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The Roles of Doula and Midwife during Home Birth

By HERWriter
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home birth roles of doulas and midwives Monkey Business Images/PhotoSpin

If you are planning on having a home birth, you may be considering hiring a doula, a midwife or both. But what exactly are doulas and midwives? Also, what are their roles during your pregnancy and birth of your child?

There are four types of midwives.

The first is a certified nurse midwife (CNM) who has at least a bachelor's degree and has completed both nursing as well as midwifery training. According to the Nemours Foundation, a CNM has taken the necessary exams to become a certified midwife, or CM, but does not have qualifications as a registered nurse.

A CNM may work in conjunction with a doctor as most births assisted by CNMs occur in hospitals. CNMs may use electronic fetal monitoring, labor-inducing drugs, pain medications, epidurals and episiotomies.

The lay or direct-entry midwife may or may not have a college degree or a certification, but may have trained through apprenticeship, workshops, formal instruction or a combination of these.

A certified professional midwife (CPM) has passed written exams and hands-on skill evaluations to become certified by the North American Registry of Midwives.

It is very important to note that a certified midwife, certified professional midwife, or direct-entry midwife may not legally be allowed to use any medical techniques without a doctor's supervision, while a certified nurse midwife can work independently.

In case of an emergency none of the above midwives can perform an emergency caesarean section.

There are two types of doulas. The first is the birth doula and the second is the postpartum doula.

A doula must go through certification, training and participate in live births. However, requirements vary from state to state. During the birthing process and approximately three months prior, a doula becomes a pregnant woman’s coach and best friend.

A doula is there to provide supportive care for a pregnant woman during labor. She can provide massage, as well as offer advice on different labor positions. After the birth of your child, a doula can also offer counsel on healing after childbirth, breastfeeding and general care for your newborn.

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EmpowHER Guest

Another inaccuracy:
"A doula must go through certification, training and participate in live births. However, requirements vary from state to state."

Doulas are not regulated by any state or federal agencies, as they are not clinical/medical care providers. Training and certification is available through many local and national organizations but is not a requirement.

Also, doulas frequently work with families from as early as the first trimester.

March 14, 2015 - 9:04pm
EmpowHER Guest

There are some fairly basic inaccuracies in the article, which I believe had great intentions.

Who works independently? It depends on the state law, in each jurisdiction there can be different laws governing midwifery, home birth and routes of study.

Physician supervision of Certified Midwives, Certified Nurse Midwives, Licensed Midwives, Certified Professional Midwives, and Registered Midwives depends on the state in which the midwife is practicing.

In California, Licensed Midwives, (who have passed the CPM exams, and clinical requirements) can practice independently and CNMs must work under the supervision of a physician.

All the CNMs I know are also registered nurses, having passed those exams as they became CNMs.

Treesa. an LM in CA

June 15, 2014 - 5:55pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.