For centuries, accompaniment during pregnancy, childbirth and postpartum has been fundamental for women. The assistance of a figure capable of providing a safe environment for the mother and her partner, making her feel calm and confident is one of the main concerns, especially at the time of delivery. Who will assist me? Will I feel comfortable with that person? What can you do for me and my baby?
So much midwives such as doulas are figures that accompany mothers during the process, but what is the difference between them? What is the work that each one performs and the training they have in childbirth care?
The midwife: professional assistance
The role of the midwife is very important, both during pregnancy, such as childbirth and postpartum. The midwife (or midwife), or the matron (although there are few there are also men), is responsible for accompanying the woman and her partner before and during childbirth, and in the period after the baby is born.
It is responsible for monitoring pregnancy, advising healthy habits, informing about prenatal tests, monitoring the fetal condition, assessing risk factors and early detection of problems.
At the time of delivery, it is the person who assists the woman during the period of dilation and expulsion. Control fetal well-being and in low-risk births, can even attend the full delivery.
After the birth of the baby, the midwife takes care of the state of the mother and the newborn after birth, advises on breastfeeding issues and controls the points of the episiotomy or caesarean section, if applicable.
They are professionals who they form for six years (four from university studies and two from specialized training) to obtain the title of Nurse Specialist in Obstetrics and Gynecology.
In hospital birth, the cost of the midwife is covered by social security, but in the case of a home birth, the price of home birth assistance is around 2,000 euros.
La doula: emotional support
The figure of the doula is contemplated in the Strategy of normal delivery care in the National Health System, published by the Ministry of Health in 2008 and revised in 2010. However, it does not specify its functions or how its training should be.
This document describes "the continuous permanence of an accompanying person chosen by the parturient (couple, family member, friend) or health personnel (midwife, doula, nurse) who provides personalized support during childbirth."
A doula is a woman escort and his family during childbirth offering emotional and physical support, but never sanitary. They do not perform any type of clinical intervention or medical examinations.
They are generally women who have been mothers and accompany from the experience, contributing emotional and physical support. Many women find the doula service in childbirth beneficial, feeling wrapped in a figure that gives them peace of mind and accompaniment.
Before delivery, she accompanies the woman, provides information and emotional listening. During labor, its task is to help calm the pain by performing massages, with breathing and relaxation methods, suggest the most appropriate positions to facilitate the development of labor, transmit the mother's wishes, and advise on the onset of breastfeeding, so as in the postpartum.
The doula does not replace the midwife, since it does not provide the same services. Is a complementary figure if the mother wants to have her specific accompaniment, in addition to that of the midwife.
His training covers diverse knowledge about pregnancy physiology and about childbirth and puerperium, but they have no specific academic preparation. There is no official degree to be a doula in Spain (at least for now).
Your hospital delivery fees are not covered by Health in Spain, so if you want to have a doula in childbirth you must contract privately the full service of delivery and postpartum assistance, which is around 1,000-1,200 euros.
Midwives versus Doulas
Three years ago the General Nursing Council published the "Doulas Report" in which some midwives declared the "war" to the doulas by denouncing the professional intrusion of this figure and the risks that it may entail for childbirth care.
The truth is that, whoever it is, the continuous accompaniment of a person of trust and support is beneficial for women and for the development of childbirth. A review of Cochrane studies indicates that women who received continuous labor support were more likely to give birth through spontaneous vaginal delivery than those who had not received such support.
Obviously, the emotional has effects on the development of childbirth, but the attention of a medical professional who assists with health guarantees to the mother and the baby is also essential.
Doing some self-criticism, some midwives believe that the doulas have reappeared because they (the midwives) have failed to comply when caring for women, while the doulas feel persecuted and underrecognized. There are also those who believe that both can work very well together and provide a happy experience for the mother and family.
