• nicole02806

Why I Am a Doula & Not a Midwife

Last year, while supporting a first time mother and her partner through a particularly

intense (aren’t they all really?) and precipitous labor, I had a very illuminating experience

as her doula. Upon our arrival at the hospital, my client was clearly in active labor and after

routine monitoring, baby was doing fine. When the nurse midwife entered the room, she

could see that all was well albeit in a heightened phase of intensity, She very sensitively let

the mother and her partner and myself continue the groove that we had established, with

the partner supporting her from behind and she and I communicating more through eye

contact and occasional but clearly needed words of encouragement: “you’ve got this”, “you

are doing a phenomenal job”, ‘stay with your breathe and look at me”, ‘only one

contraction at a time’...

At one point the midwife brought in two medical students and asked me to share with them what I was doing and why.

I was honestly taken aback and surprised by her unspoken acknowledgment of my role by

not ‘taking over’ and instead ‘reading’ the dynamic of the room and choosing her role and

presence with consideration. While nurse midwives are far more likely to do this than OB’s,

there is still a ‘power’ dynamic in the room. As a result I felt very clear and confident in my

role as ‘the doula.’ The midwife and I worked seamlessly together with her focus on fetal

heart tones, cervical dilation and a smooth delivery and my focus on staying connected to

and supporting the women doing all this incredible work! That she also included me in her

student’s learning process, was both unexpected and incredibly validating. Less than 3

hours after our arrival, my client delivered her baby boy, with the wild shock and disbelief

that she actually made it through the unmedicated birth she had hoped for. She did have a

very normal vaginal tear and while the midwife was suturing her she tuned to me as said,

“so, are you planning to be a CNM or an LM?” I was, for a moment, insulted by her

incredible assumption. After a few moments of pause, I responded, “do you see what you

are doing right now? That is not for me.”

That I have no desire to include sewing up vaginas on my professional list of skills is but

one of many reasons why I am very happy with my role as a doula and am not simply

‘getting birth experience’ before I move on to my inevitable goal of becoming a midwife.

Don’t get me wrong, midwifery is an essential and amazing skill and the world needs more

midwives and less OB’s!! However, I am not one.

I am a doula and I love the role and relationship that affords with my clients. There have

been numerous occasions where I have been part of the birth team in a hospital setting:

the labor and delivery nurses and OB’s who come and go with their shift changes, the

medical students, residents and attending’s who presence are ephemeral and brief, only

memorable should complications arise. I couldn’t help but concluding, in spite of my

regular questioning of my own role and professional potential, that I truly had the best job

in the room.

I am all too aware of the ‘status’ we grant to various medical professionals usually

depending on the difficulty and intensity (not to mention cost) of the training involved. The

single factor that differentiated my role from theirs, aside from the obvious non clinical role

of a doula, was my relationship and connection to the most relevant and significant person

in the room: the mother. I am often, along with the mother’s partner, the only person in the

room that is chosen to be there specifically by the mother. I work for her and not the

hospital. While that does set the stage for some difficult situations and can require a great

deal of sensitive diplomacy when questioning possibly unwanted interventions, it also

allows me incredible clarity and freedom as to my role and my priorities. In other words, I

have the privilege of having a single client to focus on, offering continuous care and

unconditional support, in no way beholden to hospital policy or fear or litigation.

I am also a qualified acupuncturist who studied and practiced in the UK for 8 years prior to

returning to the US and choosing doula work over the administrative, costly and frankly

daunting task of translating my UK license to both California and now Seattle where I

currently live. I loved my work and relationship with clients as an acupuncturist and I did

relish the more clinical nature of my role as well as the ‘status’ of being a licensed

healthcare provider. After my own experience of birth, however, I knew that I wanted ‘birth’

to be my work and welcomed the focus on birth work that doula support required. It is also

very likely that my success as a doula is very much buttressed by my experience and

training as an acupuncturist. What I have learned along the way is that there is a great

deal of satisfaction, freedom and self-determination that comes from working closely with

women outside of the restraints and limitation of clinical licensure.

More importantly, so much of what birth is ultimately about and certainly what draws me

towards it is not clinical. It is deeply emotional, mental and physical not to mention the

mountain of ‘information’ and ‘decisions’ that face every expectant family. To provide a

container of support for this entire journey and help women and their partners find their

own path forward, nourishing their self-confidence and innate intelligence along the way, is

profoundly gratifying work.

A colleague of mine once said, “midwives catch babies. As doulas, we catch parents.”

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