Who is a midwife? And what is her job?

The popularity and position of the doula has increased in recent years. The presence of the doula as an attendant of the parturient is increasingly encountered by the staff in the delivery room.

Who is a midwife and what is her role?
How to contact a midwife?
What are her duties and responsibilities?
And what is the cost of a midwife?

Who is a doula?

The name doula comes from the Greek word "doula", which translates to a woman's personal slave.

Any woman can become a doula.
A qualified doula has knowledge of medicine and psychology.

A doula is like a friend, only with a lot of experience.

The job of a doula requires..:

• High empathy
• When interviewing for a doula course, the personality and character of the candidate is taken into account.
• if she can't handle stressful situations, she is not suitable for this position
• does not have to be a mother or have direct experience of childbirth

A doula should:

• have completed a relevant course
• practice after the course
• pass an examination at the end, after which she will be licensed

She can practice this activity as a supplementary occupation or as her main profession. It depends mainly on the number of clients she gets.

Dula is:

• A specially trained woman who accompanies the mother-to-be during pregnancy, childbirth, six months and breastfeeding.
• provides emotional and psychological support to the mother-to-be
• if a partner is present, her care will also focus on him
• a source of practical information and an overview of the options available in your region

Dula versus midwife

A doula is not a midwife.
However, a midwife can also work as a doula.

A doula does not provide medical care, as many people think.
In no way does it interfere with the responsibilities of medical staff.

Table: doula versus midwife

The midwife, working in the delivery room, is fully available to the mother during labour.

However, the working system and staffing conditions in maternity hospitals do not usually allow her to attend to only one parent during working hours. If she does, this is the exception rather than the rule.

No one from the hospital staff is with the mother-to-be around the clock - for example, in the shower, giving her water, giving her a massage when she is in pain...
Dula does all of this.
She ensures that the client is physically and psychologically supported and feels that she is not alone.

From this perspective, we can therefore define a doula as a specially trained helper who complements the care of the professional staff with her continuous support of the mother.

The 4 main areas of activity of the doula

A doula can help her client:

1. during pregnancy
2. just before giving birth
3. during labour
4. after delivery

It is up to the mother-to-be to agree on the form of cooperation with the doula.
Each area is characterised by a specific list of tasks.

1. The role of the doula during pregnancy

In this phase she acts as a counsellor:

• helps the pregnant woman to find her way around the childbirth preparation courses
• she can attend the antenatal course with the client, either alone or in the presence of her partner
• practices the knowledge and skills acquired in the course with the mother and her partner (relaxation methods, breathing exercises, etc.)
• provide the client with information on maternity hospitals/obstetricians and practical experience from your region
• provide information and recommend additional literature
• advice on how to manage common pregnancy problems (swelling, iron deficiency, heartburn, calf cramps...)
• provides psychological support during pregnancy
• support you if things don't go as you wish (e.g. risky pregnancies, but also private situations)
• advises you on what you need for the delivery room
• has an overview of the various medical facilities in your area (in case you need to have routine or special examinations during your pregnancy)
• supports communication with the baby in the tummy
• advises you on diet during pregnancy
• can explain unfamiliar terms from the medical records

Dula is an important source of specific and practical information about pregnancy.

You can ask her anything.
If she is unable to help you within her remit, she can point you in the right direction and advise you further.

2. The role of the midwife before the birth

• Helps with health problems in the last weeks, such as swollen feet, haemorrhoids, fatigue, etc.
• together with the client, purchases equipment for the delivery room and for the newborn
• helps to arrange the household so that it is ready for the arrival of the new baby

Dula is also a psychological counsellor:

• she talks a lot with the mother about what motherhood entails
• relieves her of unnecessary fears
• prepares her for the birth and explains how it will all work
• preparing for birth eliminates the fear of childbirth
• dula provides individual preparation for birth, helping you to look at birth as a positive experience
• gives you practical advice on how best to manage the birth
• if you want to give birth with your partner, prepare him or her to be a good support during the birth
• can help you make your birth wishes/birth plan
• advice on how to induce labour after the due date using natural methods

3. The role of the doula during labour

This is the most important part of the collaboration.
During labour, the doula provides continuous mental and physical support to the parent or her partner. She helps the parent find natural means to facilitate labour.

The doula can recommend when to go to the delivery room.

The doula comes to the delivery room with the client:

• First they are together in the waiting room, where she tries to calm the mother.
• relieves her pain from contractions
• monitors the time between contractions
• selects relaxation techniques from her own experience (this may be ball exercises, correct breathing, massage, aromatherapy or walking)
• provides minor assistance (hand towel, slippers, moisten lips...)
• if a partner is also present, the doula provides help and support to the partner

The doula assists with what the mother needs at the moment.

In some cases, the doula acts as an intermediary between the staff of the maternity hospital and the woman giving birth:

• she can translate information from the staff to the mother or vice versa.
• an experienced doula already has several contacts in maternity hospitals
• knows the staff, which facilitates communication
• it makes the pregnant woman feel better mentally
• the client has trustworthy information from the doula about how things work in the maternity hospital and what to prepare for
• the woman can avoid unpleasant situations that sometimes arise from minor misunderstandings

The doula may or may not be present in the delivery room.
It depends on the decision of the mother.

If the doula's role continues during the next stage of labour, she mainly acts as a psychological support:

• she cannot be involved in the work of the medical staff and cannot take over the birth itself - she is not trained to do so
• helps the mother to breathe properly
• gives her a sense of security
• the doula is prepared for various complications and offers solutions
• supports the mother's decision, does not convince her of other opinions
• if a woman intuitively decides to do something during labour, she must be supported in her decision

4. The role of the doula after birth

During the six-week period, the doula supports the new family and contributes her practical experience:

• psychological support continues after the birth
• ensures early contact between mother and child in the delivery room
• gives practical advice on childcare
• provides information and support during the six-month period
• help with the processing of the birth experience

May come for several visits during the six-week period:

• cannot replace the doctor
• if the woman or baby has any health complications, must refer her to a specialist
• also monitors the mother, detecting early signs of postpartum depression
• can often give you advice similar to that of a lactation consultant
• helps with the care of the baby

Dula is trained not only for psychological but also for practical help after childbirth.

She also helps parents with administrative matters:

• registering with the social insurance office
• finding a health insurance company
• arranging the relevant financial contributions
• provides parents with a complete list of these steps
• help with filling in forms
• advise on how and where to deal with the following official matters

Cooperation with the doula

Have you decided to give birth with a doula but don't know how to do it?

We have some advice to help you find your way around:

• Don't leave the choice of a doula to the last minute.

If there are not enough doulas in your region, there may not be one available for your delivery date.

• The ideal time to contact a doula is in the 6th month of pregnancy.

This will still give you time and space to choose another doula if you don't get along.
In addition, you need to allow for the possibility of early delivery so that your new helper will be available in time.

• Choose your doula from the official list of doulas you can find on the internet.

This way you will get a trained assistant who has undergone complete training or is just about to complete the course.
Of course, there is nothing like a personal recommendation.

• You can contact a doula on the internet or by phone.

• Arrange a personal meeting.

How much does a doula cost?

There is no fixed dula price list.
Each dula determines its price individually.

The price for doula services depends on several factors such as:

• the experience and experience of the doula
• a lot also depends on what specific services you require from her

The more births with good references she has had, the more she can charge for her services.
The question of the price of services should be discussed together with the doula, during a personal meeting.

A doula may also be in charge of another mother.
Sometimes she has to coordinate several appointments to be able to fully assist each client.

A doula is always available for 1 to 2 weeks around your expected due date.
However, if the birth occurs earlier, the doula may be assisting with another birth at that time - this cannot be ruled out.

If the doula is unable to attend the birth for these reasons, there is no charge for her services.
Only the amount for the time you spent together before the birth will be calculated.

Contribution of the doula at the birth

The doula aims to contribute to the physical and mental well-being of mother and baby.
She helps to create an atmosphere where the woman feels safe and can concentrate fully on the birth.

Several studies have confirmed that working with a doula reduces some of the risks of childbirth.
Many of these are due to the stress of the mother or the workload of the staff.

According to the study Childbirth with a doula (M. H. Klaus, J. H. Kennell and P. H. Klaus):

• the risk of caesarean section is reduced by up to 50%
• reduces the risk of forceps delivery by 40%
• often no need for pain killers or epidurals

Dula is a great second in a difficult life situation.
And who knows, you might even make a new friend this way.

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