The Difference Between a Doula, Birth Keeper, and Midwife
A Doula is a support person who provides emotional and physical comfort to women during life-changing experiences such as fertility, pregnancy, labor, birth, postpartum, and death. A Doula may or may not hold a certification. Holding a certificate does not automatically equal better care or more wisdom than someone who chooses not to certify.
Mainstream Doula Programs train women to suggest different positions to encourage labor, keep labor going, or change the baby’s positioning to AVOID or PREVENT intervention. They strongly encourage their Doulas to follow hospital policy and never intervene with hospital staff, even if they are witnessing abuse. In the rare instance that a Birth Doula decides to speak out against a provider, she risks banishment from that hospital or birth center. But this is where things get complicated. Many birthing women view Doulas as “saviors or protectors” of the birth space and hire a Birth Doula to avoid manipulation and abuse by hospital staff. Conversely, many Doulas view themselves as the “saviors” creating an unhealthy power dynamic.
Traditionally, a Doula was just a woman serving women, but the meaning has changed. A Doula is no longer just a woman who serves but also someone hired to stop injustice in a corrupted system, which is simply impossible. It doesn’t make sense to me that women continue to give birth in a space where they feel the need to hire protection.
A Birth Keeper can also provide emotional and physical support, but additionally recognizes and honors the spiritual side of birth. She is there to hold space and witness the sacredness of birth and never tries to manipulate or change the natural unfolding of birth. A Birth Keeper does not view herself as an authority but as an equal, walking alongside women as they discover and navigate their journeys to, through, and beyond birth. A Birth Keeper is not a savior and will not show up to protect or save a woman from her experience. She understands physiological birth but also knows and respects that a birthing woman knows her body better than anyone else ever could. A Birth Keeper does not empower but instead maintains a safe space for women to discover that the power they seek is already within. A certificate does not bind her and, therefore is fully present and willing to serve women in whatever capacity the mother desires.
There are two categories of Midwives, an Authentic Midwife and a Medwife (Medical Midwife).
An Authentic Midwife is a woman who practices outside of any governing body. She serves women independently in a divine non-medical way. She shows up for women just as a Birth Keeper would, trusting women, respecting physiological birth, and honoring the spiritual transformations. She obtains her knowledge through self-education, personal experience, independent programs, or shadowing mentors. An Authentic Midwife and a Birth Keeper are essentially the same and may use either title.
A Medwife or Medical Midwife is usually a licensed or formally licensed provider trained within the medical model and operates under the belief that all birth is a medical event. She considers herself an authority of birth, showing up for women by anticipating complications and looking for ways to manage a mother's experience. A Medical Midwife likes to interfere with the physiology of birth by manipulating a woman’s birth position, regularly monitoring fetal heart tones (FHT), and using cervical dilation to indicate if a woman is ready to give birth. You might also see a Medwife use coached pushing, hold a woman’s perineum without consent, rub down a baby immediately after birth, or use a suction bulb on a newborn before they have even had a chance to clear fluid on their own. Additionally, Medical Midwives may carry drugs, use Pitocin to “prevent” hemorrhage or to expel a placenta in their desired timeframe, pull out a mother's placenta, or use fundal “massage” as standard practice.