What are midwives?
There are several alternative choices for the birthing process in general. Besides doctors, midwives are another option a pregnant woman may choose to include as part of her birthing plan. Midwives, specifically certified nurse-midwives or CNM, are trained to deliver babies in a hospital or home setting. Midwives do not, however, have medical training equal to that of a doctor, they cannot care for more complicated cases and they cannot perform cesarean deliveries. Typically, pregnant women who wish to employ a midwife for their pregnancy care should also employ a physician to work hand-in-hand with the midwife if needed.
Certified nurse-midwives (CNM)
Certified nurse-midwives (CNM) are required to complete formal academic training and commonly hold an RN or BSN degree. They are licensed. Hospitals usually employ only CNMs.
Other midwives (CPM, CM) are not equivalent in their training to CNMs. CM/CPMs do not meet the Global Midwifery Standards and are not accepted as midwives outside the US. CPMs or "direct-entry midwives" are often not licensed, have no hospital privileges, most have no malpractice insurance, and usually deliver babies at home.
What are doulas?
Doulas are very different than midwives. They are not rigorously and academically trained to handle the birthing process itself. Doulas do not have hospital privileges. Doulas work with pregnant women as a birthing partner, helping to guide her through pregnancy, labor and delivery. Doulas can work with the woman by attending lactation classes, birthing classes and breathing classes. Many women think of doulas as their pregnancy best friend. Doulas can also be certified as birthing assistants by the Doulas of North America or DONA Association.
Doulas and midwives offer support for pregnant women during pregnancy, but they are not medical doctors. If medical problems arise before birth, such as preeclampsia or high blood pressure, a medical doctor may be needed for advanced care. Birthing outside of a hospital setting may also present a problem if there are complications during the birthing process or after birth for either mom or baby.
Alternative care is quickly becoming more accepted in the medical community so some doctors now employ midwives to attend to patient care in the office. During the birthing process, the midwife may be the primary caregiver, but a doctor is always apprised of the situation should the need arise.