Midwives, doulas, and breastfeeding consultants have been around in some form for a long, long, time. Their roles at the height of the industrial age may have receded into the background, but the past few years have seen a renaissance of sorts in the birthing process. As more women research a host of choices for prenatal care and birth, the roles of the newly appreciated old birth professional are coming to the forefront once again. To go along with our New Moms and Expectant Moms Guide in this issue, we’re providing a glossary of sorts, defining the roles of these birth-related occupations.
Midwives
Women who are looking for alternatives often seek out the care of a midwife. Midwives are most well known for caring for generally healthy pregnancies, labor, and birth, but midwives licensed through New York State also have prescriptive authority and can provide primary care for healthy women, though not all midwives offer these services.
“We have a different philosophy than most OBs,” says Susanrachel Cordon of River and Mountain Midwives in Gardner. “A midwife’s model of care holds that pregnancy, labor, and birth are normal physiological processes and most women can do them successfully—the OB’s model of care holds that pregnancy is a pathology that must be treated. One thing that is disturbing is that it’s very hard to have a normal birth in a hospital—it’s just difficult. It’s assumed you have to be kept anesthetized and quiet. You have to fight, argue, and have an advocate in many situations. Physicians may be very skilled at surgery, but they’re not so good at just being with a woman in labor, holding her hand, nodding, saying “It’s OK”.
Although Condon estimates that midwife care is appropriate for 90% of pregnancies and 70% of births, it’s certainly not ideal for every expectant mother. “Women who are concerned about having all the latest tests and screenings for diseases and pathologies are probably not the best candidates for midwife care.”
“I always say that at any birth, not only is a baby being born, but a mother is being born as well,” she says. “And that is just as significant. Midwifery really is about celebrating and embracing women throughout all their lives’ journeys-from menstruation to maternity to menopause.”
Doulas
“I think women are seeking alternative birthing options in response to the rising c-section rate in hospitals and want to avoid interventions that are routinely and frequently offered,” says Mavis Gewant of Gentlecare Doula Services in New Paltz. Gewant has been a doula for 17 years and is the founder of Doulas of the Hudson Valley.
“I became a doula after giving birth to my 2 sons, both with midwives, one in the hospital the other at home, both natural: no drugs. Trusting my body and the birth process, I wanted to support women to experience this as well. When I first started out, I was more militant in my views, and as I attended many births over the years, I realized that women need support, emotionally and physically in all birth situations,” says Gewant.
Doulas do not deliver babies as do midwives, but instead offer support to women in labor, whether in a hospital or at a home birth. “My role as a doula in the birth process is to provide emotional and physical support for the laboring woman and to do the very best I can to shield her from outside stimuli,” says Liz Pickett, a student midwife and also a member of both Gentlecare Doula Services and Doulas of the Hudson Valley. “I do a lot of light dimming and telling people to lower their voices. Sometimes people say that the laboring woman cannot make decisions for herself when she is in labor, I don’t believe this is true. If you can keep the environment calm, the laboring woman will be able to be aware and make decisions about her birth.”
Hudson Valley families seeking the support of a doula have many options to choose from. Aside from the Doulas of the Hudson Valley, another active group of doulas is Orange County Doulas. “We are working to increase birth options awareness in the area and serving our community with prenatal education, birth support and postpartum services. At events, we speak with couples who are trying to conceive or already expecting, relatives and friends of birthing women and all interested members of the community about preconception health, healthy pregnancies and childbirth options and comfort measures.”
Breastfeeding Experts
Studies show that breast milk benefits both mother and child in a variety of ways. Far from being merely a source of nutrition for baby, breast milk has been shown to be a virtual panacea for both mother and baby. Full of antibodies, breast milk may help prevent SIDS, asthma, and childhood obesity among a host other conditions.
For mom, studies show that breast milk can help reduce the risk of cancer and post-partum stress levels, and can help promote weight loss. Breastfeeding also helps facilitate the bond between mother and baby. Women hoping to breastfeed can seek out support from a variety of resources such as lactation consultants, advocacy groups such as the La Leche League and the International Lactation Consultants Association, as well as from medical professionals.
Laura Keegan, a Family Nurse Practitioner in East Fishkill often counsels mothers on breastfeeding in her practice. She authored and published the book Breastfeeding With Comfort and Joy, a collection of evocative photography of baby at the breast designed to guide women to successfully breastfeed. When the book was released nationwide, the response was overwhelming.
“It’s a very simple book,” explains Keegan on the book's success. “A massive didactic book on breastfeeding can be overwhelming, whereas Breastfeeding With Comfort and Joy is renewing old information in a bottle feeding culture. It’s much easier to learn from seeing other women successfully breastfeed as opposed to simply reading an instruction manual.”
Many new mothers complain of difficulty breastfeeding. Keegan says breastfeeding in a way that allows the baby to take charge often relieves some of the pressure that moms may feel with breastfeeding. “I want women to learn to breastfeed because they want to, not because they feel like they have to. We need to give each mother room to find her own way."
Courtney Bonfante lives in Marlboro, NY with her family. She publishes newburghmama.com, a site dedicated to families in the Newburgh area and works in social media marketing.
Learn about the Midwifery Modernization Act.