Should a midwife or doula be part of your birth plan?

While many women traditionally choose a physician (OB or Family Medicine), midwives and doulas are becoming increasingly popular options. A midwife may take the place of a doctor. Midwives are often a good choice for women with low-risk pregnancies who want a high touch, and individualized birth plan that is more naturalistic with less pharmacologic interventions as permissible to ensure safe outcomes for mom and baby. They support care in hospitals, birth centers and at home. However, they do not perform C-sections or manage high-risk births.

A doula works alongside either a doctor or a midwife to provide emotional and physical support. The most common type is a birth doula who helps prepare for labor and provides comfort and guidance during delivery. Many women begin working with a birth doula in the second or third trimester.

"Pregnancy is a journey of discovery, where you will grow and learn about how resilient and capable you are as individual.,” said Dr. Christopher Smyre, physician with Family Medicine. “Doctors, midwives and doulas form a compassionate circle of care, supporting women throughout the process.”

What is a midwife?

A midwife is a licensed health care professional who provides care during pregnancy, labor, birth and postpartum. Many midwives hold nursing degrees along with specialized training and certifications.

They can:
•    Order lab tests and imaging
•    Prescribe medication
•    Provide comprehensive care

“Midwives offer a comprehensive, patient-centered model that provides continuous, personalized support,” said Daphne Kuehl, a midwife at SIU Medicine. “Our holistic approach addresses not only the physical aspects of pregnancy and childbirth, but also the emotional, psychological, and social dimensions of this transformative life experience.”

There are three levels of midwife certification:

•  Certified nurse-midwife (CNM) – A registered nurse with a master's or doctorate and advanced midwifery training, certified by the American Midwifery Certification Board. CNMs provide care to women from the onset of menstruation through post-menopause, as well as care for newborns.
• Certified midwife (CM) – A non-nurse with a post-graduate degree in midwifery, certified by the American Midwifery Certification Board. However, this certification is not currently recognized for licensure in Illinois. CMs also provide care to women from the onset of menstruation through post-menopause, as well as care for newborns.
• Certified professional midwife (CPM) – A specialist certified by the North American Registry of Midwives. CPMs provide care to families throughout the prenatal, birth, postpartum and newborn stages. They typically attend home births and do not hold hospital privileges. While they cannot prescribe medications, they often incorporate herbal or homeopathic remedies as part of their care approach.

SIU Medicine midwives hold the highest level of certification, and many insurance plans include coverage for midwifery services.

What is a doula?

A doula is a trained professional who provides information, physical support and emotional care during pregnancy, labor and the early postpartum period. Unlike midwives, doulas do not provide medical care.

"The most effective birth experiences happen when medical professionals and doulas collaborate,” said Dr. Smyre. “A doula’s focus on emotional well-being, complements the clinical care provided by physicians or midwives.” 

Other types of doulas include:

• Pregnancy doulas – Support women experiencing difficult pregnancies by helping them manage severe morning sickness, navigate bed rest, prepare meals, handle housework and care for other children.
• Postpartum doulas – Help new mothers adjust in the weeks after birth with breastfeeding, child care and recovery.

Studies show that having a doula can lead to:

•  Shorter labor times
• Reduced use of pain medication
• Higher rates of vaginal births
• Improved breastfeeding success
• Less stress and anxiety

While most private insurance plans do not cover doula services, Illinois Medicaid does. In Illinois, doulas must be certified by the Illinois Medicaid-Certified Doula Program administered by SIU Medicine. 

Choosing the right support

Deciding whether to include a midwife or doula in your birth plan depends on your preferences and medical needs. Understanding their roles and benefits can help you make an informed decision about the support that best aligns with your birthing goals.