Defining Roles: Midwives and Doulas

I had not heard the term “elevator speech” until I became a doula. In my previous career as a high school Spanish teacher, I never had to explain what I did for work. Toward the end of my training to become a doula, I was advised to come up with a quick but thorough definition of what I do because I’d be asked questions. Lots and lots of questions.

Once I explain how to pronounce it (doo-luh), and give a short definition (I’m a professional birth partner), the response is nearly always “Oh, so you’re like a midwife.”

Not exactly.

A midwife is a highly trained professional who specializes in women’s sexual and reproductive health, pregnancy, labor and delivery, and the postpartum period. In my estimation, midwives are doctors without the M.D. after their names. Before I end up writing an essay here, let’s move to a chart format to illustrate some of the similarities and differences between midwives and doulas.

Please note, this table is not a complete list for neither doulas nor midwives.

Please note, this table is not a complete list for neither doulas nor midwives.

A doula’s scope of practice is highly specific. There are certain tasks I simply cannot perform because I am not trained to do them. A midwife’s role often depends on the location of the birth. Each * in the chart above denotes a tricky situation for midwives if they practice in a hospital setting. Often they are called out of the room to visit other patients and cannot provide continuous labor support or offer their best physical comfort measures. Their ability to assist with breastfeeding or give emotional support might be lacking if they are stretched thin. While their mentality still centers on an appreciation for the woman’s ability to naturally give birth, midwives in hospital settings are often about as present at deliveries as OBs. However, at a birth center or in a couple’s home, midwives often stay for the duration. In those settings, they are able to give a birthing mom the continuous emotional and physical care for which midwives are known.

To be likened to a midwife is most definitely a compliment. However, the widespread confusion over our jobs, at least in this country, means that we still don’t understand or appreciate childbirth for all its natural glory. People still associate birth with the medical model: OBs and hospitals. If we can flip that image and begin to internalize the midwifery model of care, perhaps then my role and the role of a midwife will become clarified.

Interestingly enough, I have not once been asked why I do what I do. Sure, people have asked how I got into it or what I enjoy about attending births. But I believe there’s an implicit understanding, especially among women and men who have given birth or witnessed it, that there is a need for what I do.

I love my work. And I relish the opportunity to work alongside likeminded midwives who care about birthing women as much as I do. Midwives are my heroines.

In another life, maybe I’ll even get to be one.