• The Fit Midwife

Is the Doula culture in the UAE preventing the development of a Midwifery culture??

Can you tell which one is the midwife and which one is the doula??

Thought not.

Haven’t you heard a lot recently about all the differences between us? Because that is all I am hearing of late. I am positive I will receive some scrutiny for this but since when did that ever stop me.

First let me say this is in no way an attack on Doulas. Some of the best women I know are Doulas and they support women incredibly well and I would recommend them without hesitation.

But I (alongside many Midwives here) am getting a little bit worn down recently at persistently hearing how a Doulas role is “to provide emotional and psychological support” or “to serve the mother”. Pretty sure we do this as a midwives too…..

And whilst I am a huge advocate of Doulas I am beginning to realise the UAE has a Doula culture in lieu of a Midwifery culture. The gap in care is being filled but not particularly to its full or required potential.

Is that bad? Well…. not quite. Happy women and positive outcomes are the desired goal. But we are finding ourselves facing a loss of faith in midwives here in the UAE. As well as a loss of faith in midwives it can also create a loss of faith in the Obstetricians. Now we all know I am the first midwife to call people out if their care is sub par and of a selfish nature but I am also the first to admit when the sh*t hits the fan that I need a doctor and their skills!

The gap in care here has been filled by Birth Support Workers because as Midwives and Health Visitors our professions are neither valued nor respected by official legislation, by institutions, or even by other medical individuals. If we are not trusted by the ‘powers that be’ or by physicians how will women ever trust us? The fight is not with doulas. As they should always compliment our profession and vice versa. But of late we find ourselves being passed over for them.

The reason Midwives are so important is because a part of HOLISTIC care is physical/clinical. That is imperative in the pre and postnatal period and Midwives are quite literally experts in this.

I have stayed for a full 24 hours to support women. Spent 12 hours in a room. Rubbing backs, assisting their birth choices, supporting, talking. Midwives do this. The good ones do anyway.

There needs to be a huge change in the UAE. The midwifery culture needs to be allowed to develop. The belief that midwives cannot provide emotional and physical care needs to be thrown out.

But how do we do that? Well the UAE hospitals are finally catching up and realising that there is a huge gap in care. They have launched home healthcare visits, postnatal visits, antenatal education. But what they really need to offer is continuity of care. Someone, somewhere has to have the lady balls to push for more autonomous midwifery care.

Again, I am not against Doula’s. I refer many women to them. Because in reality they met a much needed demand from women who needed support. And that is something invaluable. A doula’s role should be to encourage and foster the relationships between herself, her clients and her clients caregivers. There should be multidisciplinary working between all parties involved to enhance the woman’s birth experience.

But please, on behalf of all the midwives who really care, please stop saying “Doulas provide emotional support and midwives provide physical/clinical support”. We train hard and work hard to ensure both needs are met and we take great pride in doing so. We don’t always get it right but that does not mean we are incapable or unwilling.

Ultimately what we know to be true is developing a midwifery culture here in the UAE is unequivocally going to be the turning point in maternity care. Improving outcomes all round and empowering all birth workers alike!

Nikki xx

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