feto

Midwives and Doulas

Pregnancy, breastfeeding, birth, preparation for birth, advice, support… When we mention these words, the professional image that might come to mind is a midwife, although some people might think of a doula. So what is a doula? What about a midwife? How are they different? Are they opposite or complementary? Below we’ll tell you all about them.

 

Iris Franco and Mila Bena

What is a midwife and what is their role?

A midwife is a healthcare professional who, along to the Nursing and Midwifery Council Rules and Standards:

“Makes sure the needs of the woman and her baby are the primary focus of her practice and works in partnership with the woman and her family, providing safe, responsive, compassionate care in an appropriate environment to facilitate her physical and emotional care throughout childbirth.”

Rule 5: Scope of practice – Mirwife Standards

What services can a midwife carry out?

  1. Create or participate in mother-child health programs.
  2. Diagnose, monitor and assist women during pregnancy using clinical and technological means.
  3. Detect high-risk situations early and refer patients to other health professionals with whom they work in an interdisciplinary fashion, and even take urgent measures if needed.

Academic training

Thus, the training of a midwife must be regulated and legislated in the legal framework. In UK, this legal framework is twofold:

en-legislacion The Nursing and Midwifery Council (NMC) Rules 2012 govern the framework in which midwives, supervisors of midwives and local supervising authorities meet the requirements of the Nursing and Midwifery Order 2001.

legislacion-eu   Via European Union Legislation

Courses usually take a minimum of three years, although a registered level 1 (adult) nurse can undertake a reduced training course of 18 months, for dual registration with NMC.

Midwifery training takes place at an NMC-approved educational institutions, with half of the programme based in clinical practice with direct contact with women, their babies and families. This can include the home, community and hospitals, and in other maternity services such as midwife-led units and birth centres.

 

What is a doula?

Etymologically some authors claim that it comes from ancient Greek and means “slave” or “servant”.

Today, a doula is a person who:

Accompanies women during pregnancy, birth and the post-partum.

Provides support during conception or during perinatal loss.


How do they do it? 

The Doula helps mothers trust their own ability to give birth, breastfeed and raise their child by providing information and resources so that motherhood is experienced fully and mindfully, given the circumstances and wishes of each mother.


 

What kind of academic training do doulas have?

Midwives and doulas in crono seconds

A nurse may be a doula.

A nurse may be a midwife.

A midwife must always be a nurse.

A midwife may be a doula.

Any woman may be a doula, regardless of whether or not she has previous healthcare training.

A midwife can do a doula’s job, but a doula cannot do a midwife’s job.

 

What are the kinds of birth and which professionals participate in each of them?

Normal birth, using no instruments or medications. Synonymous with a physiological birth.


PROFESSIONALS YOU MIGHT FIND IN A NATURAL BIRTH
  • Midwife
  • Nurse
  • Nurse’s aid
  • Doula
  • Obstetrician (may be in the birthing room or not, but will always be nearby to intervene in case of complications).

Also known as Assisted birth, uses medications and instruments.


PROFESSIONALS YOU MIGHT FIND IN A DYSTOCIAL BIRTH:
  • Obstetrician
  • Midwife
  • Nurse
  • Nurse’s aid
  • Anesthesiologist
  • Pediatrician (If the birth is high-risk and there might be risks for the newborn, there will be a pediatrician to guarantee immediate care after birth)
  • Doula

A birth that takes place at home.


HEALTH PROFESSIONALS YOU MIGHT COME ACROSS IN A HOME BIRTH
  • 2 Midwives
  • Doula

Throughout pregnancy or during the post-partum period you might come across:

Physiotherapist 

A physiotherapist is a health professional with university training.
They are specialists in therapy through the application of physical means such as massage, cold, heat, electricity, air and light among others. Their objective is to prevent, treat and alleviate disorders of the musculoskeletal system. They also work on aspects related to posture. Physiotherapists also use as a substitute or even as help, pharmacological treatments.

Salus or maternity nurses

Also known as a newborn baby nurse or night nanny. They are women who care exclusively for newborn babies to “guarantee” rest for the mother. They are often professional nurses who come to your house to help with the care of your baby, as well as assessing you on things such as food, bathing the newborn, umbilical cord care, etc…

Difference between gynecologist and obstetrician

Gynecologist

Gynecology is specifically concerned with monitoring women and diseases of the female reproductive system outside of pregnancy, while obstetrics is charged with caring for women during gestation, birth and post-partum.

Obstetrician

Obstetricians are gynecologists who specialize in pregnancy. That is, all obstetricians are gynecologists, but not all gynecologists are obstetricians.

casa Criteria for a home birth

  1. The pregnant woman should be healthy, with a straightforward pregnancy and no health conditions or previous obstetric complications that might affect this pregnancy. Are also included women who have previously given birth and had a straightforward labour.
  2. The woman must be pregnant with one baby who is positioned head-down.
  3. The birth must take place between weeks 37-42 of the pregnancy.
  4. The pregnancy must be low risk.
  5. The decision to give birth at home must be informed and taken freely by the mother-to-be, and an informed consent form must be signed.

datos Information of interest on a European level: 

  1. In the UK, home birth, hospital birth and births at birthing centers are all included in the public healthcare system.
  2. In Holland, home births are encouraged for women with low-risk pregnancies, and they are covered by public healthcare.