A Who’s Who of Birth Workers
Demystifying the nomenclature of the birth world! What is a midwife vs a doula vs a birthkeeper? Starting with obstetricians, we work our way through the “food chain” of people who attend birth; what their roles and responsibilities are; what they fundamental beliefs MAY be; and how they might practice. But don’t be fooled by labels! Each care provider comes with their own stories, backgrounds, beliefs, training, fears, and traumas that influence how they support women, meaning that just because someone is a “something-something”, doesn’t mean they will behave exactly in the way you think a “something-something” should.
You'll hear about:
Obstetricians. Their general scope of practice is emergency medical situations around pregnancy and birth. Many of them may have never seen a physiological birth! While crucial in true emergency scenarios, I think it’s pretty wack that they are the standard of care for normal, healthy pregnancies.
Quick detour into the history of the medical system in the US. (Hint: it was founded by one dude so he could make money) And a further detour into how I have politely stepped out of those mental programs of control and money and disease.
Midwives
CPMs, CNMs, DEMs, CMs, oh my word! I get into the acronyms and the certifications for these sorts of midwifery, at least as far as I understand it because it’s very complicated! These licensed midwives have attended at least 2 years of school (either accredited midwifery school or nursing school and a masters program in midwifery), have attended a certain number of births in various capacities, are all up to date on their testing and their certifications (and fees).
A lot of these differences in titles are bureaucratic and I express some strong feelings about everyone running around asking for, and paying for, permission to do what they already know they are ready to do. All these systems of certification and accreditation are entirely made up (recently), and I have no reason to believe that those standards are absolutely the best.
A brief mention of my displeasure with the term “medwife”. Do we really need more labels to talk done about other women?
Unlicensed midwives - exactly what it sounds like! Women who have been trained to support birth but are consciously choosing not to be licensed! Maryn and Margo from Indie Birth (the organization I studied midwifery with) both are in this category. It’s semi legal or maybe just not legal depending on your state. We believe that it’s impossible to truly and deeply serve women while also being responsible to a set of rules and regulations and their governing body that may or may not be aligned with the way they practice.
Birthkeeper - originally coined by Jeannine Parvati Baker in the 70’s as a combination of birth worker and earth keeper, meaning one who safeguards, and is an activist for physiological birth. This is a term that doesn’t really mean anything in particular, but in recent years has been coopted by certain folks.
All those other titles! I would sum it up as people who may feel they are similar to a midwife, but don’t want to use the term. Either because it doesn’t resonate with them, or maybe because they don’t truly have that skills of experience of a midwife.
Doula:
While originating from the Greek word for ‘slave’, the doula training I took told me that the word dula means talking stick in an African language. This for me is a great picture of what doula support is; a walking stick for women in this pregnancy and birth journey.
A birth doula (generally) provides emotional, physical and informational support but is not a primary care provider. In my opinion, doulas take the role of what our friends and sisters used to provide. We are all now so disconnected from community support and the natural rhythm of the childbearing year that we now need professional doulas to walk through this time. But that doesn’t mean they aren’t great support! Doulas don’t have any big picture governing board or requirements, but many doula trainings push being certified to promote professionalism in the trade.
Why we (especially as women) feel the need to have certification to do what we know we can do. Why are we dependent on someone else’s stamp of approval to offer the support we know we can.
I admit that I’m nuts!
Postpartum doulas - they provide a wide range of support in the postpartum time, from the more mundane (laundry, dishes, hold the baby so you can shower, listening), to the specific and healing practices (postpartum massage, cooking, heat treatments, digestion support and evaluation). It seem like there are some trainings that teach you more how to be the helpful friend next door, and some that go deeper into trainman healing professionals for the postpartum period. (Sacred Window Studies that I studied with falls into this second category.)
Regardless of what someone calls themselves, find someone who feels right to you. Someone who feels aligned with your core values and beliefs, and offer the care that feels most nourishing to you. These labels and certifications may or may not be helpful in this process.
So what does this mean if can’t find someone to support your birth that feels right for you? Get creative! Call it in! Open your field to beyond the labels you were previously looking through. And you might have to travel or come up with some alternative solution. But please, don’t settle for a care provider that you don’t really feel comfortable with.
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Mentioned in the show:
Margo's reel about settling with care providers
Sacred Window Studies' Conscious Postpartum Caregivers Program
My Postpartum Cooking offering
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