this one’s for eric.
so. how a baby is born. i’ll assume most of you know the general mechanics of how sperm meets egg, egg gets fertilized, starts growing into baby. in a normal pregnancy, things are just that — normal. the body knows exactly what to do, and if the mother is in touch with her body, she largely knows, too. unfortunately, the western medical way of looking at things can tend to look at pregnancy from a disease model — something to be treated.
an obstetrician/gynecologist is an M.D. who went on to specialize in OB/gyne. in my opinion, from a midwifery perspective, they are best left to handle high-risk cases and people who develop certain conditions or situations during pregnancy. they have the expertise and are often better suited for such work. they also generally have less time to work with patients on a personal level.
midwives come in three basic kinds. a certified nurse midwife (CNMs — the only kind that are legal in IL) is a registered nurse who has gone on to a graduate degree. she is an advance practice nurse and can write prescriptions and operate independently of a doctor. in IL, they are required to have an agreement with a collaborating doctor. however, they are on their own in their own practice if they so choose. they can also work for doctors and hospitals.
there are also certified professional midwives (CPMs) who are not considered legal in IL, but have gone through hours of schooling and apprenticeship. they are not required to be registered nurses. they are legal in most of the 50 states.
lastly, there are lay midwives who facilitate births as they see fit, generally taking a much smaller caseload and assuming a much higher risk as the midwife is putting themselves in direct violation with state law (at least in IL), so it’s a tetchy situation should the woman need to go to the hospital — they’ve been doing something illegal, so not everyone wants to waltz in with a woman they’ve been helping deliver. they also aren’t going to have the means to obtain certain medications that CNMs have with them in order to ameliorate some situations at home — someone who was tested postive for the group b strep bacteria pre-labor, pitocin to help someone who has delivered a baby, but needs a little help having the uterus contract post-baby to stop some bleeding, etc. they might be able to get these things illegally, but again, that’s a risk.
i don’t mean to make it sound like these women aren’t knowledgeable. remember, there are plenty of women who have been having babies like this for years with no complications and with the support of their sisters and mothers before them. this IS a natural process. but, things can go awry, and i like the idea of someone inbetween a doctor and a lay midwife who has had some medical background there to be able to know when more drastic measures are needed.
so. to your question. a doula is someone who is there to support the mother through labor. to help guide her through the process, help with pain, breathing, help encourage. it’s sort of like your own personal coach … someone who has been through this before with other women, who understands the process and who knows what they’re doing. sometimes husbands and friends and family just freeze up or aren’t very helpful. a doula is there just for you. there are people who are post-partum doulas and they are there to help the mother acclimate after having the baby, help them make sure the baby is breastfeeding correctly and sort of make sure everything is going okay — that the woman is being taken care of.
disclaimer: that’s just all my take on all of this from what i’ve seen working at the office. i don’t have children, nor do i want them. but that’s the rundown as far as i see it. hope that helped.