With Caesarean section surgeries occurring in nearly one in three pregnancies and traditional hospital births by obstetricians costing an average of $8,000 to $10,000, some pregnant women are exploring other options. And the future of childbirth in America might start looking more like the past.

Who: Midwives and Doulas

For thousands of years, women have been giving birth with the help of midwives and doulas. In some countries—both rich and developing—almost every pregnant woman sees one for her prenatal, delivery and postnatal care.

In the United States, most pregnant women see an ob-gyn for their prenatal care and delivery. Yet evidence shows use of midwives here is increasing.

There are two broad classifications of midwives in the United States. A certified nurse midwife (CNM) has completed traditional nursing school and then gone on to complete midwifery training. A certified professional midwife (CPM) has training in midwifery but is not a nurse. Generally, CNMs have clearance to deliver in hospitals and CPMs do out-of-hospital births—either at home or in nonhospital birthing centers.

According to Miriam Perez—a volunteer doula, activist, creator of RadicalDoula.com and editor at Feministing.com—while a midwife attends to the medical needs of a labor, a doula's mission is different. "A doula is only really worried about the emotional needs of the mom," she says. "She's there to coach and support the mom and kind of help her get what she needs from her birth experience. That's what makes [the doula] unique from everybody involved—from the partner to the doctor to the nurses to the midwives. The doula is the only person who is there just really focused on the needs of the mom."


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