that should be inherently trusted, while the medical model focuses on the pathologic potential of pregnancy and birth. They both have the same desired outcome, but use different routes to get there.
You should also consider the style of care you personally prefer. Midwives will tend to be more present during labor; moreover, they will be more holistically based and allow more space for the labor to unfold naturally before moving to medical interventions. Doctors are not as likely to give you as much personal care and time and may move to medical interventions more quickly.
Isn’t the nurse like a doula?
Many of the Labor and Delivery nurses (L & D nurses) I have worked with are wonderful and can offer a lot of helpful advice for the laboring mom. However, I would not advise depending on your L & D nurse to provide the same comfort and assistance as a labor support doula. The L & D nurse often has several women they are monitoring at the same time and cannot offer consistent support since they work in shifts and breaks. You may also find it appealing to choose your labor support doula and have the opportunity to previously discuss you birthing preferences with this person.
Now that the cast of characters has been laid out, I hope this makes it easier to make decisions about the model of support you will receive and who you would like at your birth.
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