I have had so many questions lately about what is the
difference between various childbirth professions. The terms “midwife” and “doula” are often
misunderstood, with some people thinking doulas deliver babies. I’d like to
take a look at the various professions here and offer some clarification on their scope of practice and certification or licensing requirements.
Typically, the first and easiest step into the birth field
is becoming a doula. A doula is a “labor coach”. Her scope of care is providing
emotional and physical support for the laboring mother and family. She does NOT
do medical procedures such as vaginal exams or heart tones, nor does she make any medical
decisions. All certifying organizations
for doula training have similar requirements. Most have the potential doula read
childbirth related and doula books and some require book reports or reading
list verification. They will observe a series of childbirth classes (or take a
one day “Basic Birth” class) to learn the basics about labor. Then, they must attend a 2-3 day seminar where
they learn about the benefits of doula care, labor comfort techniques, some
breastfeeding and newborn information, and the business side of being a doula.
They also learn about how to conduct a first visit, build relationship with the mother or couple, assess their needs for community resources/birth education and write a birth plan. They learn what to do when visiting the mom postpartum, such as reviewing the birth with the mom and bring closure to the
relationship. Next, they must coach and
document 3 births, with evaluations from the presiding birth attendant and/or
parents. Last, they may be required to write an essay on the benefits of being
a doula.
A childbirth educator (“CBE”) TEACHES pregnant moms/couples
about pregnancy, birth and postpartum, newborn care and breastfeeding. The training is much more comprehensive than a
doula. The childbirth educator must learn WHAT to teach and HOW teach
effectively. Most certifying agencies (Bradley, ICEA, Lamaze, CAPPA, etc.) have
similar requirements- reading , attend workshops or seminars to get "contact hours" (approximately 24 hours classroom time for just the basics), observe a series of childbirth classes, student teach,
take an exam. The certification process usually takes 6 mo-2 yr, depending on
the student’s schedule/responsibilities.
Midwifery is very different! It requires medical training,
plus knowledge of ALL OF THE ABOVE! Most quality programs involve 1-2 years of training plus an internship. A midwife conducts prenatal exams, gives medical advice, delivers
babies, does well woman and postpartum exams, some newborn procedures, all
within "normal pregnancy and birth".
She also learns when to "risk out" and refer high risk
patients, emergency techniques for high risk hemorrhage, inserting IVs,
intubation, CPR, suturing and many more medical procedures. She must take the
National Exam to be legally certified in whatever country she chooses to
practice, just as nurses and doctors are required to do. Midwives protect “normal
birth”. Countries with the best outcomes
for mothers and infants are those with predominately midwifery care!
I hope this helped clarify and answered some of your
questions. Please email if you need more info. =)
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