Choosing Caregivers

by Jane Baker

Choosing the right caregiver when you become pregnant can be overwhelming as well as difficult. In the past, financial considerations had often been the deciding factor in choosing caregivers to support you during birth. A doula may cost around $1,000. Hiring midwives used to cost around $3,500. However, midwifery services are now covered within our provincial health care insurance plan. This makes cost less a consideration than it used to be.

Choosing the right birth support really begins with some self-exploration. It is important to know what kind of birth experience you are looking for. It can also depend on your pregnancy. If your pregnancy is considered high risk and requires specialized monitoring, an obstetrician might be the most appropriate choice of care giver. Low risk pregnancies are easily managed by midwives. Doulas do not provide prenatal care. They are primarily hired for labour support. It is important to do your homework and understand the differences in the services available to you.

For many families, the correct answer to this question now is not to hire either a midwife or a doula, but to hire both. They actually play quite different roles, and their services can complement each other very well during labour and birth. Midwives are primary caregivers to pregnant families. They offer complete prenatal, birth and postnatal care, as a family medical doctor would.

Doulas offer labour support. They act as labour assistants to support a birthing woman through labour and delivery. However, they do not provide medical care or deliver babies. Their role is to help decrease the stress of the labouring woman and her partner and provide her with continuous support. Doulas help develop birth plans and help couples understand what is happening. They use comfort techniques, offer emotional support, labour coaching, massage, and breathing and meditation exercises. They work with the midwives or obstetrician and support the family in their choices. Their role is to support the family through the labour process. Some doulas also specialize in post natal care.

Midwives are highly trained professionals in Alberta. They have hospital admitting privileges, which allow them to assist their clients wherever they want to give birth. Midwives will review your medical history and help you with all your prenatal checkups. Their appointments are often longer than with traditional health care providers, because they work to support the needs of their clients on all levels – physical, emotional, mental and spiritual. Any standard medical tests offered by an obstetrician or family doctor during pregnancy will also be offered by midwives. However, midwives will generally provide more complete information about why the tests may or may not be necessary for you to support you in making informed decisions about them. They will be at your side throughout your labour and birth versus the possibility of having an unfamiliar “on-call” doctor attend the birth. They will be available by pager 24 hours a day.

Pregnancy and childbirth are intensely emotional times. Deciding who to invite to this event requires careful consideration. You must feel comfortable, confident, and content in the skills and abilities of your caregivers and support people. Some things to consider are:

• Do you want a home birth, a birth centre birth or a hospital birth?
• Do you want to use pain medication such as an epidural during labour or avoid it?
• Do you prefer to birth in private or with an audience?
• Do you prefer to have someone familiar by your side always during labour and birth?
• Are you interested in having a water birth?

Doing your homework and knowing what you want from your birth experience will help you to choose the right support.

BIO: Jane Baker is a Calgary midwife and is the current President of the Alberta Association of Midwives.

The information provided in this article is for informational purposes only. It is not a substitute for professional advice from your primary healthcare provider. Always consult your healthcare professional.