What Does a Midwife Do?

What does a midwife do?  How is it different from an OB / GYN or a doula?  In this section we answer questions like these, with the goal of helping you choose each health professional on your natural birth support team.

Welcome back Mama!  This is part 4 of our 5-part series which will demystify your birth options and help you understand the benefits of natural birth.  As we shared earlier, our topics are:

1. What are the advantages of a natural birth?  How does it differ from a typical hospital birth?
2. How much does a natural birth cost?  Does insurance cover it?  How can I pay for it?
3. Does a natural birth hurt more than a hospital birth?  How can I manage without pain medication?
4. How does a midwife compare to a doula compare to an OB / GYN?  Who should I have on my natural birth support team?  
5. What is the single most important thing I can do to prepare for a natural birth, regardless of the care setting I choose?
   
   

As you know, this short series will help cut through the conflicting information and mixed messages you may have received about natural childbirth.  It will help you get right to the heart of the matter – the one question that matters most:

Each Part of this series will cover a specific topic on the way to answering that question.

Before we step into Part 4, I hope that you were able to complete your simple assignments for the previous Parts.  If not, consider pausing right now and going back to complete the assignments for:

• Part 1 (which focused on the advantages of a natural birth)
• Part 2 (which helped to understand the costs of natural birth and how to pay) and
• Part 3 (which talked about natural approaches to labor pain management

If you do have remaining questions about any of these Parts, please don’t hesitate to reach out using the ASK ME button below.

And then once we are all caught up ... Let's talk about your natural birth support team.

What is a Midwife?  What Does a Midwife Do?

Many new moms considering a natural childbirth have questions such as:

• What is a midwife?
• What is a doula?
• What is a certified nurse midwife?
• How do these roles differ from that of an of OB / GYN?

This post will address these questions.  It will help you decide:

Who can I count on for support in a natural childbirth?  

How do I choose my support team?

Let’s start by describing the differences between a Licensed Midwife, an OB/GYN, a Certified Nurse Midwife, and a Doula.

Differences Between Roles

A Licensed Midwife (LM), such as myself, is a healthcare provider usually licensed (at least in the United States) by their state medical board and / or the American Midwifery Certification Board.  Licensed and certified midwives specialize in providing 'natural' prenatal care, childbirth support and postpartum care in home birth settings or birth centers to women who prefer a natural birth plan.  Their licenses orient them toward women with low-risk pregnancies, not requiring medications or surgical intervention.

An OB / GYN (obstetrician-gynecologist) is a medical doctor who specializes in women’s reproductive health.  He or she is trained to provide medical, surgical and all other forms of gynecological care for women throughout their reproductive lives.  This includes the administration of birth control and the diagnosis and treatment of reproductive medical conditions, including high-risk pregnancies and complex childbirths.

A Certified Nurse-Midwife (CNM) is a registered nurse who has obtained additional specialized training in midwifery care, has passed a national certification exam and is supported by the American College of Nurse-Midwives.  Certified nurse midwives provide a range of primary care services, including prenatal, labor and delivery and postpartum care. They are licensed to provide medical interventions such as epidurals and other pain medications and can work in a hospital setting.

A Doula is a trained professional who provides physical, emotional, and informational support during pregnancy, childbirth, and the postpartum period.  Doulas do not provide medical patient care or perform clinical tasks. Instead, they focus on providing comfort measures such as relaxation techniques, breathing exercises, massage, and positioning suggestions during labor. They also offer emotional support by being a reassuring presence, providing encouragement, and helping navigate the childbirth process.

In addition, there are professionals in related fields who are trained to provide specific health services to pregnant women. These individuals offer services such as prenatal massage, prenatal chiropractic and birth hypnosis.

In my practice we have aligned with professionals in each of these areas, to provide a well-rounded set of pregnancy care resources.  We often find them to be a great addition to mom's natural birth support team.

How to Choose Your Team

The choice of which health care provider(s) to include on your support team depends on the type of care you prefer.  That is why we waited until this point in our series to raise the question 'what does a midwife do?'

Natural Birth Team:   If you are leaning toward a natural birth experience, with minimal medical intervention you might choose a licensed and certified midwife to lead your support team.  You might also choose to work with a doula, although most licensed midwives provide the same type of support as part of their overall service.

Hospital Birth Team:   If you are leaning more toward having your birth experience directed by a medical doctor, with more direct access to pain medication and emergency care if needed, you might prefer to have an OB / GYN as one of the health care professionals on your support team.

Hybrid Birth Team:   If you are thinking about a blended approach, in which your prenatal and postpartum care are more self-directed, but labor and deliver itself take place in a hospital, with an effort to approach the conditions of natural childbirth as closely as possible – a doula and / or CNM might be good healthcare professionals to include on your team.

All of this must be influenced by your health profile and other conditions of your pregnancy that may pose risks best managed by a medical doctor.  As shared Day 1, these scenarios might include twins, breach, VBAC and health risks such as pre-eclampsia or gestational diabetes.

So here’s the question, Mama: which type of support team appeals most to you?  Do any of them raise additional questions or concerns?  If so, please don't hesitate to reach out to me using the ASK ME button below:

In the meantime, here are your key questions for Part 4:

Questions for Part 4

Choose the statement that is MOST true for you at this point of our discussion (you can always change it later):

Statement A:  I’ve made my choice regarding natural childbirth.   I know what roles I want to include on my support team.

Statement B:  I’m still considering the pros and cons of natural childbirth.  I’m not quite sure who I want to include on my support team.

Mama, I’ve said it before and I’ll say it again: there is no ‘correct’ answer.  What I want most is for you to make the best, most informed choice for YOU.  

By this time you should have a pretty good idea which way you are leaning, based on your answers to each Day’s assignment.  But you still may have questions.

So once again, please feel free to ask me ANY question that has occurred to you as you read this letter.   Even if you still just want to know 'what does a midwife do?'  :-) Simply tap the ASK ME button above.

Summary of Part 4

Now, to recap:  Today’s main questions were: "What does a midwife do?  How does a midwife compare to a doula compare to an OB / GYN?  Who should I have on my natural birth support team?"

Between this post and any questions you have chosen to share with me, I hope that we have answered these important questions for you.

In Part 5 we will focus on the final question in our series: “What is the single most important thing I can do to prepare for a natural birth, regardless of the care setting I choose?"

That will be the final topic in our series.  I’m so excited to share it with you!

In the meantime, thank you for completing Day 4 of our series on Understanding Natural Childbirth.  I'll see you in Part 5!

Warmly -

Paula Grady LM, CPM

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