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No, I’m Not a Midwife: Let Me Explain

I’m with a group of new people. We all ask the normal small talk kind of questions when you first meet: What part of town do you live? How old are your children? What do you like to do for fun? What do you do? I start to tell them “I am a birth doula” but before I even finish I am contemplating whether I will give him/her a quick definition of what it is I do or a more detailed description of what all being a  birth doula entails. It usually doesn’t matter because if the individual is not familiar with my profession I often hear, “Oh, so you’re like a midwife!” or “So what’s the difference between you and a midwife then?” The frustrating thing is not that my new friend, who may or may not have children themselves, has never heard of my profession but that MANY health professionals, including our nurses, doctors, and even midwives are confused about what our job description is.

What is a doula anyway? Do you need one really? Like really… Are we that helpful or more glorified hand-holders?

My scope of practice states that I am to provide emotional, physical, and informational support through a woman’s pregnancy, in birth, and postpartum. I give families the tools necessary to effectively communicate with their healthcare provider so they can make informed decisions and advocate for themselves. It’s always the sort of generic, cliche answer to what a doula is. It sounds fine and all, but still vague. You’re still not sure you need this and it may not clarify to you what doulas do.

Prenatal Preparation

An aspect of doula work that isn’t emphasized enough when selling ourselves to a potential client/nurse/OB/midwife is the preparation we do before the birth has even occurred. Doulas meet with their clients at least once before birth to help prioritize what is important to the family, reduce life stresses, practice techniques they may have tried in a childbirth education class, organize, and develop a solid game plan before birth and postpartum. If I have an awesome doctor or a solid midwife, wouldn’t they basically do all that stuff? The midwifery model of care empathizes spending more time with families before birth! Yes, you are absolutely correct! This is especially true if you have a home birth midwife. She will most likely spend a considerable amount of time with you. A doula will round out that care by filling in the small pieces and/or help in areas where the midwife didn’t spend as much time on. I had a great midwife with my second pregnancy but there were just a handful of things that were better fit for my doula to help me with and draw on her expertise. My midwife’s main attention and focus was on my health, safety, and answering my medical questions.

Birth Time

One of the biggest contribution doulas bring to the table in labor is our ability to think outside of the box. I do not have the responsibility of making sure mother is hooked up properly to the monitors and other potential medical equipment in a hospital nor do I have the responsibility of delivering the baby. It allows us to focus on other aspects of the birth that often time get put on the back-burner. Are we glorified hand-holders? You bet we are! And let me just let you know we are the best damn hand-holders you will ever have! We assist families physically and emotionally, giving families the space they need to make difficult decisions if things detour in the birth.

What about if I’m birthing outside of a hospital setting? It is true that you are more likely to have a very different experience outside of the hospitalWhy would you need a doula in these situations? There are a few things to consider. Your doula will have a different role in these kind of births, but make no mistake there is a place and a role for them to play nonetheless! Your midwife’s main focus is on your medical care and safety in your home birth setting. Home birthers are screened heavily and evaluated throughout the pregnancy and from time to time transfers do occur. Midwives are making sure your best interest is in mind at all times in the process. She will most likely have an assistant that comes with her to the birth or shortly before the baby is born. It can be argued the assistant can provide all the emotional and physical support a doula would do. Chances are you are meeting her for the first time in your birth or haven’t developed any sort of relationship. Sometimes that is completely fine but some women like to have someone they have already worked with, trust, and are already comfortable with. The assistant is also less likely to take photos of the birth, prepare a meal, or have an in-depth knowledge of your fears and concerns. You should also be aware that when it is time to deliver the baby the assistant’s focus shift on helping the midwife in any medical assistance needed.

Even if you are the woman who has all the education, knows how to cope with birth like a champ, and has the best midwife/doctor that supports everything you stand for hiring a doula can still be for you. Think of this: doulas hire doulas! I admit to you all that even I questioned if having a doula would be necessary since I was a  doula myself! My birth doula ultimately played a role in my birth that I never would have expected and will forever be grateful for! She was an absolute life-saver for us.

Breastfeeding and Bonding

Another aspect of doula work that is often overlooked is our up-to-date lactation education. No, not many of us are IBCLC’s but we often know our stuff when it comes to assisting you breastfeed for the first time. A good doula will stay within her scope and never hesitate to get you in touch with an IBCLC. Babies are not always great at being born during business hours. It could take a little while for a lactation consultant to come visit you. It is great if you take a lactation class before birth but when that tiny, warm, breathing baby is on you most women are like, “Okay let’s see here… yeah, this is very new!” We can give you a really good start at this and reassure you that you can rock this! We are also able to bring the level of excitement back down in the room after birth so mother and baby are able to bond, hopefully without too much disturbance.

Postpartum Check

We also follow up after the birth. Some doulas love this aspect of work and focus a lot of attention here. There is even a whole other specialized field of focus on this: postpartum doulas! A birth doula will make sure life is functional and refer a mom to a professional or a postpartum doula to juggle life’s stresses if she is needing a little extra care. It is especially important of a task since many women only see their provider once, at the 6 week check-up. Come on America, we need to support our mothers much more than that!

 CODEWORD: Comfort

Is a doula for everyone? No, perhaps it’s not for everyone and that’s okay. Could they benefit a lot, if not most women? I do truly believe we do! We are worth the investment and just from personal observation from the years spent as a doula we seem to have an incredibly high satisfaction rate. We are supporters for improving birth and women care in our communities. We help build confidence in families as they transition into parenthood. My job is quite different than that of our midwives, doctors and nurses. I am a professional birth doula and we are quite frankly here to stay.


Hello, my name is Jessica Thomas. I am a professional birth photographer and certified labor doula through CAPPA. My family moved to the Pittsburgh area in 2015. Prior to moving to Pennsylvania I was a birth doula in Denver, Colorado where I belonged to a very strong and thriving birthing community.