Doula or Midwife

you should listen to or read birth stories from both sides, that’ll give you more insight on what to expect! i had an unmedicated birth, and most of my labor was great! i’ll definitely do it again. i did have to get stitches and a shot, honestly it sucked but i recovered quickly. doulas aren’t for unmedicated only, they can assist and support you in any type of birth. i had one and she was amazing, during pregnancy and birth. 100% recommend

I believe you’re more likely to tear when you have an epidural and are coached to push, especially on your back. But there’s a chance either way. If you’re birthing in the hospital you could go with a doula as they can advocate for you to the doctors. But with midwives you can birth at home or a birth center. Definitely talk to some and read up a lot.

I don’t think that’s an accurate description of a midwife vs doula. A doula is a birth support person and advocate only. They are appropriate for both unmedicated and medicated births. So basically they have your birth plan and they make sure it’s followed and advocate for you if hospital staff tries to pressure you into interventions you don’t want. they can also help support your birth partner - get food/water, step in to provide comfort measures to you along side your partner or in their place if they need a break, etc. they are basically a highly trained and knowledgeable second set of eyes and hands in the room. A midwife can function that way in certain situations but they are actual medical providers who deliver the baby. So you would have a midwife INSTEAD of an obstetrician. In a home birth setting they only oversee unmedicated births. Some hospitals have midwives who can oversee medicated births as well, but an OB would step in if any medical interventions are needed…

… such as a c-section or forceps delivery. Midwives preside over low risk births. It is very common to have a midwife and a doula because ultimately they do different things. For example, I was planning a homebirth and I had both. My doula would arrive once I went into labor and my midwife would only come for active labor. My baby ended up being breech and I had a planned c-section, so in that case I got to decide if I wanted my doula to come to the hospital or if I wanted my midwife to come and act as a doula. I had my midwife come. But that feature of a midwife acting as a doula really only happens during homebirth transfers. You wouldn’t have that happen in a hospital birth. You just get to choose if you want a midwife led birth or an OB led birth. And then separate from that you decide if you want a doula.

I’d highly recommend listening to the birth hour podcast and hear some birth stories because it will really help you get a sense of your options and what they actually look like in practice

I’d go with midwife as a more medically qualified person. Personally I’d want an OBGYN too! But I’ll tell you my reasoning in case it helps because I know there’s a lot of pressure out there to go unmedicated and I think there’s less noise online about the other side. I don’t want to scare you but if this is your first baby, it’s over 90% chance that you’ll get some sort of tear. Most won’t need stitches but even so… a graze sounds bad enough! I figured, if I’m 90-95% likely to tear as a first time mum, I might as well be numbed for it, especially if they then need to stitch me up! I had an epidural and my god, it was the best thing ever. I had all of the euphoria, all of the hormones. I was awake and aware for the whole thing but in a really chilled environment. These days they don’t coach you to push the way they used to, and there’s not really much evidence to support that epidurals make you more likely to tear. I did a lot of research and can share more info if you like.

Again, I just want to emphasize that a midwife is a care provider NOT a support person! And you can have either a midwife or a doula regardless of whether or not you want an epidural. Medicated vs unmedicated is a separate decision from doula vs no doula which is a separate decision from midwife vs no midwife/OB. A doula is appropriate for all types of births, even c-sections. A midwife is appropriate for all types of non-surgical, low risk births. Even if you have a midwife leading your care, if you are having a hospital birth there will be an OB on staff to take over should any complications arise. Typically if you have a midwife leading your care for a hospital birth you will have longer, more involved prenatal appointments which is a huge benefit.

In the UK, we have midwives only and they just do check ups, blood pressure, urine samples and they may ask you about your mental health but that's it really. I had the privilege of being referred to a no-cost doula service, and my doula advocated for me and my child, listened to my emotions, told me about natural birth and even gave me free baby supplies. It's like what @Natalie said.