"Do I Need a Doula if I Have a Midwife?"
In the wee hours of the night a woman is working to bring forth her baby. Her heart is open and her body is opening. She knew her body was designed for this miracle. She only needed a place in which she felt safe and people who she could trust to keep an eye on the details. She would have to let go of her alert attention to detail, she knew, for her labor to progress.
The smell of her mate is comfort itself. Her mate holds the story of who she has been. She wants him to see the birth, to be part of the event that brings about who she will become.
She chose a midwife for her patience with the natural process of birth. Her midwife also knows how to handle common birth complications and knows which signs mean its necessary to move on to another provider, like a family practice physician or obstetrician. Her midwife not only believes in the normalcy of birth in general but can also assess and validate that her labor is normal.
In early labor the comfort from her mate was just right. In active labor, the midwife’s presence is comforting to both her and her partner. Now, as the sky lightens, the labor picks up even more intensely.
Our birthing mother notices her mate pulling back a bit. It happens as she slips deeper into the labor, into that primeval place, where her partner cannot follow. The midwife, too, seems distant for a moment. Ahh, there she is, bringing her instruments closer. The smell of the ginger compresses is rejuvinating. She hears the midwife tearing open the paper package that holds her sterile gloves.
A contraction sweeps over her rocking her to her core. Wait. Can’t quite stay with it. She wonders will she ride it out or will it ride her under?
She feels a warm touch on her shoulder, hears her name spoken kindly. The doula is there. Oh, yes, that’s right, women do this.
Now she knows she can do it, too. The next contraction comes. The doula is face-to-face, speaking the rhythm of calm. Her partner sees how transition is supported and comes close, confident again.
Suddenly comes this powerful force within her; the urge to push. The midwife speaks. Her voice leads her through this almost overwhelming shift. The midwife shows her how to breath in ways to prevent a tear and bring oxygen to her little one just inches inside. The doula reminds her that her body can give birth.
On one of the days to come, she hopes to share reflections of the birth with her midwife. She is hungry to hear her midwife’s view of her labor and get a few details figured out. She looks to the midwife to hear of her birthing strength and of the highs and lows of the course of her labor. What her midwife says seems to validate her initiation into the mystery that birth is.
She will also talk with her doula, probably several times, about the birth. Even though the doula was there, telling the birth together moves the story into the fabric of her new motherhood. She sees the doulas face light up with that awe and celebration that lets her know she has successfully become a mother victoriously and in honor. Her doula is a peer who shares her community.
I am a midwife who has also been a doula for many years. The roles may overlap. Both celebrate the strength and glory of birthing women. But, the roles are different.
The doula is concerned with the mother’s emotional experience first and foremost. The midwife must be concerned with the health and safety of the mother and her baby first and foremost. The doula is a peer, like a new friend with experience in birthing. When birthing in a hospital, the doula may be the only objective person a pregnant woman meets in pregnancy, has beside her through birth and spends time with after the baby comes.
Birth is personal. Trust is an intimate avenue to a physiological function. We can trust birth not just because of a statistical advantage, but because we live in relationship between our physiology and the people we love and have community with. Peace on both sides, physiological and in relationship, is a balance between the two. The doula seeks to clear obstacles to peace while the midwife steers clear of the obstacles of birth.
The midwife is an ancient role renewed to modern times. The doula is a modern role reflecting ancient times.