You’ve probably heard about doulas and independent midwives, or private midwives. They are all practitioners who help and support you through pregnancy, birth and the postnatal period. But what’s the real difference?
Actually, the roles are distinct and the training and responsibilities of the midwife and doula are very different. So, if you’re considering employing a doula or independent midwife, it is absolutely essential to know why and what you hope to gain from them.
What is a midwife?
A midwife is a health professional, nationally registered and regulated to provide medical/midwifery care for women and babies throughout pregnancy, labour and the early weeks of motherhood.
The midwife can check and monitor both yours and your baby’s progress and general health and will be able to answer any medical/midwifery questions you might have. She can work autonomously without direct supervision and can be the lead health professional for you.
What is an Independent Midwife?
An independent midwife is a fully qualified midwife who has chosen to practice on a self-employed basis outside the NHS. They can provide care either at home, or in a hospital setting as necessary.
Usually private midwives work in a similar way but are employed by an organisation or a private hospital.
Employing the services of an independent midwife does not in any way mean you have to forego NHS privileges or any extra care you may require at a later date. You can stio get all your screening and scans done at an NHS hospital and can give birth there too. You are still an NHS patient.
Also, your independent midwife is still trained and regulated in the same way as NHS midwives. There are requirements for regular re registration, they are fully qualified by law and are required to keep all their knowledge and training up to date.
Some independent midwives seek out extra training (for example in complementary therapies) in order to offer the woman holistic care. They may also have additional skills in terms of home birth, breech birth and breastfeeding.
Most importantly the IM can provide complete continuity of care for you throughout pregnancy, birth and the postnatal period. This type of care has been shown to provide safer care, better outcomes and greater satisfaction.
Why employ an independent midwife?
Many women seek out an IM in order to gain more control or for a more personal service. Some woman want the security of continuity, others may have had a negative experience first time around and want a different experience this time. Many women say that it gives them peace of mind. An independent midwife also has more time, she will provide more than just clinical care, she will support you emotionally and physically too. It is a very close trusting relationship. She will offer your antenatal care at home, she will advise you on choices and the evidence around childbirth options. She will advocate for you to gain the birth that you want and if things do not go as planned she will be there to help you make sense of it all. She walks the journey with you as a skilled, qualified helper.
What is a doula?
Doula (pronounced ‘doola’) is a Greek word for ‘caregiver or woman servant’. The Doula offers emotional and practical support, she “mothers the mother”. Many doulas are skilled at support in labour and breastfeeding but she cannot give you advice about your care. She may also help after the baby is born with cooking and caring for you.
Whether this is your first or subsequent child you may need or want the additional help and support that a doula offers. She will also be able to work with your IM if that seems appropriate for you.
A good doula is flexible and will use her skills and knowledge to meet your needs.
Some doulas only offer pre-birth or labour support; some only postnatal services. Many offer all three. She can help you to prepare for birth, support you during birth and help around the house and support you after birth.
What a doula does NOT do
Doulas are very knowledgeable but a doula is not a trained medical professional.
Even if she is a qualified health professional, as far as her role as your doula is concerned, she cannot give medical advice or diagnose problems. It is the job of your midwife or obstetrician to do that.
A doula is not a midwife replacement. They work well together.
If you decide to opt for a doula, you need to be clear what her role is. Remember that a doula is there to support you with your decision-making process, she cannot advise you or influence your decision making. This is your baby and your birth.
Also, unlike midwives, there is no statutory regulatory body for doulas.
Employing a doula could be amazingly helpful – as long as you are clear about what her role is.
Some IM’s would argue that their care bridges the gap between a doula and a midwife. The best advice is to read widely around different people’s experiences and talk to IM’s and doulas.
Most IMs offer free consultations which gives you a chance to see how comfortable you feel with her.