Many people assume that midwives and doulas play the same role—but they don’t. Each provides unique and valuable support when it comes to women’s health and pre- and postnatal care. In this episode of HEALTH Yeah!, experts explore the distinct roles of midwives and doulas and how both contribute to the comprehensive care offered at Stony Brook Medicine.
The Experts
- Rakiya Watts, CNM, MSN
- Heather Findletar Hines, DNP, CNM
- Noelle Beutler
What You’ll Learn in This Episode
- 00:00 Opening and Introductions
- 1:57 The journey to becoming a Midwife or a Doula (education, training and certification)
- 3:16 Midwife and Doula support during pregnancy, labor and postpartum
- 8:08 Supportive partners versus the support of a Doula
- 9:08 Comprehensive, well-rounded care
- 9:58 Doctor – Midwife collaboration
- 12:08 Pain management
- 14:37 Facilitating labor and delivery with additional support, guidance and resources
- 17:07 Reducing C-Sections at Stony Brook Medicine
- 18:40 Midwife and Doula support for a variety of birthing preferences and plans
- 25:10 Doula partnership at Stony Brook Medicine
- 30:30 Patient anecdotes/case studies
- 35:59 Closing Remarks
Full Transcript
00:00 Opening and Introductions
Announcer
Welcome to HEALTH Yeah!, where experts from Stony Brook Medicine come together to discuss topics ranging from the complex inner workings of an infectious disease to tips and tricks for staying safe and healthy all year long.
Rakiya Watts, CNM, MSN
Hello and welcome to HEALTH Yeah! My name is Rakiya Watts, licensed midwife and Midwifery Division Director right here at Stony Brook. Today, we will be having a conversation with the community midwife and doula, discussing the type of care that each of these professionals provide.
A common misconception is that midwives and doulas are the same, when in fact, they are not. Midwives are licensed healthcare professionals who provide holistic and patient-centered medical care during pregnancy, labor and the postpartum period.
Doulas, on the other hand, are non medical professionals who offer emotional, physical and educational support to the birthing person and their family throughout pregnancy, labor and the postpartum period.
I have two friends here with me today, and I’d love for them to introduce themselves, Heather?
Heather Findletar Hines, DNP, CNM
So you know me, but if other people need to know me also, I am Dr. Heather Findletar Hines. I am a doctorally prepared midwife who earned her Doctorate and Masters here at Stony Brook. I am a clinical associate professor and a community midwife that does both hospital birth, here at Stony Brook, and home birth.
Noelle Beutler
I’m Noelle Butler, and I am a community doula. I do birth and postpartum work. I also do placenta work. I’m a childbirth educator with Stony Brook, and I run the doula partnership program together with you two. Happy to be here.
1:57 The Journey to Becoming a Midwife or a Doula (Education, Training and Certification)
Rakiya Watts, CNM, MSN
Yay. So Heather, let’s start with you. Can you talk about your education, training and certification that was required to become a midwife?
Heather Findletar Hines, DNP, CNM
So in the United States, there are a few paths to get to Midwifery, but for credentialing purposes, you can either be a certified nurse midwife or a certified midwife. Those individuals need to be Masters prepared, and then they need to take a certification exam through the American Association of Midwifery Credentialing, and they also need to be licensed within their state to be able to practice their midwifery.
Rakiya Watts, CNM, MSN
Beautiful. And Noelle, same question for you, what was the journey to becoming a doula like?
Noelle Beutler
So I went through a certification program, which many doulas choose to do. I think now, more than ever, it’s more important to be certified because there are some hospitals that require that certification before you can gain entrance, and it’s usually just a three day training, and then you’re doing your readings, you’re submitting your book reports and then supporting clients, as like your first steps into the birth world, where you write up a little birth story on them, and then they write a review on you, and then you get your certification.
So it can take, I think, up to six months, but certifications usually allow for about 12 months to a year and a half.
3:16 Midwife and Doula support during pregnancy, labor and postpartum
Rakiya Watts, CNM, MSN
Now what many people may not know is that you can have a midwife and a doula support you on your birthing journey. Heather, can you talk about how a midwife provides support during pregnancy, labor and the postpartum period?
Heather Findletar Hines, DNP, CNM
Absolutely, but I think I’m going to need your help on this because I’m going to take it from the community aspect, and then maybe you can help me with the hospital aspect.
So with regards to, we’re talking about midwifery care in the community, it’s that full prenatal care, right? It’s that, you know, pre-conceptual counseling, it’s that education of nutrition. It’s the what to expect when you become pregnant.
It then launches into the routines of coming for visits, scripting for sonograms, spending time with the patient, really unpacking the process of you know, have you had any trauma? Is there anything that makes you anxious? How is your family treating you to help mitigate some of those issues, to help your birth process be better.
We give people sonograms, like all people do. We refer people to pelvic floor or a chiropractor for care. We also, some of us deliver in homes. Some of us deliver in birth centers. The care that we give is well rounded. It’s evidence based, and it’s scripted for the patient individually. I always say the care that we give in the community, it’s like knitting little booties for each patient. We don’t cover everyone with the same blanket. We make it specialized for that patient.
Now tell me about what you guys do in the hospital.
Rakiya Watts, CNM, MSN
I love that – Little booties. Here in the hospital, we try to do the same thing, just in a different setting. So we build relationships with our patients, we spend time, we answer questions, we view pregnancy as a normal life event, right? Not pathology, not an illness, and we continue through the pregnancy and labor and birth with that same mindset.
I think that midwives were considered natural birth, normal birth experts, and whether a person decides to birth at home or in a birth center or at the hospital, the care we provide is pretty much the same.
Heather Findletar Hines, DNP, CNM
I would definitely agree with that.
Rakiya Watts, CNM, MSN
You brought up a great point. So when someone sees you for a birth, they also can see you for the prenatal care. They’re not just meeting you at the end for a birth.
Heather Findletar Hines, DNP, CNM
No, as midwives, we want to develop relationships with our patients that helps to fortify their process of delivering. Delivering is a sacred process, and I think, over the years, meeting your provider at the bedside causes anxiety. And I think with midwifery care, that makes it so unique, and then adding a doula to that, where we’re going to hit Noelle with, meeting your midwife, knowing your midwife, spending time with your midwife, develops trust. And I always say, when you have trust, the vagina opens, and that helps a baby to come out.
So it’s that relationship that we build that helps our patients to be successful.
Rakiya Watts, CNM, MSN
Thank you. And Noelle, I mean, I think that also there’s maybe a misconception where people feel like doulas are only present for the birth. Is that when you’re meeting a client for the first time, or do you meet them prenatally?
Noelle Beutler
Definitely, 99 percent of the time, not at the birth. Yes, we do like to create a relationship with our clients beforehand so that like Heather said, like you said, that we feel comfortable, right? We have that relationship with them. We’ve already done education with them prior to.
So I typically see my clients three times before they deliver, and we’re getting to know the family. We’re getting to know the other kids. We’re talking everything childbirth. We’re answering questions. We’re helping them navigate their plan, right?
And then yes, we are with them continuously – a key point of a doula is that continuous support, so from start to finish of their labor to that immediate postpartum time, we’re there to help answer their questions, to help get them to move into different positions, because nurses, they’re busy, they’re not in the room all the time. So we’re there to get them moving, to keep them moving, to help them think of questions they have for their providers, to get the partners involved, to allow the partners to take a break and just hold space.
And then we do postpartum visits as well. So we check in with the client postpartum when they’re home, then maybe two weeks after, and just to make sure that their lactation journey is going well, they don’t have any questions that they need answer or navigation, or people to point to, referrals, things like that. So we have that like full circle care from start to finish, as midwives do.
8:08 Supportive Partners Versus the Support of a Doula
Rakiya Watts, CNM, MSN
That was beautiful. And you know, you touched upon the importance of getting to know family, and I think that’s something that can be missing when someone is coming to an office setting. So I thought that was beautiful.
And you also mentioned, so someone can have a supportive partner and still need a doula. Can you talk a little bit more about that?
Noelle Beutler
Oh, absolutely. We’re definitely not there to take the partner’s place. I will say that I have had clients that would prefer my hip squeeze over their partner’s hip squeeze. But we’re there, we’re supporting everyone, right?
Seeing a partner labor can be difficult for the supportive people, right? So we’re there to kind of make sure that, to let them know that everything is going well, right? This is how it’s supposed to be. We’re getting them involved with any comfort measures. I love tag teaming hip squeezes and counter pressure, because my arms start shaking at that, you know, minute mark when we’re doing things.
So, yeah, we’re definitely not stepping on toes. We’re there so the partners can take a break, get some fresh air outside, come back in. The birthing person is never left alone, right? So we’re there as a full team to have the best birth possible.
9:08 Comprehensive, Well-Rounded Care
Heather Findletar Hines, DNP, CNM
One of the things that she said that I think we should really touch on is you said that nurses are busy, right? Nursing in America is busy, and I think that we all need to share space with our patients, nurses and providers, so that we’re giving well rounded care, right?
Nurses are doing their charting and medication, doulas and support people are supporting. And we need people holding every appendix right, like someone’s holding the right hand, someone’s holding the left hand, someone got the foot because we’re trying to usher people into a safe space, and we need a community to do that.
So I think it’s, we need to give over territorial and start becoming a community, right with regards to taking care of our patients.
9:58 Doctor – Midwife Collaboration
Rakiya Watts, CNM, MSN
Beautiful. Doulas are part of the team, for sure.
Because midwives provide medical care, where does a doctor come into play? Are doctors involved if midwives are involved in the care?
Heather Findletar Hines, DNP, CNM
So you’re going to help me with this one again, because as a community midwife, doctors for me come into play if my patient falls out of that low risk setting. So if my patient maybe has a sonogram, that might need a follow up or something. I need a physician who is trained in complications or highly trained in surgery to help me make a good plan for my patient, an evidence-based plan.
So for me in the community, collaboration might be my patient has a prior history of thyroid dysfunction or has a parent that has a clotting disorder – is this a good candidate for someone that I could see in the community? The last sonogram said, A, B, C, D, E, F, G, is this okay? When should I follow up?
I think that as midwives here in New York, we have a really good place and collaboration with our physicians, and it helps us to give well rounded care for our patients, meaning our physicians can help do that medical management, and we can help educate and support that, and ultimately help our patients to have a vaginal birth. So collaboration for me is very important because it allows me to support what the patient wants, present to my physician in a way that he can understand what the patient’s needs are, and then come back and really give a comprehensive plan of care.
Rakiya Watts, CNM, MSN
Beautiful. So what you’re saying is midwives can take care of patients who are not just low risk when you have the right type of relationship with a collaborating physician?
Heather Findletar Hines, DNP, CNM
Correct, like your relationship here at Stony Brook, right?
Rakiya Watts, CNM, MSN
Very true. I’m very fortunate with our practice here that we are independent, but when a complication arises, we have the support of high risk physicians of maternal fetal medicine physicians, and sometimes we are able to collaborate, right? So sometimes that care gets transferred, and sometimes it’s exactly like you described in the community, where they see us for some, they go for a consult, maybe have a few more sonos, but then they still have access to midwifery care.
12:08 Pain Management
Let’s debunk some myths now, because there happens to be a lot of misinformation out there about midwives and doulas. Let’s see, a myth is that midwives can’t handle medical interventions or prescribe medications.
Heather, can you talk to us about options for pain management with midwives?
Heather Findletar Hines, DNP, CNM
So we’re going to talk about it in the hospital setting. Okay, you don’t want me giving you your epidural. I am not trained in that. I have no medical background in that. But as midwives, we are independent practitioners that can order a medication for which a nurse would give, so if you wanted a pain medication, we can order that. If you were feeling nauseous and needed something to help decrease your nausea, we can order that and your nurse can give that to you.
In the community, if you’re in the community, your doula is your medication, so I can write you a prescription for that, and you can have a doula help you.
So the first one to debunk, midwives have full prescriptive privileges. That means you can get birth control from us, you can get a pain medicine from us, you can get something to treat an itchy vagina. We can give you that, so that’s the first one that’s checked off: debunked.
Rakiya Watts, CNM, MSN
Debunked. All right. Now, Noelle, I know that you’re not a medical provider. You’re not prescribing medications. So what can you do as a doula to help with some pain relief?
Noelle Beutler
Lots of comfort measures. So when a person is delivering in the hospital, we usually start at home, and when they’re laboring, I come to their home, and doulas can help them move because movement, surprisingly, can help with labor sensations.
We have options like their shower, their tub and then just resting in their own bed can be a comfort measure, right? But then we’re also doing hip squeezes. We’re doing counter pressure. We come with our bag of goodies that we whip out, and we’re just, you know, doing whatever feels best because if it doesn’t feel good, then we don’t want to do it.
So we’re doing whatever feels best for them. And sometimes when you’re navigating labor in your home, it’s much easier than navigating labor in a place that you don’t know, right, it doesn’t feel familiar to you. So then when we make that transition, we can set up the room right with nice lights and affirmations, dim everything, put on soft music so that they can kind of find that rhythm again until they are requesting more pain management.
So we’re kind of delaying it with a hope that maybe we won’t need it at all, but it’s there for them if they need it.
14:37 Facilitating Labor and Delivery with Additional Support, Guidance and Resources
Rakiya Watts, CNM, MSN
Beautiful. You mentioned a bag of goodies. What’s in your bag of goodies?
Noelle Beutler
I have lots of things in my bag of goodies, starting with a nurse favorite, extra long bendy straws. But I have massage walls that have spikes on them. I have a birth comb. I have a rebozo. I have a 10s machine. I have honey sticks, organic lollipops, if we need that pick me up, some essential oils for people who are routinely using essential oils, because we know that in labor, our senses are heightened, and we might not want to introduce that if it’s a scent that they’re not used to. Let me think, what else? Affirmation cards, fairy lights, yeah, and we set up the room nice.
Heather Findletar Hines, DNP, CNM
One of the things that you said that was just, I think that we need to really highlight is movement is medicine, right? And I think it starts prenatally, right? Rakiya, like, when we see patients, people are like, can I work out? Yes, the American College of Obstetrics says please work out during pregnancy, right?
But we need to keep moving right, because if you don’t move, what happens? You get stiff, and in early labor, you don’t want to sit in the pain. You want to move through it. You don’t want to sit in discomfort. You want to move through that because that actually helps to facilitate Cardinal movements, the movements of the baby coming down the pelvis.
As midwives, we know that movement helps that baby to do that labor dance, right? And then, if you’re at home or in the hospital, movement can also help ease some of that discomfort, so you having all those goodies, and us knowing to move, that’s what makes midwives so great at helping get babies out. Because we know that you can’t stay by yourself, you need a community, and the fact that you also need to have, you know, movement to make things work best.
Rakiya Watts, CNM, MSN
I love it. So the movement is for both of us.
Noelle Beutler
Yeah, to add to that as well, when we do cross that line, and we do have that epidural at Stony Brook, it’s really great because we can still move, right, like that epidural is just taking away the sharpness and the edge of the contractions, and you’re still feeling the pressure, so they’re still able to move their legs right so we can get them into different positions. We’re using the peanut ball. We’re still getting them to move, to facilitate that baby coming down in different positions that they might not have realized they could do with an epidural, right?
I’ve got clients squatting, on all fours, right? The only thing they can’t do is get out of the bed.
17:07 Reducing C-Sections at Stony Brook Medicine
Heather Findletar Hines, DNP, CNM
That’s right. Rakiya, what are we doing now at Stony Brook, everyone’s getting trained on what’s that, spinning babies, right? So can you tell us a little bit about that initiative and stuff that’s going on here that people in the community should know? The people at Stony Brook are 100 percent committed to getting babies out vaginally.
Rakiya Watts, CNM, MSN
That’s right. So when both of you are talking about the power of movement to decrease pain and also to help that baby get out, spinning babies is just a culmination of all of that. It is intuitive movement. It is movement that can be started prenatally, where you can get someone out of bed, someone who maybe has a job where they’re working from home, or they’re in a seated position, and you can get them moving, moving on a birthing ball, some positions for side lying, release.
And then we take all of that information when they come to the hospital, and we can continue to help them move. And the beautiful thing about what’s going on here at Stony Brook is not only were midwives trained and doulas trained, and the three of us were trained, but our labor and delivery nurses were trained.
So this is just the culmination of teamwork, where the doula maybe is starting at home with spinning babies. Actually, let’s go back. The midwife during a prenatal visit is talking about some spinning babies movements. Then the doula comes to the house and does some spinning babies with that client. Then that client comes into the hospital and their labor and delivery nurse can help.
I mean, it’s a beautiful thing, and it really does help babies find that optimal position to come out.
Heather Findletar Hines, DNP, CNM
Correct? Movement is medicine.
18:40 Midwife and Doula Support for a Variety of Birthing Preferences and Plans
Rakiya Watts, CNM, MSN
Movement is medicine. Noelle, a common myth about doulas is they only attend natural births. I know you talked a little bit about this, but is this true when you’re preparing a client prenatally, are you only preparing them for an unmedicated birth?
Noelle Beutler
Absolutely not. We’re there to cater to what they want. This is their story. It’s not my story. So I’ll provide them with the education that’s required or needed or asked for, so that they can navigate their plans with their providers, and then know what their options are when we get to the hospital. And then when we do have pain medication, like I said, we’re moving, we are moving. Sure you can take your nap right, because when we’re in labor, we need to take our nap and rest. But otherwise, we’re moving through these contractions. And we’re utilizing Stony Brook’s peanut ball, Stony Brook’s birth ball. And I think now there’s the cup stool.
So we’re using everything, every tool that we can get to facilitate a nice, smooth, easy labor with an epidural. So absolutely, it’s never just natural birth. It’s whatever birth the client wants, and they might plan for a natural birth, but birth plans change and end up with an epidural. So we’re educating all aspects of labor and delivery.
Heather Findletar Hines, DNP, CNM
You know, the other day we were talking, and you educated me on something that I didn’t even know. So as a midwife, I fight for all vaginal births, but I had two C-sections.
Noelle came in the other day and was someone’s postpartum C-section doula. Can you tell us about that? Because, listen, I would have had six of those.
Noelle Beutler
I mean, it was a fabulous idea. She reached out to me and was looking for doula support in the hospital because she had a young toddler that she wanted her partner to go home to take care of. So she called me in and I cared for her baby while she, you know, rested, got good rest in the hospital, was cared for by her nurses, and she didn’t have to get up once to care for the baby.
Heather Findletar Hines, DNP, CNM
I don’t think people know about that. That’s why I want to highlight that with this doula partnership that we’re doing here. If someone knows that they’re going to have a scheduled C-section and they’re already worrying about, oh my goodness, how am I going to do A, B, C, D, E, right? Hon, you can go home with the baby. I hired Penelope to come up and spend the night with me.
They got that support that helps with breastfeeding, right? It helps with someone negotiating, bringing the baby from the bassinet over to the bed. And the thing that you said that really helps healing is the rest, right? Imagine having someone that’s there to support you during that time where you’re feeling the most pain, that support helps decrease the pain, and then they’re resting. So guess what? It might help to decrease postpartum depression or anxiety. It might even let the milk come in. So I think that’s really a great thing.
Rakiya Watts, CNM, MSN
Yeah, it’s fabulous. I love it. So doula for birth, doula care starting during pregnancy and sometimes separate doula care postpartum. I love it.
Question for you, Heather, so when someone comes to see you in the community, do you talk to them about planning for an unmedicated birth?
Heather Findletar Hines, DNP, CNM
I talk to them about planning for everything. The thing that I think that’s so funny is none of my patients have birth plans because I spend all my visits talking about their wishes. We do a lot of unpacking, right? Because once you get pregnant, you’re going to have a baby, you need a new suitcase, so you got to unpack that suitcase so you can now fill it up with some other things, right?
So we talk about methods to help them achieve, ultimately, people in the community want to have an unmedicated birth. How are we going to get there? You can’t just wish upon it. You have to educate yourself on it, and you have to have the right team, meaning you have to have a doula, you have to have a midwife that’s capable of doing it. And then you need family members that support you.
And if you don’t have one of those aspects, it’s gonna be pretty hard, right? And I think one of the things that’s great for me is I get to know what my patients want. So if you told me that your mama wasn’t gonna be there, if I pop up and your mama’s there, guess what? Girlfriend, can you go out and get a bagel? Right? Like, can you go get something? We gonna get the baby out before your mama gets back.
But I think that’s one of the things that’s really great about being in the community is you get to know your patients so intimately that I literally was with Noelle in the office the other day, and my patient took an inhale, and I was like, what’s wrong? Right? Because I understood her body language. So when people are about to enter a difficult conversation or something has sparked a memory, they take a breath to ground themselves. I was very grateful for that moment that I was able to see that. Because sometimes, when you’re busy at a place and you don’t know the patient, if they take that breath, you might have missed it. And that was an opportunity where you could dive in and get that trust going.
Rakiya Watts, CNM, MSN
Beautiful. I mean, birth plans. Hot topic, hot hot topic, do patients come to you Noelle, to develop birth plans.
Noelle Beutler
Listen, I am a big advocate for birth plans, but not because of what many people think. I want people looking at all of the free birth plans that are online and then going through everything and checking off what they don’t know. What is this? What does this mean? What are the ingredients in that? And then going back and doing the research or asking their provider the question, because if they don’t know what’s going to be happening to them, what’s going to be offered to them, what’s going to be offered to their baby, how do you make a plan? How do you go in with an informed choice.
Heather Findletar Hines, DNP, CNM
Oh, that gave me chills. That’s dope. Listen, my patients don’t have a birth plan, but I like that. You should use that one, Rakiya, that’s a good one.
Rakiya Watts, CNM, MSN
I think I am gonna use it. And the funny thing is, what I say is, I don’t like to call it a birth plan. I like to call it a birth wish or a birth preference, so that we can talk about what you think you might want, what you heard, what maybe your mom suggested, and then be flexible about it, right?
Because sometimes when you say a plan, it sounds like it’s set in stone that that’s it. When you say a preference or a wish, it’s like, if this could happen, I would want this to happen, but if it doesn’t, I’m going to be flexible. And we all know midwife, doula, we have to be flexible when it comes to birth.
Noelle Beutler
Yes, parents have to be flexible too. Because there is a tiny passenger that is going to dictate a lot of their birth.
25:10 Doula Partnership at Stony Brook Medicine
Rakiya Watts, CNM, MSN
Noelle, can you talk to us a little bit about the doula partnership program and what you and Heather are doing here at Stony Brook?
Noelle Beutler
Yeah, sure. So we started this doula partnership back in April, I think it launched. We have flyers in the offices, so patients can scan a QR code, and then they fill out a registration form. It comes over to me, and it’s a matching program. So they’re filling out five qualities about them. Our doulas have filled out qualities about themselves so that we’re kind of matching.
We’re overlapping, we’re sending them three doulas that we think would resonate, and then they interview. We have a set budget. Doulas that are on our list cannot charge more than a certain amount, so that it’s even across the board. But then we also work in their budgets, the patient’s budgets, so that they can have access to a doula that maybe they thought was too overwhelming to search for one in their own time.
So we connect them, and we hope for the same as an outside would do, right? We’re hoping that they’re doing prenatal appointments, right? Prenatal meetings, they’re bringing them for the labor and birth, and that they’re doing postpartum visits as well.
In that aspect, if the doula partnership, we do have a lot of clients who don’t see it right away, a lot of patients, and they’ll scan the QR code, and they’re coming in late, right? So they might not have as many visits with their doula beforehand, but they’re still being supported beforehand, during labor, birth and postpartum.
Heather Findletar Hines, DNP, CNM
And I think to add to that, the best time for people to establish the doula is around 20 weeks, right? They’ve had that anatomy scan. They know their baby got ten fingers, ten toes, and it gives the opportunity to space the education and support. So it really helps us support them, you know, until postpartum, into the end.
I think what we need here at Stony Brook is we want every patient to have a doula, right? So our opportunity for our partnership is people that might have not obtained, like Noelle said, a doula, can get a doula. But there are private doulas. They have the Long Island Doula Association, the National Black Doula Association. There are private doulas all over the place.
What we have is an ability for patients at risk who need doulas to really have it. And I’m grateful to the people that we have in our offices that are helping to push this initiative so people can get support.
Rakiya Watts, CNM, MSN
Beautiful. Yes, and our Stony Brook doulas, how are they different from a private doula? Do they undergo different training, different credentialing. What’s the difference between a Stony Brook doula and a private doula?
Noelle Beutler
We do vet the doulas. We do make sure they’re certifying, right? So we do accept the newer doulas who are looking to come on board and get their numbers and just be a part of the partnership.
We’re hoping to offer a mentorship soon, but then, yes, we are checking their credentials to make sure that they have their certification. They have to have malpractice insurance, liability insurance, and then we get to offer them trainings, they’re signing up with us. So we’re doing spinning babies in December that they can sign up for, and we’re hoping to do a skills class coming up soon for postpartum.
Rakiya Watts, CNM, MSN
That’s lovely. I mean, it definitely sets them apart from a private doula. The fact that there’s that continuing education piece, that there’s that vetting piece, so people can come to the two of you and say, hey, we had a wonderful experience with doula so and so. Or, hey, we had an experience with doula so and so and we weren’t too sure. I love that there’s that accountability piece with our own doulas.
And then this information from the doula project, do we have plans for future research with the information that’s gathered?
Heather Findletar Hines, DNP, CNM
Absolutely, I think one of the major looks that should be is the patients that had doulas, do they have better births? Do they have a vaginal birth? Right?
We already know that research states that people who have doulas, they have shorter labors, less use for pain medicine, more bonding and breastfeeding, and lower incidences of postpartum depression.
But how do we use that at Stony Brook, like did our patients here at Stony Brook have better births? Do they have vaginal births? Did they have better C-sections because maybe now we’re using them for postpartum C-section care. Are they breastfeeding? So I think we once we get to April, we able to extrapolate some of this data and say that our little 10 percent helped to make, you know, decrease our C-section rate here at Stony Brook, that would be phenomenal.
Rakiya Watts, CNM, MSN
Yeah, the C-section reduction is a huge initiative, and I love that we’re going to be able to gather some information from this program. And, you know, I’m curious, are we going to have less incidents of postpartum depression, right? So there’s so much potential for research with this initiative, with the doula program, and I’m excited to see what the numbers show us. Especially, listen, you can have a doula and a midwife at Sonia Brook? Why would you go anywhere else?
Heather Findletar Hines, DNP, CNM
A team.
30:30 Patient Anecdotes/Case Studies
Rakiya Watts, CNM, MSN
It is the A team. And before we wrap things up, can you two share some stories of some successful relationships between doulas and midwives. Some, you know, great birth stories where there was a doula and a midwife involved.
Heather Findletar Hines, DNP, CNM
So I’m going to take my aspect in the community. In the community my first time birthing people, people who’ve never had a vaginal birth, or someone who’s never had a home birth, has to get a doula. That’s just my standards. Everyone knows it on the street, because you need an A team and able to do it at home.
Y’all don’t want me see me coming up here, transferring my patients because they weren’t successful at home, so I have to have a doula. Noelle knows that, right? All the people in the community know that, because what happens is, first, they’re supported by their doula, they are trusted by their midwife. They know their midwife, and they know their midwife has them. And then they have vaginal births.
Last week, I had a beautiful home birth. This patient, I knew her, she taught me yoga. So everyone in the community knows that I teach yoga, and I have to hold my rep up with my yoga people. Her first birth, she wasn’t successful at home. She needed some pain medicine. That was back in 2023, she came and she had done an epidural, she had her baby, she had her doula, same people, same scenario. Everything was fine. She was happy.
She got pregnant again, and she had the same doula, and she did some education, she had her midwife, and she had a supported birth, right? So it’s good to know that the team worked, and sometimes you need to have a hospital birth and have a vaginal birth, but knowing that your body is fully awesome, and you can have a vaginal birth. So for me, doulas make my life easier. Sorry they do, but it also helps to support the patient. And ultimately, it’s not about me, it’s about the patient, right? So if a patient can have a great birth, we have to have a team with a midwife and a doula.
Noelle Beutler
I think if I’m sharing experiences, my favorite experiences are with clients who are going in expecting to get an epidural, but then decide not to, and decide to push it off, and anesthesia will come in. And, you know, we’ll have anesthesia in the room, and they’re no, no, no, not yet, not yet. Just come back in half an hour, please. Anesthesia leaves, and we rock and roll for a few more hours. And then they opt in to the epidural. They get their epidural, and then their baby comes flying out.
And it’s just so beautiful to see somebody who was, nope, I’m going to the hospital. I’m getting the epidural, and then to be like, no, no, I think we’re good. We’re good. We got this. And then, you know, sure, you opt into the epidural, right? That’s fine. You’re still doing what’s right for you, right? And then they have their baby, and it’s just beautiful, and they’re happy, right? Because that’s what I care about. I don’t care if you have an epidural. I don’t care if you have a bellybirth. Obviously I do, but I want you to feel that you were supported through each decision that you made, and happy with the outcome, right? And happy with the path that you chose. So I think those are my best client experiences.
Rakiya Watts, CNM, MSN
Beautiful. I feel like I’ve had a few, probably more than a few, beautiful experiences, hospital births with doula and midwives. But what comes to mind as maybe one of the most special memories was actually a patient who started with the midwives, and then, unfortunately, risked out of care. So someone who was looking for that holistic model of care and then, because of a reason outside of her control, was no longer appropriate. But she got a doula, and this doula was with her through her complicated pregnancy, and towards the end of pregnancy, little bit before she was scheduled for an induction, this patient reached out to her doula, who she trusted, and told her about an elevated blood pressure.
You remember the story Heather? And that doula said to the patient, you need to call your provider. You need to call your doctor. I think you need to the hospital, and the patient called, and she came in and ended up having her baby. So one of the things that just speaks to me in that is the power of having someone with you the whole time, right? This is someone who went into the process thinking she was going to have a midwife, and though that didn’t happen, she had the support of a doula who was there for all the education, and then was the one who said, you know what? Gave her that nudge. I think you should call the hospital. I think you might need to go in.
And it just shows that doulas can be present even for a high risk risk pregnancy, even if the patient is not having a midwife as a provider. Because I know we spent a lot of time today talking about midwives and doulas, because that’s who we are. But even those who need a doctor, who end up with a surgical birth, can still benefit from doula care. And that just it meant a lot to me, and I want to say it probably meant a lot to those doctors, right? Because here they are saying, oh, it was your doula who told you to come in. And actually, I heard from one of the doctors, and it was a moment of maybe surprise, and then pride in the okay. You know, I love that you had someone with you, maybe for support, but it was them and their nudge who actually helped you in terms of a medical decision. So that’s one of the stories that I hold dear, and it just highlights the beauty of the work that we do here at Stony Brook, where we can give, you know, all the care, the higher risk, the things you can do, none of the things, and you can have the support of a doula the whole time.
Heather Findletar Hines, DNP, CNM
Doulas are really great because their eyes on the ground, and I think we need to think of them as that. They’re not a substitution, they’re an addition, right? So if we get a ice cream sundae, right? We get the ice cream, we get the whipped cream, we get the cherry on top. The doulas are the whipped cream, and the care that we give is a cherry on top. We got to put it all together so that we give that whole great Sunday that we love to enjoy.
And I think that because Stony Brook is doing it, this process, it’s really going to be a model for how we should be having care in the community, right? And I think the thing that you took away from that last statement was the fact that doula knew what something was that was worrisome. Was able to advocate for her patient by telling her patient to call her provider, and that ultimately, might have saved that patient’s life.
We need people like that, and in a place in you know, out here on Long Island where people don’t know, you know, their neighbors, or maybe not have family around. Having a doula is important. People should check their insurance, right? Because doulas are covered by insurance, some insurance companies, and people should check their insurance. Midwives are covered by every insurance. And guess what? If you can’t go to a midwife, right? Get some education. Stony Brook has childbirth education. The Department of OBGYN is doing it, educate yourself so you know what choices you have, right? So that you can have a doula, you can have a midwife, and maybe you don’t need a doctor, but maybe you can have a doctor and a doula, and you can have a vaginal birth.
35:59 Closing Remarks
Rakiya Watts, CNM, MSN
That’s right, that’s right. That’s all the time we have today. Thank you so much to our panelists, and thank you to all of you, our listeners and viewers.
Remember, every birthing person deserves a doula, and when low risk, a midwife too.
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Stony Brook Medicine is Long Island’s premier academic medical center. We transform lives through scientific discovery, education and care, and we bring together innovative research, advanced education and extraordinary healthcare expertise to set the standard for how healthy communities thrive. For more information, visit stonybrookmedicine.edu or follow us on social media.
*DISCLAIMER: The information provided in this podcast is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. If you think you may have a medical emergency, call your doctor or emergency services immediately.
