Midwife? Doula? What’s the Difference & Why You’ll Love Them

Baby #2 is weeks away from making it’s debut and as the big day approaches I’ve been reflecting on my two pregnancies and the importance of having a support system before, during, and after giving birth. I have to give Will his credit, he was amazing during labour with Ari and was with me for the entire 23 hours (keeping my fingers crossed #2 doesn’t take nearly as long!!!). But for some ladies having support beyond family and/ or a close friend is important.
I’ve had a midwife for both pregnancies and have been very happy with their methods and attention to both myself and the bumps. One of my closest friends enlisted the help of a midwife and doula for her pregnancy and delivery since she suspected her hubby would be a little squeamish in the delivery room and credits her doula for being everything she hoped for (for the record, I know her hubby was grateful for the doula as well 馃槈 ). While I was familiar with both while chatting with my friend, I thought this would be a good opportunity to share some more information on the topic with TPB readers. Even if you’re like me and this isn’t your first rodeo, knowing what your options are- especially with 1 or more kids already at home awaiting your return from the hospital- can help your experience go smoother and reduce stress when the time comes. 
To help me with this post, I asked Sarah Thibault of TBO’s Doula Services to collaborate. See below for her in- depth look at the role of doulas and the difference between them and midwives.

What is the difference between a midwife and a doula?

This is a question I get asked often. It is sometimes perceived that you will either
choose a midwife or a doula, or that there is no value in hiring a doula if you
already have a midwife. The fact is that midwives and doulas have completely
separate roles
when it comes to caring for you and supporting you in your birth.
More on midwives
You can choose between having a midwife or a doctor/OB under MSP.
Midwives in Canada are licensed medical professionals. They have the ability to
attend both hospital births and home births. If you choose to have a midwife
you will be under their care only.  This
means that your midwife will be responsible for the health of you and your
child prenatally and during your labour and delivery.  Often, expecting parents choose to have a
midwife if they crave a more intimate care, as she will work with them closely
to make sure their vision of their birth turns into a reality.
Here鈥檚 a glimpse of the role
of a Midwife:
-Performs gynecological exams (prenatally, during
labour, and postpartum)
-Suggests and prescribes health related medications or
-Runs prenatal tests
-Teaches you about health during pregnancy, birth, and
-Monitors you and your baby during labour and birth
-Consults with an OB if a medical complication arises that
is outside their scope of practice
-Helps make your birth a peaceful and calm experience
-Delivers your child
-Provides family planning, infant care, and women鈥檚
health care

There are two types of doulas; a birth doula and a postpartum

A doula is a non-medical professional who provides
emotional support and physical assistance.
A birth doula
will usually meet with you during your pregnancy, around your 30 week mark.
Her main role is to be there for you,
your partner and your baby. She will help you envision what
your birth will look like and help you understand the birthing
process. She can also teach you techniques for relaxation and how to get in the
right headspace for a healthy pregnancy.  During labor, your doula can use a variety of techniques to help with pain management.Examples include acupressure, hypnobirthing, rebozo, massage, and
different labor positions.
During your postpartum stage, your postpartum doula can help you to take care of your baby by helping
out in areas such as breastfeeding, mother-baby bonding, basic newborn care,
emotional support, and sleeping. She can also help you in your physical recovery
after childbirth. Your postpartum doula is there to help you and your family in
the first few weeks after bringing home your baby.
Here鈥檚 a glimpse of the role of a Doula:
Establishes a prenatal relationship with you
-Helps you create a birth plan
-Guides you to useful resources in your community for your prenatal and
postpartum stage
-Helps you to learn and acquire a deep understanding of the birthing
process so you can be more prepared and confident
-Uses tools and techniques which help aid in pain management and relaxation
-Encourages and teaches the partners ways to be involved in the birthing
process (as much or as little as desired)
-Acts as an advocate for the mother
-Helps to guide you in birthing positions and your labouring
-Ensures that you feel safe and confident when communicating what you
-Acts as a liaison with medical staff
-Provides postpartum at home care for you and your baby   
Is a doula covered by MSP and/ or extended
are not covered under MSP. However, most doulas believe that every expecting
mother should have the right to have one. The difference a doula makes to
the entire birthing process is so substantial that having doulas
covered under MSP is in the works. It won鈥檛 be happening anytime soon, but
hopefully will be approved within the next decade.
are also not usually covered under extended medical. Sun Life insurance, however, has
recently approved the use of doulas as a reimbursable service to clients. You
must be covered through a Health Spending Account with Sun Life and your doula
must be DONA certified. Although the number of insurance companies that cover
doulas under extended medical is slim to none, it鈥檚 a good start. We are very
hopeful and are excited to see what positive changes are made in the near
What is the cost of hiring a doula?
cost of hiring a doula varies, and the cost can even vary a great amount just from city to city. Although many doulas believe in providing a birth free of charge
every once in a while (once or twice per year), it is not the norm. You can
find doulas that are willing to work for as low as $200, and these doulas are often associated with a company that provides doula services for lower income
families. On the other side of the scale, you can find doulas that will charge
around $3,000 for their services. Depending on what you鈥檙e looking for and who
you are wanting to hire, the price can fluctuate.
2015 in the Lower Mainland, the average cost of hiring a doula ranges within $650-$1,000.
Considering all of the services a doula provides for her clients and that this is usually her livelihood, this is a realistic and fair rate to pay.
Why do people hire a doula?
a doula by your side every step of the way during your birthing process brings
feelings of security, calmness, confidence, excitement, and peace of mind. The
stories I have personally heard from women who have had a doula attend their
births have been very positive. I haven鈥檛 met a person yet who has had a
negative experience with a doula!

There鈥檚 no arguing the difference they make to
your entire experience, starting prenatally and ending postpartum. Here鈥檚 why people will hire a doula. 
doula鈥檚 attendance at a hospital birth reduces
Cesareans by 50
Labor time by 25
Epidural requests
by 60 percent
Use of synthetic
oxytocin (Pitocin) by 40 percent
Use of analgesia
by 30 percent
Use of forceps by
40 percent
of a doula鈥檚 support to the mother:
Increases positive
feelings about labor
Decreases interventions
Decreases need for
acceptance of the baby
maternal/infant bonding
Decreases neonatal
Decreases anxiety
and tension
Shortens labor
Increases feelings
of self-esteem
Increases feelings
of control
Increases mother鈥檚
cooperation and participation
postpartum depression

What’s your favourite part about being a doula?
Watching my clients and their partners
realize the potential they have in their birthing process: Helping them learn
what birth can actually be like and watching them discover the power and
freedom they now have with this information is the most incredible feeling. I
get to empower them!
I get to encourage them and positively influence one of the
biggest days of their lives!
be able to be part of the miracle that birth is and to witness the difference I
made is exhilarating. Knowing that I aided in turning a baby to the right
position so the mama didn鈥檛 have to have a c-section, knowing that I helped in
the process of encouraging baby to drop down further in order for the mamas
cervix to dilate more, using counter pressure, massage, and rebozo techniques to
help in managing pain and keep mama focused are all incredibly rewarding things
to see. The greatest feelings for me is when each of my
clients tell me, 鈥淚 couldn鈥檛 have done it without you, Sarah鈥.
How did you decide to become a doula?
few years ago I found myself glued to Google. I was researching anything and everything
regarding pregnancy, labour, birth, and postpartum care. I was researching for
my own personal desires and finding it exciting, dreaming about how one day I
might become a momma too. I was infatuated with everything birth related! I did so much
research that I found my friends starting to ask me questions, or coming to me
to find out the latest information on this and that. After a full year of
realizing that this was not just something I 鈥渓iked鈥 but that I was deeply
passionate about, I decided to go for it and book my DONA* doula training
Within the week of deciding this, one of my best friends asked me to
be her doula, and attend the birth of their first baby. I couldn鈥檛 believe this
and asked her if I had ever shared with her my desire of becoming
professionally trained. She was pleasantly surprised and explained that I had
never told her my dream of becoming a DONA Doula, but that she was confident of
my ability to be everything her and her husband needed for the birth of their
baby. Both her and I were excited in the uncovering of this gift I
have. It was at that moment that I was confident in my decision to pursue being
a doula, and it was at this birth that confirmed I was born to do this!
*Learn what this means here
Do you find anything in common with the births you attend?
have never really witnessed a totally, stereotypical, Hollywood kind of birth.
You know the kind where there鈥檚 uncontrollable screaming, yelling, freaking
out鈥h and blood and guts! I鈥檓 not saying I have never witnessed any of these
things before, but I definitely don鈥檛 experience birth as the terrifying and out of
control experience that our society seems to believe it to be. Birth can be an incredibly
beautiful process.

know those moments when you just want to burst out laughing, but really you
have to keep it together? That鈥檚 me in about 95% of the births I attend.
There鈥檚 a moment, usually occurring at the beginning of active labour, when my
client grabs at my shirt or shoulder and just stares at me, looking directly in
my eyes and says 鈥淚鈥檓 sorry if I yell at you, or get mad at you, or even hit
you. I鈥檓 just sorry!鈥 I giggle. The look of uncertainty on their face and not
knowing how they are going to handle themselves obviously brings them to apologize
in advance for anything they might do or say to me at some point during their
labour and delivery. That is when I just smile at them and give a little laugh,
assuring them that I will never be offended or upset with them. I confidently
encourage them that they have full control during their labour and that I will
be there with them every step of the way. 

When I share with my client- that
almost every single one of the women I work with says this to me around the same
time, apologizing in advance- they can hardly believe it! Reassuring
them that they aren鈥檛 the only one who has ever gone through what they are
experiencing is big鈥 it can change their whole outlook and mind frame of
whether or not they鈥檙e going to make it through this massive goal they鈥檙e
trying to achieve. In these funny moments I know it can be good to just laugh
out loud, easing the tension they are feeling. In these moments it is when I
realize that all labouring mothers can relate to each other in some way or

I hope this post has helped you understand more about the options you have when it comes to giving birth and how hands- on & dedicated these ladies are to what they do. I encourage you to explore these options for yourself. Whether you opt for a midwife, a doula, or both as part of your support during pregnancy, labour, and postpartum care, know that you and your baby will be in good hands.

A HUGE thank you to Sarah for contributing such an in- depth post!

If you would like to learn more about hiring a doula or would like to get in touch with Sarah, you can visit her website & email her at sarahtbo@hotmail.com. You can also find her on Facebook, Twitter, & Instagram.

Image Sources:
Friends screenshots: Buzzfeed
Women’s humor image: Women Employed
Sarah headshots by Bethany J. Menzel 

March posts sponsored by Little Dreamers Consulting


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