Midwives and Doulas Working Together

by  Sinéad Morgan

The midwife and doula collaboration truly puts a new family in a fantastic position to have a healthy, happy, and satisfying outcome during pregnancy, childbirth and postpartum. With ample evidence from lower cesarean section rates, less inductions, shorter labors and even better Apgar scores for baby, when a birthing person is supported by a midwife or doula; this team is a powerhouse for any expecting family. Which is why the two of them working together seamlessly is absolutely imperative to positive, nurturing beginnings for the whole family. While a doula is specifically hired by the family or birthing person for non-medical, unbiased, evidence based, emotional and physical support. The midwife is hired for clinical support in addition to emotional and physical support, and more often than not is chosen over an obstetrician because of their ability to view pregnancy and childbirth as a natural process rather than an ailment to be intervened with. Here are 5 ways that doulas and midwives can work together to ensure a successful and flourishing relationship.

Doulas must practice within their scope of practice.

As with any collaboration, there is the risk of “stepping on each others toes”. In order to avoid this a well trained doula should always keep in mind the importance of practicing within their scope of practice. The doula is hired as nonmedical support, this should be specified to the client at the time of hire and reminded throughout the relationship when necessary. Not only is this imperative in order to maintain a positive relationship with the entire birth team, but also in order to support positive healthy outcomes for the birthing person and baby. Unfortunately there have been instances where hospitals, or obstetric practices have disallowed patients to utilize doula support for this reason. While a doula may have a basic understanding of certain pregnancy/childbirth issues and may be able to help a birthing person and their family understand some of those issues, it is the midwives responsibility to monitor, interpret and treat the health and safety of the baby.

Fill in the gaps.

Just as a doulas role is to fill in the gaps of the birthing persons partner when he or she is not present, the doulas role is to also fill in the gap when the midwife is not present. The midwife may not always be present throughout the entire labor process (especially during a hospital birth) as she may often have other laboring people at the same time. In addition to this, the midwives attention may not always be on the emotional needs of the birthing person; for example the birthing person or babies safety may be of utmost importance and so the midwife is unable to provide physical comfort for pain, or emotional support during a situation that may need immediate attention. This is where the doula must fill in the gaps and really has the potential to provide calm for the birthing person, midwife and even their partner in a possibly emergency situation.

Midwife, invite doulas to prenatal appointments.

Something that midwives might take into consideration is extending an invite to their patients doula to a prenatal appointment. If this is the midwives first time working with the doula, one of the patients prenatal appointments can be a great opportunity to briefly meet with the doula (while obviously still keeping the focus on the patient). This is a great way to get on the same page as the doula and discuss any boundaries/protocols. The midwife will usually see the patient more throughout the pregnancy than the doula, so this is a fantastic chance to include the doula, not only fostering a relationship between doula and midwife but also between the doula and birthing person. All of which will lead to happier outcomes for all.

Advocate for each other.

As doulas and midwives, it’s safe to say we all have one thing in common and that is to help a birthing person and their family achieve whatever birth plans they desire (within reason) safely, while feeling supported throughout pregnancy and childbirth. Because of this mutual goal, this is a great reason to advocate for each other. Doulas should be recommending and discussing the benefits of hiring a midwife to women with low risk pregnancies and midwives should be doing the same!

Remember who you are working for.

At the end of the day both the doula and midwife are striving to provide the birthing person with the best care possible. When both professionals keep this in mind throughout the pregnancy, labor and delivery, being mindful of the fact that the birthing person wants BOTH parties there this can really foster a positive work environment for all.

Both midwives and doulas are deeply rooted in cultural practices that have existed for centuries. However, today most birthing people in the United States are giving birth in hospitals and are attended to by doctors. Yet still, our maternal mortality rate has been on the rise while most of the world maternal mortality rates have been declining. Not to mention that more than half of these deaths were preventable. As a doula myself, I do not take the responsibility and privilege of working with midwives lightly and always encourage birthing people to utilize their expertise throughout their reproductive years.

The ultimate goal is for us to complement each other in the birthing space, coming together as professionals for birthers and their families and respecting and welcoming each others position with open arms. I wholeheartedly believe that we as birth workers have the ability to make birth safer and remind birthing people of our innate power as life givers.

“The midwife considers the miracle of childbirth as normal, and leaves it alone unless there’s trouble. The obstetrician normally sees childbirth as trouble; if he leaves it alone, it’s a miracle.”
Sheila Stubbs

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Sinéad Morgan is a full time mom of 3 living in Atlanta, Georgia. She is a Postpartum Doula currently working on her Birth Doula Certification, a freelance writer and breastfeeding educator with a passion for holistic healing and supporting families throughout their reproductive years. She can be found on Instagram @nurtureempowerdoula and at www.nurtureempowerdoula.com.