Doulas are non-medical birth workers experienced in the process of labour and birth. The biggest two roles that doulas often have are holding space and promoting self-advocacy. What does that all mean? In a nutshell, holding space is being a rock for you - that one constant in your birth space who won’t judge you whatever happens. This blog article provides a great explanation on what ‘holding space’ means. Holding space can be a tough role for someone who has a relationship with you (partner/parent/friend), especially if they have not been present at a birth before, and this is why doulas are so valuable (it is not impossible for family/friends to hold space, and some can do this well).

Promoting self-advocacy is another area where doulas shine. Doulas can help with understanding the medical side of labour and birth and support you with making decisions. For example, explaining how a particular choice may adjust your original birth plan (and support you with those changes), or requesting that your care providers give you and your partner some time alone to discuss the new advice given to you. Some doulas may also have some secret knowledge, such as that the hospital may have a policy to not offer waterbirth as an option (even though they do provide it on request!).

Some doulas provide care from pregnancy through to the postnatal period, this is a great option for families who want continuity of care but it is not provided by their health care provider.  These doulas will often meet you a few times during pregnancy to learn your needs and wants, and plan with you how best to make these things happen. They support you through labour and birth (always check if the hospital has a limit on support people, as this may impact who you ask to be present) and they also visit you at home after birth to check on your wellbeing. They can also direct you where to find extra help if you need it. Other doulas specialise and provide support in a particular area, for example postnatal only.

Doulas are an extra expense to your pregnancy/birth/postpartum, but a good doula is definitely worth the investment. Alternatively, a student doula may be available in your area at a reduced price.

Aboriginal Maternal Infant Care (AMIC) workers are specialised support people for pregnant women who identify as indigenous and oftentimes these workers have an indigenous background themselves. AMIC workers are not medically trained but work alongside midwives and doctors to ensure care is culturally safe and appropriate to your individual indigenous needs. They can also support you by explaining medical advice in a way that may be easier to understand and helping to develop a plan between you and your care provider.

Unfortunately, AMIC workers are not available everywhere and generally this service is provided through larger public hospitals. If this service is available to you, you will usually be assigned one AMIC worker, who will get to know you and your family. This can be a great way to have continuity of care, even if your doctor or midwife can’t provide it.  The level of support given by AMIC workers varies and may be antenatal and postnatal support only or may also include birth support.

Some hospitals also offer an indigenous birthing program, which offers more flexibility in appointment times and location of appointments (hospital, home or other).

In order to graduate, student midwives are required to follow the perinatal journey of a number of women from pregnancy to after birth. Sometimes a lot of information is given in a short timeframe during antenatal appointments and this is where a student midwife may really benefit you. Students can support you by offering simple explanations of some medical advice and researching the evidence (and alternatives) on medical advice. They can answer general questions you may have during your pregnancy (eg. if exercise is okay during pregnancy) but they cannot offer medical advice. Students also provide that beneficial continuity of care, for those who are not receiving it from their primary care providers.

A student’s role is different to a doula, as they are bound by hospital policy and are limited by what they can do. However they can (and do) participate in your care by monitoring your blood pressure and baby’s growth during pregnancy, monitoring your progress during labour and administer medicines, they may catch your baby at birth, perform postnatal checks on you and your baby and help with breastfeeding - basically anything they have already learnt and practised at university. Anything a student does, it is always done under the supervision of a qualified and registered midwife or doctor.

Many women who have had a student midwife have felt well supported and were grateful for their role during labour and birth - and the best part is, they’re free! They also don’t count as a support person; this means if there is a hospital limit on how many support people you can have in labour – a student is not included in this number.

Being a birth support for a family that is birthing in hospital as a public patient is not a common role that a private midwife will take on, as this is normally the role of a doula. However, there are a few that offer this and some may agree in unusual circumstances. Most often this would occur if you were planning a homebirth with a private midwife but a transfer to hospital is required.

Commonly your private midwife would not accompany you to hospital as they do not have permission to practise there and your care would be taken over by hospital staff. However, you may come to an agreement with your midwife that s/he remains with you in the capacity of a birth support. Rarely, there are some private midwives who offer their services to act as a doula and there may be a higher cost associated with this, compared with a doula.  Although private midwives usually do not act as a birth support, it never hurts to ask.