Birth Team 101: Who’s Who
With all of the options for your birth team – doctors! nurses! labor doulas! postpartum doulas! midwives! the list goes on… – it can get a bit confusing for expecting parents. I’ve asked the Northeast Doulas to give us a quick rundown of who can help you give birth so you can make the best choice for your family.
What’s a Doula? Is that like a midwife? Should I have a doctor? Do I need all 3? AGHHH! It’s so confusing!
There is great misunderstanding in the birth world surrounding who a woman needs, wants or desires to help her have a baby. Unfortunately most of us only have about 40 weeks to figure it all out. After that, it is what it is. No do-overs.
21 years ago, my husband and I were expecting our first baby. I was a healthy 25 year old woman. I saw a variety of care providers throughout my pregnancy, as the group I chose happened to be a large practice. There were several doctors and several midwives associated with the practice.
Sometime around 32 weeks, I was asked if I wanted a doctor or a midwife for my delivery. I was furious!! I thought to myself, “do they think I can’t afford a doctor?! Why would I choose a midwife over a doctor?! That would be like choosing a hamburger over a steak! (if you ate meat…)”
I was 32 weeks pregnant and had no idea what a midwife was! I had never even heard the term somehow and assumed they were much less qualified to deliver a baby than a doctor.
There were differences that I didn’t understand and perhaps, I missed out because I wasn’t educated.
Thanks to our friend, Rosie Pope, who asked me to break this down, YOU will make educated decisions about this that suit you best!
Let’s break it down.
An obstetrician/ gynecologist (often abbreviated as OB/GYN) is a doctor who specializes in obstetrics and gynecology. Trained as surgeons, ob/gyns are able to serve women through all aspects of women’s health. Obstetricians focus on pregnancy, birth and the early postpartum period and are able to care for women with complicated as well as un-complicated pregnancies. They are able to deliver babies surgically when necessary.
The midwifery approach focuses on the normalcy of pregnancy. Birth is viewed as a natural process that has profound meaning to many people and should be treated as normal until there is evidence of a problem.
There are several different types of midwives. I will discuss the 3 main groups here.
- Lay Midwife
The term “Lay Midwife” has been used to designate an uncertified or unlicensed traditional midwife who was educated through informal routes such as self-study or apprenticeship rather than through a formal program. This term does not necessarily mean a low level of education, just that the midwife either chose not to become certified or licensed, or there was no certification available for their type of education (as was the fact before the Certified Professional Midwife (CPM) credential was available).
- Certified Professional Midwife (CPM)
A Certified Professional Midwife (CPM) is a professional independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the midwives model of care. As of November 2010, there are approximately 1800 CPMs practicing in the US. However, midwives practicing with a CPM certification are not required to carry insurance.
Certified Nurse Midwife (CNM)
CNMs function as primary healthcare providers for women and most often provide medical care for relatively healthy women, whose birth is considered uncomplicated and not “high risk,” as well as their neonate. Often, women with high risk pregnancies can receive the benefits of midwifery care from a Certified Nurse Midwife in collaboration with a physician. Certified Nurse Midwives may work closely or in collaboration, with an Obstetrician & Gynecologist, who provides consultation and/or assistance to patients who develop complications or have complex medical histories or diseases.
The term doula originates from the Ancient Greek word meaning “female servant”. A doula is a nonmedical person who assists a woman before, during, and after birth. Additionally, a doula provides physical assistance, educational information and emotional support for both the pregnant/laboring woman as well as her partner, during the pregnancy and labor and after birth.
Research shows that birth with the continuous support of a doula leaves the mother with a more satisfactory feeling regarding her birth. Additionally, studies have shown that having a doula attend your birth decreases your risk of cesarean section dramatically.