Doula, Nurse Midwife, or Lay Midwife?

Sara - posted on 06/10/2010 ( 3 moms have responded )




Hi... New here, but I have a question. About 5 months ago I went through the normal induced, "epidural-ed," cut-my-belly-open "labor." I wasn't very happy about it and I'm going to do a VBAC with the next one [whenver that may be]. Since then I have educated myself even MORE on natural birth alternatives. [My sister just had her 8th. Her first was in a hospital, the next 4 were at home with a midwife, and the last 3 were at home unassisted, so I learned quite a bit from her - I was there for 3-4 of her births.] I decided I want to be the educator, the helper, the support person, the midwife. But I can't decide which I'd like to acquire certification in. Any opinions?


Mason - posted on 06/14/2010




HI Sara,

I'm a licensed midwife, another option available in many states.
Here's what I ask potential midwifery apprentices:
Do you want to live your life on-call? No alcohol, few vacations, missed birthdays, graduations and weddings?
Are you willing to be political and go to the mat for your belief in a woman's right to birth any way she wants?
Would you like to be able to move to another state and practice there without having to be re-licensed?
How good are you at paperwork? (ok, I ask this because I dislike paperwork but still :)

We have CNM's facilitating home births in our area but the majority are LM's and almost all started as doulas. We have VERY few unlicensed midwives anymore and they are getting to retirement age. None of the CNM's do home birth and hospital as their hospital malpractice won't allow them to.
Doulas: Have a high burnout factor as they have a ton of knowledge and very little power in a hospital, eventually that combination causes them to throw up their hands in frustration and go back to school to be a midwife. The very few professional long-time doulas provide an amazing and needed service and have my undying respect.
Does this bit of rambling help? Fee free to contact me for more info about CA if you'd like.

Good luck!

Rachel - posted on 06/11/2010




That's great Sara! The more women out there who are ready and able to support pregnant women and educate them about their choices, the better!

The choice about what to pursue, specifically, is a difficult one for anyone else to answer. If it were me, I'd ask myself a few questions to help figure out which direction to take. Remember, too, that you can always start with the less expensive and time consuming option, then move up.

Things I would consider:

1) What are the costs associated with each option?

2) What does each "job" entail? Write a sample job description for each role. This can be as simple as a list of tasks each role would perform or you could write out a scenario for each role and what you would do for a pregnant mom during pregnancy and birth.

3) What is my favorite part/aspect of each role? That is, what would be most satisfying to me? Is it the support I can give to each mother (like in a doula capacity). Or is it the idea that I can be a nurse-midwife in a hospital and help these moms who have to feel they have to have a hospital birth (maybe for insurance reasons, or whatever). Or is it the idea that you can have a personal relationship with a mom and be honored to be part of her home birth, supporting her emotionally and medically?

4) Which option best fits my lifestyle and commitment abilities? For example, with small children of your own, you may not be free to be a lay home birth midwife because you may not be able to get up and go at any time of day or night for a birth. Or, you may not have the financial capacity and time to go to college for your nurse midwife degree. This doesn't mean you can't do either of these things, but that you would need to figure out how to make it work by changing your lifestyle, getting an extra job, finding flexible child care, etc.

I hope that helps!



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Leslie Anne - posted on 08/11/2010




I've been interested in the same things and I decided to become a birth doula. One reason for this decision is that I have a baby and I can train mostly online. Also, I have asked a number of women in my community what paths they took to end up at their careers (for example my lactation consultant, baby massage instructor, midwives) and they all started off as birth doulas. It is a great way to learn everything you need to know about birth before you commit to a long-term career. I am now hoping to become a lactation consultant (/ neonatal nurse), not a midwife, but I never would have figured that out on my own. Being a doula is also a great way to make money to put yourself through school. Good luck!

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