Confessions of a Labor Nurse
Part I, Choosing Your Care Provider
Midwife. Obstetrician and Gynecologist. Doula. What are their roles and differences, and how do you know which is right for you? We are going to discuss their roles, differences, and ways you can choose the best plan of care for you!
As a former Labor Nurse, I have had experience with all of these care providers, and they all have their pro’s depending on your specific situation, healthcare needs, and desired birth experience!
“A trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible.” DONA International
Doulas have existed for all of human kind. A Doula is a support person for an expecting, laboring, or post-partum mother. Doula’s in our day and age are trained professionals, many of which have certifications through DONA or other trusted training organizations.
Antepartum Doulas are there to help mother’s both physically and emotionally that have challenging pregnancies, such as being put on extended bedrest, carrying multiples, or preparing for a preterm delivery.
Labor Doulas provide evidence based information, emotional, physical, and partner support. Labor Doulas have a long standing evidence based POSITIVE impact on birth outcomes both for babies and mother’s. Partner’s often sing their praises, too. Doulas in the laboring space offer a great balance. They allow the mother and partner to focus on birth and often advocate for the birthing person’s desired birth goals to the rest of the team. I am a firm believer in labor doula support!
Post Partum Doulas provide emotional, physical, and family focused support for new parents. This includes helping with infant feeding, sleeping, and the new parent transition. This may also include completing household chores so that the Mother can focus on healing from birth, and bonding with her baby.
My thoughts as a Hospital Based Labor Nurse? DOULAS ARE SO IMPORTANT! No matter which space you choose to birth in, a Doula is welcome, encouraged and valued!
A sometimes confusing term. There are a few different types of Midwives, which we will cover here! But let’s first chat about what being a midwife means.
To bring into being. To Assist a Woman During Childbirth. and SO much more!
Midwifery in Modern times is not just about birth. Many midwives also see women preconception, prenatally, and certainly post partum. The Midwifery Model of care is patient centered, evidence based, holistic, and treats birth as a normal life process.
Let’s talk about the different types of Midwives.
Certified Nurse Midwife CNM
CNM’s are trained in both Nursing and Midwifery. Many Nurse Midwives worked as NURSES at the bedside, before they became MIDWIVES. CNM’s can attend birth in ANY setting (Hospital, Birth Center, Home Birth). Some may also assist in the operating room in the event a cesarean birth is deemed necessary. They attend nationally recognized program’s and complete Graduate level programs- meaning they obtain their Master’s or Doctoral Degree. Many CNM’s also see their patient’s in clinics, dr’s offices, birth centers, or during home visits if they choose to work outside of the Hospital setting. They may also care for a woman across her lifespan, not just during childbearing years.
Certified Midwife CM
A CM has a health related background (often times other than Nursing), and then obtains a Master’s Degree in Midwifery! CM’s may attend birth center and home birth’s. Depending on the state you live in, they may also attend hospital birth. CM’s also provide prenatal, and post partum care. They, too, can provide care to a woman across her lifespan.
Certified Professional Midwife CPM
CPM’s are trained in out of hospital birth and often work in brith center’s or attend home birth’s! They also provide prenatal and post partum care to their patients. They must have a high-school diploma and submit their portfolio of clinical work to become a CPM. They may care for women during their childbearing cycle.
Now that we’ve discussed what the different types of midwifery are, and where they practice primarily, let’s chat about OB-GYNS
OB-GYN’s stands for Obstetrician and Gynecologist. OBGYN’s have earned their undergraduate degree, then an additional four years of medical school. After that, they complete another four years of residency training in Obstetrics and Gynecology. THEN they may apply for their board certification.
While many OBGYNs practice from the Medical Model of care, rather than a Midwifery Model of Care, there are OBGYN’s that embrace the Midwifery Model of care, and have Midwifery care inside of their office, too! This way, they can help their patients have the holistic midwifery care, and if high risk situations arise during pregnancy, they are there to co-manage your care with your midwife. I absolutely love that more and more practices are adopting this model of care, and I think this will be a turning point in women’s health.
If you are high risk, you may “risk out” of midwifery care, and benefit from seeing an OBGYN solely for your pregnancy and birth. Some high risk situations may arise that you may even enter into the care of a Perinatologist. Perinatologists specialize in caring for Women and babies in utero, during birth, and after. They work very closely with your OBGYN to create the best plan of care for high risk situations. OBGYN’s and Perinatologists only attend Hospital birth’s.
So…how do you choose which provider is right for you?
Well, that is a highly personal preference, and depends on what type of birth experience you desire. As well as your overall health condition.
You may be low risk and decide you’d like to birth in the comfort of your own home! Selecting a midwife that attends home birth’s would be the right choice for you! I also high recommend a doula for all women, especially those desiring a medication free birth.
What if you are low risk and decide you don’t want to birth at home, but also don’t want to be in the hospital? Then finding a birth center may be the best choice for you. Seeking out a midwife that attends birth’s at the birth center you’d like to be at would be the choice for you. Birth Center birth’s are also a great choice for women who may be “medium” risk, if the birth center is within, or right next to a hospital. Many birth centers within or near a hospital have great rapport with the hospital staff and are great at seamless transfers of care if needed.
The goal for ALL BIRTH WORKING PROFESSIONALS should be to give the best, evidence based care to their patient’s, and to do so seamlessly when plans change, supporting women to feel empowered and educated during their birth.
Low Risk. Medium Risk. High Risk. All birthing women are welcome in the Hospital setting. You CAN have an empowered hospital birth experience. Labor nurses and CNM’s work alongside OBYN and Perinatologists in the hospital setting to provide you with holistic care at all risk levels. We will be chatting more about how to prepare for the birth you desire in another blog post of this series, including how to have an empowered hospital birth experience. Because ALL WOMEN DESERVE AN EMPOWERED BIRTH EXPERIENCE.
*I have no personal affiliation with any of these links, and cannot give medical advice. These references are provided for your ease of searching google 🙂 *
Finding a local Doula :
OBGYN Offices with Midwifery Services in Phoenix, AZ:
Birth Centers in Phoenix, AZ:
Home Birth Midwives in Phoenix, AZ:
Some of the birth centers listed above, also offer home birth’s!