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Birth team roles

February 3, 2017

"If I have a midwife, do I really need a doula?"

 

"My nurse is going to be there the whole time, right?"

 

"Will a doula take over my partner's job?"

 

These questions, along with others, are ones that commonly come up during our consultations with prospective clients and lead us to  a discussion on the various members of the birth team that are available to you. 

1. Your doctor or midwife

 

Your doctor/midwife is responsible for your medical well-being and the well-being of your baby. You meet with your medical provider at regular intervals during your pregnancy and they monitor you and your babies health. It's their job to help you manage your health and to provide medical oversight for you and your baby's care throughout pregnancy, labor & delivery, and  early postpartum. When you think you are in labor, most providers want you to check in with them. During your labor, they may make medical suggestions based on the path your labor is taking. If there are any medical concerns they may order tests (such as ultrasound or blood work) or they may prescribe medicine (such as antibiotics or anti-nausea). In hospital settings, doctors/midwives may pop in and out of your room periodically to check your labor progress or make suggestions, but they don't stay in the room with you until you are close to delivering your baby. Then their focus turns to receiving your baby and making sure you and Baby are staying healthy. Your provider will watch for and manage any delivery related medical issues (such as those having to do with cord blood, placenta and blood loss.) Once your baby is born, her medical care will transition to a Pediatrician. During a home birth, your midwife will assume medical responsibilities that are kind of a combination of your your doctor and nurse's. She will provide medical oversight, monitor you and Baby, chart, remain with you during active labor, receive the baby, and stay with you during the immediate postpartum to make sure you're both doing well.

 

2. Your nurse

 

In a hospital setting, your nurse will usually be in your room much more frequently than your doctor/midwife. Your nurse is responsible for handling the logistics of your medical care, including getting you admitted the hospital, taking frequent blood pressures and temperatures, monitoring baby, getting you water/blankets/pillows, and doing a LOT of charting! Nurses are excellent care providers who have your best interest in mind, but the reality of their job doesn't typically allow for a lot of hands-on labor support. Depending on their patient load, they may or may not spend much time in your room during labor. Once you are ready to push, your nurse will usually be the one to work with you and monitor your progress and will call the OB when she thinks you are very close to delivering. Once Baby is born, a baby nurse will take primary responsibility for checking heart tones, performing apgar tests, etc. and your nurse will continue to monitor your recovery.

 

3. Your partner

 

Your partner is probably looking forward to being your primary support person and as doulas, we LOVE that! Sometimes a partner can't be present or has other limitations that they know will make labor support difficult for them and your doula will take a very primary role. More often, a doula will come on your team and work beside your involved partner to offer you continuous labor support. Whenever possible, we really do encourage partners to take a very active role in your labor support. Partners do a great job at bringing the oxytocin, helping you feel safe and loved, and in so doing, encouraging normal labor progress. However, we also recognize that there can be a lot of pressure put on partners to somehow be able to anticipate everything you are going to need or want during your labor and to be help you make game-time decisions in an arena where they have little experience. Understandably, this can feel very overwhelming! We encourage partners to think of their job as to simply to be WITH you. Being present and speaking words of love will make you feel safe and cared for and will go a long way in creating a positive labor experience. When you have a doula, your partner is free to be in the experience with you and let go of the pressure to do everything, be everything and somehow remember everything on one of the most important days of their life. Someone else is looking out for that.

 

4. Your doula

 

Depending on when you hire us and what our services include, doulas offer varying degrees of support and education during your pregnancy. We recommend hiring a doula early on to get the most value from her services. Most professional doulas are involved in the larger birth community and able to offer education and resource support during your pregnancy. For example, at SBBS, we like to offer our clients the benefit of our experience in terms of best preparations for labor and delivery and we have a special interest in optimal fetal positioning.  Of course, as birth doulas, our main focus is to provide you with continuous labor support on the big day - 24/7 phone support from your first "is this labor?" contractions, hands-on support during active labor and delivery, and helping with first latch after your baby arrives. During labor, having your doula's breadth of experience and her knowledge based reassurance, can give you a great deal of peace of mind and help you relax into this new experience with confidence. We help you and your partner think through birth preferences/options so that you can feel like you are in charge of your birth and the decisions being made. We pay attention to  important details that support labor progress and comfort (like when and where to change positions, go the restroom, drink water, or use hydrotherapy). We provide you with very hands on, skilled labor support, like massage, counter pressure, and hip squeezes, to help ease your physical sensations. We help you create an environment in your room that fosters relaxation and peace, by promoting "your space," using aromatherapy and setting up electric candles. We offer you strong emotional support and honest encouragement and feedback to help you accomplish your goals. Our role is entirely dedicated to supporting you and looking out for  your concerns. We provide you with physical, emotional, and educational support throughout the whole process of your pregnancy and birth.

 

So, yes. We think doulas offer something extra. Something that your doctor/midwife or nurse simply isn't able to provide within the construct of their role. Something that allows your partner to be present and enjoy the birth of their baby. Something that allows you to experience the biggest day of your life feeling supported, empowered, and heard. And hopefully, feeling like a super hero - because you are!

 

 

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