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Doulas and Midwives in the current Birthing Landscape

Updated: Jan 22

Written by Zahra Batool - Naturelle VBAC Ambassador, Doula & Childbirth Educator

Holistic maternity care includes having a complete support system framework that works towards a shared common goal and this complete support system comprises of the care from all the birth professionals, the medical and non-medical. Now, when we talk about goal it is imperative to know that it should be a same shared goal. This shared goal is usually phrased as, “healthy mother and healthy baby” but the real question here is about the route that is taken to reach the goal. non-medical perspective and its impact in the birthing world.

They are ready to embrace the existence of the role of childbirth educators and the birth doulas. And therefore, a new role of a doula is born. Doulas and midwives share the same yet complementary workspace in the current birthing landscape. To begin with, let us understand who actually is a birth professional and how are they classified. A birth professional is someone who is skilled in providing medical or non-medical care, attendance, information and services to the mother during or of related to pregnancy, labor and birth. Ideally, birth professionals are classified as medical and non-medical. Since we are now talking about childbirth educators and doulas, they fall under non-medical care providers.

Is it the same or are there any major differences? Are the medical care providers, the mother, the doula and her birth partner all on the same page? Do all of these people speak the same language and are on the same page of the birth plan?

These are some of the questions we need to keep asking while we focus on giving the best possible outcome of the birth plan as a birth team and this is what ideally defines the birth team.

When you look at the illustration of the concept of the birth team you can see the contrasting roles of midwives and doulas while they work together along with the other birth team members to give the mother a better positive birth experience. A midwife here is a medical care provider with her objective being to taking care of the mother medically and perform all the clinical tasks. At the same time, she is more focussed on perceiving birth as a physiological event. She most likely exercises midwifery model of maternity care unless stated otherwise and works towards making birth as a shared memorable family event.

A doula, on the other hand, stands more as a support person and shares the space with the other non-medical birth partner. This birth partner is most likely someone whom the labouring mother chooses for herself and feels safe and secure to be around with. You can see below the common space that both the doulas and midwives share with each other.

So, to have both the midwife and the doula side by side in a birth team is to have the best of the best when it comes to benefits for the birthing mother.

While the mother would recognise that her midwife would support healthy, low risk birth she would also see the benefit of hiring a doula to improve her birth outcome.

The mother if informed and educated of the roles of both of them,

she would understand how important it is for them to collectively stay within

their scope of practice without feeling the need to get territorial or defensive.

She would also understand that having doulas in her early labor would

increase her chances of giving birth vaginally.

At the same time, the doulas and midwives need to understand to respect each other’s role. They need

to know that they wear their own respective hats; only one at that time while they attend the laboring mother which means that the midwife wears her hat of a

midwife and doesn’t play the role of a nurse or a doula in

between for that particular labor and similarly, a doula wears

her hat of a doula and not perform any clinical tasks whatsoever

or give any medical advice for that particular labor even if she

is certified as a different medical practitioner alongside of a

doula. Respect, trust in each other’s abilities and mutual

understanding of their respective boundaries while working

collaboratively will give the best birth outcome for all.

So far, we have got an idea of how doulas and midwives together bring simple yet overlapping skills and abilities to the sacred and intimate event of birth. We also understood the contrasting yet complementary roles of both the midwives and doulas in the birth team. So, now where do you think both the doulas and midwives stand in the current birthing landscape? With the rise of midwives while advocating midwifery model of maternity care there is the birth of doulas, and the need for childbirth education to impart knowledge and information on these changes and roles. In order to fill this gap, we need more birth doulas, childbirth educators, and pre and postnatal coaching and counselling.

And this is crucial when we talk about birth reform. We need to understand the need for doulas to be recognised alongside midwives in a new way that shows our support for bridging any gaps between these two communities. Doulas and midwives working alongside each other in their realm of work with good coordination can make a big difference in the current birth culture of Saudi Arabia and in improving maternal and neonatal health outcomes. Having additional doula support during labor and birth with the primary care providers being the midwives is more likely to lead to improved health outcomes which may result in greater acceptance and demand of midwifery on the whole.

When doulas are given this safe and shared space along with the midwives at this level in the current birthing landscape, we have achieved it all i.e. a safer, healthier, positive and an empowering birthing experience while we witness the transition of our women to stronger, informed, fulfilled, confident, empowered and fierce mothers. Imagine a generation that would come from them...... So, what are we waiting for?


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