The Difference Between a Doula and a Nurse at Your Birth

One of the things that I’m asked about A LOT is: 

What’s the difference between a nurse and a doula and how do they work together when I’m having a baby?

The short answer is:

Nurses take care of the physical and medical needs of your entire body. Doulas take care of your physical needs, too- but only from your waist up and they never provide any medical care. They also give you emotional support that nurses simply don’t have the time or training to give you.

Things a nurse does during labor and delivery:

🩺 Monitor vital signs for you and your baby

🩺 Cervical checks as needed

🩺 Administer medications as needed

🩺 Monitor epidural

🩺 A butload of charting

Things a doula does during labor and delivery:

✨ Massage, pressure points, guided relaxation

✨ Suggest position changes to help keep labor moving along

✨ Patterned breathing with you to manage contractions

✨ Remind you to eat and drink

✨ Remind you how fucking awesome you are

Seems like a marriage made in birth heaven, right? But be warned, mama- sometimes there’s trouble in paradise.

I'm a nurse. I'm also a doula. It’s a weird fence to straddle sometimes because both have their own culture. When wearing my nurse’s hat, I’ve heard the snide comments from other nurses about doulas. In my doula work, I’ve heard countless complaints about the “bitch nurses” at their local hospitals. 

But I’m different. I have my feet firmly planted in two different worlds, which means that I’m skilled at taking care of you clinically and emotionally.

It also means that I’m a bit of a ‘fly on the hospital wall’ when I hear things like,

Oh, yay. I'm gonna spend my 12-hour shift explaining everything twice because she brought a doula.

Or

The doula in room 4405 asked the doctor if she could suture a patient's 2nd degree tear.

-because sometimes nurses forget my skill set. (btw- I'm not saying that a doula didn't ask to suture- but if you're a doula reading this it's not in your scope of practice so never ask to do that, ever.)

And I’ve heard comments from doulas like, 

Her nurse insisted on the epidural and then left mom in bed to watch her progress on a computer monitor in the nurses' station. 

And

Her nurse laughed at her birth plan and said it was way too long.

(btw- it's not cool for anyone to laugh at your plan, but nurses don't have time to read a binder. That's why I've created a new tool that asks you a few questions and generates a custom made birth plan for you! Cool, right?)

Quite frankly, I'm tired of it all. I get it, I really do- there’s always gonna be people working in positions where they really shouldn’t be, and nursing and doula work is no exception. 

What I’m really tired of is the distrust in the medical community as a whole and I'm sick of doulas being fluffed off as "hippies". All of this is is hurtful to YOU, the woman giving birth.

The truth behind the nurses vs doulas debate

People have preconceived ideas about things like birth and breastfeeding before they choose their careers, based on their family history and their own experiences. That means that everyone who supports you in childbirth comes with their own set of biases.

For instance, not all doulas believe in breastfeeding a 5 year old. Not all nurses believe it's weird to breastfeed a 5 year old. 

Having a nurse in the hospital is inevitable.

When you choose a hospital birth, you choose to have a nurse attend your birth whether you have a doula or not. Everyone knows that if you go into the hospital to have your baby with a family doctor or an obstetrician, you’ll be assigned a nurse. Remember: this is a clinically trained professional who has policies and procedures to follow that are mandated by an employer: the hospital. Nurses also have to follow Standards of Practice based on our governing body, The College of Nurses. We’ll bend rules to suit your' needs whenever we can, but we are accountable for every decision we make and that means our careers are at stake.

Having a doula at your birth is your choice.

When you choose to hire a doula, you’re choosing to have uninterrupted support and information. I can’t tell you how invaluable that is, especially if you’re choosing an unmedicated vaginal birth. (Which, by the way, is the SAFEST way to have a baby based on the very best evidence) Doulas are specifically trained in areas that nurses aren't. Nurses don't have the time in their 12 hour shift to perform the clinical tasks that their employer and the College of Nurses requires AND to provide the supportive care that a doula can. It's just not possible.

When you assemble your birth support squad, you inherently know what’s best for you. You know where you’re gonna need support and you’re proactively prepping for the biggest day of your life. Listen to your gut and believe it!

(RELATED: Do I REALLY Need a Doula?)

Doulas may not always realize the realities of a nurse's job, and nurses don’t always trust doulas to do what's best for laboring women. That’s a power struggle between nurses and doulas and it should have nothing to do with you.

Building trust

But when you’re considering hiring a doula it’s important to remember this: you’ll have weeks to forge a trustworthy relationship. You’ll have time to discuss and strategize your birth. You’ll have the opportunity to interview different doulas and choose one that you click with. You won’t have that same luxury when you land in the hospital in labor; you’ll end up with the first nurse available on that shift.

When you’re interviewing doulas, ask about their relationship with the staff at the hospital where you’re having your baby. Ask them about the culture there and how open they are to having doulas on the unit. Be wary of terms like, working on it and it’s getting a bit better. Keep looking until you find a doula who is proactively forging a positive relationship with your local hospital.

(RELATED: Twenty Questions to Ask in a Doula Interview)

You can’t really choose your nurse. But you can choose a doula, so choose wisely Mama.

Post Gallery