Midwives and doulas are often thought of as being present at childbirth, providing support and medical care to people giving birth. Although these providers each play integral roles in childbirth, they also offer many different health services to our communities.
To provide a more in-depth perspective, we asked Catherine Burke, CNM, a Certified Nurse Midwife with Rochester Regional Health, to explain the roles of doulas and midwives before, during, and after childbirth, and how patients can benefit from their care.
Midwives and doulas
Certified Nurse Midwives are medically trained Advanced Practice Providers who complete nursing school, then attend 2 additional years of education & training to earn their midwifery certification. Certified Nurse Midwives are required to take a national certification exam and be licensed by the state in which they practice.
In addition to assisting through pregnancy and childbirth, midwives care for patients from adolescence through menopause. Services offered by midwives include but are not limited to:
- Prenatal, childbirth, and postpartum care
- Annual GYN exams
- Contraceptive counseling and management
- Pap smears
- Breast exams
- STI screening and treatment
- Evaluation and treatment of pelvic health issues
- Menopausal management
Birth doulas are health care professionals who provide physical and emotional support of a pregnant person through their pregnancy, birth, and postpartum journey. Doulas undergo specialized training, but are not required to be certified or licensed.
A birth doula supports patients and families by assisting with:
- Creating a birth plan
- Offering evidence-based advice & resources during pregnancy
- Massage, breathing techniques, and position changes during labor
- Emotional support during labor
- Support partners & family members throughout pregnancy & birth
- Breastfeeding assistance
“People who receive midwifery care and/or doula support have decreased risk of needing a Cesarean section, lower rates of induction or augmentation of labor, decreased risk of preterm birth, higher rates of breastfeeding initiation, and overall higher rates of feeling satisfied with their birth experience,” Burke said.
Working together
Midwives are part of the Rochester Regional Health staff at Rochester General Hospital, Unity Hospital, United Memorial Medical Center, and Newark-Wayne Community Hospital. Midwives also offer OBGYN and prenatal care at most Rochester Regional OBGYN locations. Midwives work collaboratively with physicians and nursing staff, as well.
Doulas meet with families during pregnancy, then come to the hospital when a person is admitted in labor. These professionals are present and provide support during labor, childbirth, and the early postpartum period.
“Midwives, doulas, doctors, and nurses work collaboratively as part of the same childbirth team,” Burke said. “Each profession has its role in helping families to have a safe and satisfying birth experience. There’s a lot of support for birthing families at Rochester Regional Health.”
Financial and connective resources
Midwifery care is covered under all insurance plans.
For doulas, most patients pay for their services out of pocket. Legislation is being discussed to expand coverage for doula services covered by private and public insurance plans. As of March 1, 2024, Medicaid-enrolled members must obtain a written recommendation for doula services in New York.
Pregnant people looking for a doula can contact several local organizations and communities that are supportive. Beautiful Birth Choices and the Doula Collective of Rochester work to connect doulas with people searching for them. The state offers the NYS Medicaid Doula Directory, which lists all doulas who are enrolled as NYS Medicaid fee-for-service providers. The directory is updated regularly.
An initiative called the Community Doula Program provides free doula services for people of color who have Medicaid, are Medicaid-eligible, or are uninsured in the 13 counties surrounding Monroe County. Funded through a multi-year Finger Lakes Performing Provider System (FLPPS), services are provided by Finger Lakes Community Health and the Healthy Baby Network. People can be referred to this program by their primary care provider, or refer themselves by calling (585) 710-3159 for Monroe County residents, or (315) 781-8448 for residents outside of Monroe County.
The Doula Reimbursement program offered through CDPHP also allows patients to receive up to $1,500 in reimbursement for the cost of the doula’s services.
“Midwives and doulas make such a huge difference in improving the health of pregnant people and babies,” Burke said. “Whether in urban, suburban, or rural settings, these trained professionals will support and care for their patients – before, during, and after their babies are born.”
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