When I tell people that I’m a doula, and explain that I accompany births, they’ll often say ‘ah so you’re a midwife?’ There is definitely some confusion and I’ve found that many women have not considered having a doula as they thought that midwives and doulas have the same role. I experienced this confusion again a couple of days ago, which has prompted me to write this little blog.

THE SHORT ANSWER

A midwife is a medical professional. A doula is an experienced support professional. They have very different responsibilities and, more importantly, having one does not mean you don't need the other. In fact, they work best together!

WHAT A MIDWIFE DOES

In Belgium, a midwife (sage-femme/vroedvrouw) is a trained clinician. During labour, their job is to monitor you and your baby medically: checking heart rates and blood pressure, assessing dilation, helping with pain relief, suggesting position changes to help your baby to descend, reassuring you and ensuring that everything is progressing safely. They are responsible for clinical outcomes of your birth for your and your baby and they are wonderful at what they do.

If you give birth in a hospital, the midwife who is assigned to you is not usually able to be consistently present with you throughout your labour because in a busy labour and delivery ward, a midwife may be caring for several women at once. They will check in regularly, but they will not be by your side continuously. You may therefore be on your own, managing contractions for long stretches at a time. At some point there will be a change in shift so you may have different people caring for you depending on the length of your labour.

WHAT A DOULA DOES

A doula is a trained professional who provides continuous physical, emotional, and informational support to families before, during, and after birth. They help to create a safe, informed and loving pregnancy and birth environment. As a non-medical birth companion, a doula’s role is to support you (and your birth partner if you have one), emotionally and physically and provide you with information that can help you make evidence-based choices. You will generally build up a relationship with your doula during the last months of your pregnancy so that by the time of your birth you feel like you have a trusted companion by your side.

*Counter pressure on the back can be so effective at relieving the intensity of contractions*

During labour, doulas provide continuous comfort and reassurance to both the birthing mother but also her partner. Whether your labour lasts for 3 hours or 15 hours or more, your doula will stay with you and will be a constant source of comfort and guidance. Doulas offer reassuring words, a sense of calm, comfort measures and massage. They help to keep you focused on your breathing and to find your way through every single contraction. They advocate for your birth preferences to be respected, they make sure that you eat and drink and pee and change positions regularly. Doula support is equally invaluable for a partner because watching someone you love in pain is hard, and partners often don't know what to do with themselves. A doula gives them a role but looks after their well-being too.

DO I STILL NEED A DOULA IF I’M PLANNING AN EPIDURAL?

Yes, absolutely. An epidural removes the pain of contractions but it doesn't remove the uncertainty, the waiting, the decisions that still need to be made, or the emotional weight of what's happening. Labour with an epidural can still be long and things can still change quickly. And the moment of birth, whatever form it takes, is one of the most significant of your life. It is incredibly valuable to have support through all of it.

ISN’T IT TOO MUCH TO HAVE A DOULA AND A MIDWIFE?

Not at all… hospital midwives and doulas work alongside each other and their roles are very complementary. In my experience, midwives in Brussels hospitals welcome the presence of a doula; it means their patient has consistent emotional support, and they can focus on clinical care. Since they can’t be in the labour room continuously, they are happy knowing that their patient is being well looked after constantly throughout labour. That said, if you have an independent midwife accompanying you to your hospital of choice, in that instance you would not need both a doula and a midwife as your midwife will be with you continuously.

CURIOUS TO KNOW MORE?

If you're pregnant in Brussels or surrounding areas and wondering whether a doula might be right for you, I'd love to have a chat with you. There's no obligation, just a chance to talk through what you're hoping for and to see whether you feel that I might be able to help you. Please go ahead and book a discovery call or send me a WhatsApp! 0491 08 28 85

Jane Piot is a birth doula and breastfeeding specialist based in Brussels, Belgium accompanying births in Brussels and Leuven

What does a doula actually do? Isn't that what a midwife is for?