While the traditional image of childbirth has a doctor in the delivery room, nearly one in every ten babies in the U.S. today are delivered by a Certified Nurse Midwife. And many births are assisted by the presence of a birth coach, or doula. Midwives and doulas are often sought after by expectant mothers looking for a more individualized birth experience, but very few understand the difference between the two roles.
A Certified Nurse Midwife is a trained medical professional: a registered nurse who has undergone extensive training and education to become an advanced practice nurse. A Certified Nurse Midwife is able to provide preconception care, prenatal care, may attend your labor and delivery, and provide postpartum care. A Certified Nurse Midwife is present with the mother through much of her labor to provide direction and guidance, and attends the delivery, always attempting to safely honor the mother’s wishes and birth preferences.
A Certified Nurse Midwife can prescribe medications and may also recommend alternative therapies to promote wellness. In addition, Certified Nurse Midwife can perform routine well-woman exams and problem-focused visits, family planning counseling, and has the convenience of being able to collaborate with an OB/GYN doctor to provide optimal care when complications arise.
A doula, on the other hand, provides physical comfort and emotional support to the mother throughout labor and after delivery. A doula is not a trained medical professional and cannot deliver babies. The doula may assist the expectant mother in navigating birth choices and with developing her birth plan. She will work with the mother during labor to promote comfort by varying positions, practicing breathing techniques, or through massage, for example. Doulas often continue to assist the mother after delivery and through the healing process, often visiting the mother and newborn in their home environment in the postpartum period.
Midwife, doula, or both? Which choice is the right choice? The decision lies solely with the mother. She may choose to be delivered by an OB/GYN or family practice physician and have a doula present for support throughout labor and delivery.
However, if a woman is most interested in receiving personalized care focused on fulfilling her desires, than a Certified Nurse Midwife may be the best fit. Of course, a woman might choose to have both a doula and Certified Nurse Midwife present, working together as a team.
Whatever the choice, today’s expectant mother has more options available to her. Understanding those options can help her to have the kind of birth experience she most desires.
Elizabeth Ann Bary, RN, CNM
As the region’s most experienced Certified Nurse-Midwife, Elizabeth specializes in natural childbirth, deliveries and fertility counseling. She also provides care for well women, annual exams, preconceptual counseling, contraceptive services and prenatal care. Elizabeth received her RN and BSN degrees from Indiana University Southeast, and earned her MSN and CNM designations from the University of Kentucky. She is a Member of the American College of Nurse-Midwives, a presenter at area high schools on topics such as birth control, pregnancy, breastfeeding and STD prevention. A native of Harrison County who served as an Army Nurse at Fort Campbell, Kentucky, she has four children and four grandchildren.