The following article is an exclusive interview with one Doula and two mid-wives, and it will enlighten women about being pregnant, as well as bring to light some facts that one may need to know before picking a doctor. Back in the day, choices for giving birth were limited to giving birth in a hospital, or at home with a mid-wife present. Mid-wives were ever-present in times when one did not go to a hospital at all to give birth. Today, women have many options and choices and these ladies will help women to make that most important decision by being informed of all options.
Meet the Ladies, Andrea Stainbrook is a Doula , Goldie Parker and Amy Lechtenburg are both direct entry midwives.
What is the difference between a Doula and a mid-wife? Stainbrook states that a “doula is there to support the birthing mother. They provide support through pregnancy, birth, and after birth, and may specialize in one of those areas. Commonly in labor a doula may massage, give counter pressure on the lower back, give water to the laboring mom, give words of encouragement, and remind the mother of her birth plan. A doula can also use aromatherapy, and just be present for whatever that mother needs. A doula cannot perform anything medical.”
Lechtenburg provides that a midwife is the care provider for the mother. She monitors her health with regular prenatal appointments, and she is there for the birth, and postpartum visits. She will check and clean the infant directly after birth.
Are any of you certified? Direct entry midwives work with births out of the hospital setting. It could be a free standing birth center or most commonly at home. Parker has been attending births at home for almost 30 years. Direct entry midwives gain their knowledge from experience as well as reading, classes or workshops, and there are some home birth midwives that are certified professional midwives.
Stainbrook states that she calls herself a “direct entry doula.” She goes on to say, “I have a strong passion for all things pregnancy and birth. With that and with helping out Parker, I have gained hands-on experience to lead me down the doula path. There are certification programs for both midwives and doulas. Everyone’s path is different and every state has different regulations. Michigan is currently a progressive state allowing women the freedom to choose from every type of midwife. Some states have outlawed home births, or banned direct entry midwives. By enforcing things of that nature those states are successfully eliminating the woman’s right to choose her birth professional and have the birth that best matches her needs.”
Most people know that a Doula helps in the actual birthing process, however, what other services do you provide, before and after the birth? Are any of you antepartum or postpartum providers? Doulas can specialize in a certain part of the childbearing year or do them all. You will commonly see a lot of doulas who are just birth doulas or just postpartum doulas, Stainbrook offers both, and goes on to say “birth doulas typically meet with you while you’re pregnant a few times to get to know you, understand what type of support you need for your upcoming birth, and be there for you for any of your questions. They are always just a phone call away. They will also meet with you once or twice postpartum where you can discuss your birth and newborn care.”
Postpartum doulas are there for that transition into a new family. A postpartum doula duties are really tailored to what the new family needs and desires. Care can begin as soon as the day the baby is born. Stainbrook tells us that she has been called, “Hey I had my baby this morning, are you available to help us out tonight?” or down the road after visitors have calmed down, or anywhere in between. She does light housework, help with newborn care, help with baby wearing, walk the dog, run errands and take care of older siblings. Every day can be different too. One day a mom may need someone to hold their newborn so they can shower and nap! Other days they may need more help doing the dishes and tidying. A doula is really there to help make things easier on the new family whatever that may be.
Midwives start their prenatal care just as one would start care with a doctor. Typically care begins at 11 to 14 weeks. The mom-to-be continues to have prenatal’s throughout the pregnancy. A midwife is there for the birth and postpartum care usually follows a 24hr visit, a three day visit, a one week visit, a three week visit then a six week visit. Women really don’t see that type of post natal care in the medical model.
Do you only do home births? Stainbrook states “I as a doula support women wherever they are comfortable birthing. A lot of my own experience has come from home births but I have been in the hospital setting and am willing to attend more births there. Wherever that mom is I will be there.”
Parker and Lechtenburg are home birth midwives who are only available to home birthing mothers.
Birthing in water is really catching on, what are the benefits? Doula’s and midwives agree that water is a natural pain coping technique. So laboring in the pool is a great way to help ease the intensity. The Mom can also move around freely to get into whatever position suits her best and it has been known to reduce the chances of tearing. Birthing into the water is such a calm and gentle way to ease babies into the world!
What is your best birthing story? Stainbrook states that this is a tough question but goes on to answer. “One of the most inspiring was to watch a friend birth vaginally after a cesarean. She was so determined and focused, it was amazing! She had a longer labor and she really powered on like a birth warrior. I recently was at a home birth of an 11 pound babe! He came pretty fast too. We all thought he looked big. Mom said he felt like an eleven pounder. We chuckled. They weighed him and sure enough… 11lbs on the nose!”
Do women change their minds about the type of birth they want mid-pregnancy? As a doula “I just make sure they have all the resources and knowledge they need to make the most informed decision. As long as they are choosing to best suit their needs I would be supportive! You should never feel stuck with your care provider. It is NEVER to late to switch care. I have a friend who switched to a home birth 2 days before she gave birth! I know Parker and Lechtenburg get calls from women from all stages of pregnancy.”
What is the benefit of a Doula over a Doctor? A doula is solely there to support the woman. A positive presence is so important in such a new and emotional time. A doula is always on the Mom’s side and will support her without hesitation. A doula will never speak for the woman regarding her care.
How about the benefit of a mid-wife over a doctor? Lechtenburg tells us that ” Midwives view pregnancy and birth as a normal family event, not a medical condition. Midwives are experts in normal birth. They are trained to see when birth is moving away from normal so they can use tricks to bring it back again or transfer care if necessary. Prenatal appointments with a midwife are often done in the family’s home and last about an hour.”
What happens if there is a problem during delivery? Stainbrook answers for the group “As a doula I continue supporting the mother. I let the care providers do whatever it is that needs to be done. Among low risk pregnancy, home birthing has a low rate of issues and transfer of care to a doctor.”
What is the most important thing a pregnant woman should know about Doula’s? Doulas are there to help women through their journey into motherhood. Not only will she walk away with the most precious gift but also an empowering birth experience and transition into parenthood.
What is the most important thing a woman should know about Mid-Wives? Lechtenburg answers “Standard of care with a mid-wife is as good or better than in the care of a doctor and shockingly, cesarean births when in the care of a mid-wife is %5.2 compared to the national average of %31 when in the care of a doctor. Having a mid-wife is a truly personal decision, and it is care that is customized with each expectant mother.”
Do Mid-Wives and Doula’s typically work together? Is there a benefit to having both? They do work together often when mamas hire both. I think there is a benefit to both. Although midwives are there to support the soon to be parent throughout her labor, it is nice to have one dedicated person like a doula whose focus is soley on the Mom and all the little things she may need to get through labor.
In short, doula’s and mid-wives are a good choice if a person is considering home birthing. It is safe and supportive and will make the birthing experience one she will never forget. When pregnant, remember their are choices, and a woman can chose what is most comfortable for her. Every state is different and in Michigan certified nurse midwives (CNM) attend births in hospitals and direct entry midwives (DEM) attend births at home.
By Kristi Cereska
Interview with Andrea Stainbrook with input from Goldie Parker and Amy Lechtenburg
Photography by Willow Tree Birth Photography