Independent Midwife & Doula Partnership. How we work together.
Updated: Sep 5
Client feedback — October 2022
“Having had a challenging experience with my first birth, I decided to meet Victoria, an Independent Midwife, when I found out I was pregnant with my second child. I booked the midwife + doula package, and it was one of the best decisions I’ve ever made. Having these incredibly experienced, knowledgeable, thoughtful and empowering women by my side throughout pregnancy, labour and for two weeks postpartum allowed me to work through my fears, be better informed and have a truly positive birth. I wish every mother-to-be could have both a doula & IM!”
We thought it would be helpful to talk about how an Independent Midwife (IM) and doula work together.
Our roles are clearly different, with one being clinical and one non-clinical, but we work very closely and collaboratively with each family. We share a passion for physiological birth, birth autonomy, informed choice and supporting families to feel confident in the decisions they make.
We will discuss each other’s roles and how we feel they complement one another, but here is some information you may find interesting.
Independent Midwives and outcomes
Did you know that a UK study compared births supported by NHS midwives with those supported by Independent Midwives and found that:
Only 0.4% of NHS midwife-supported births were home births, compared with 66% of births assisted by Independent Midwives.
Spontaneous onset of labour was more common in the IM group, at 96.6%.
Mothers in the IM cohort were also more likely to breastfeed, at 88%.
https://www.bmj.com/content/338/bmj.b2060
Did you also know that a 2017 Cochrane Review, which brought together studies involving more than 15,000 participants, found that those supported by a doula during birth were:
More likely to have a spontaneous vaginal birth
Less likely to have a caesarean birth
Likely to have a shorter labour
Potentially at lower risk of postpartum depression
More likely to report a positive birth experience
More likely to have babies showing better signs of health during newborn Apgar assessments
The role of the Independent Midwife
Written by Doula Victoria
Independent Midwives work autonomously while taking a collaborative approach with the NHS. Their clients remain entitled to access any or all available maternity care.
IMs are registered with the Nursing and Midwifery Council (NMC), work within the NMC Code, and provide professional, safe, and evidence-based care. They are also appropriately insured for their professional practice.
For families choosing an Independent Midwife, this can provide a true continuity-of-carer experience. Depending on the package booked, families may receive their antenatal care, birth support and postnatal care from the same midwife, building a relationship of trust and familiarity throughout the childbearing continuum.
Independent Midwives are highly professional, warm, genuine and deeply passionate about their practice. They offer unbiased, personalised information and clinical support, while creating space for parents to ask questions, explore their options and make decisions that feel right for them.
With regular antenatal appointments, the IM creates space for clients to ask all sorts of questions and explore any concerns or worries from the comfort of their own home. As part of an IM and doula package, we take turns meeting with our clients and their partners and also come together for joint sessions. As a doula, I offer a minimum of four two-hour sessions together, with two of these sessions involving the IM as well. When we meet together, we can explore topics of the family's choice, often discussing the autonomic nervous system, phases of labour, options for comfort measures, positions, movement and biomechanics of birth and the role of gravity in physiological birth. As we also host our full antenatal and hypnobirthing course together, we can really immerse ourselves in all things birthy. We spend time discussing any fears or concerns, and it is a wonderful opportunity for the IM to listen to the baby's heartbeat, check measurements and go through any notes or appointments that may have taken place within the NHS. The IM brings their clinical knowledge and experience, while also offering time, presence and genuine connection. This antenatal relationship allows parents to grow in confidence, trust and connection with their pregnancy and baby, something that sits at the absolute core of building a positive attitude towards birth and parenthood.
In the birth space
In a birth setting, the IM provides a close but hands-off approach, guided by the client. They remain available and attentive while equally allowing the birthing woman or person the space to listen to their own body, movements and positions. The IM listens intently to the sounds and movements of the birthing person and carries out appropriate clinical observations and checks of the baby throughout labour. Together, as a birth team, we support with encouraging words, calm and trusting presence, creating a space where the birthing person can remain in their rhythm and feel confident in their ability to birth. The IM remains with the family through the immediate postnatal period and returns over an agreed period of days, looking holistically at the mother/baby dyad and how both are doing from a clinical perspective.
The doula and IM can visit alternately, with the doula's role including time to talk through the birth together, process the experience and discuss the early days of parenthood and the transition from womb to world for both parents and baby. As an IM and doula partnership, we are a team that knows, cares for and supports one another. We understand each other's roles and respect each other's presence in the birth space. Together, this can create a calm, connected, positive and trusting environment for the birthing family.
The role of a doula
Written by an Independent Midwife
A doula is a trained, non-medical birth companion offering presence, support and guidance throughout pregnancy, birth and the postnatal period. Although doulas are not clinically trained, this kind of support has existed for centuries. Traditionally, women would often have a midwife present during childbirth alongside female family members and friends who provided emotional and physical support, helping the birthing person feel grounded, safe and less afraid.
Doulas hold a safe and protective space, offering positive encouragement, gentle reassurance and continuous emotional and physical support. This kind of support can also benefit the midwife, as the doula helps ensure the mother or birthing person is comfortable and supported, while also helping with practical needs within the birth space. Victoria is a very caring and highly emotionally intuitive birth practitioner. She is able to gently feel her way through women's emotions, fears and needs during pregnancy, preparing the groundwork for their birth. She puts her energy and attention into the person and family she is working with, getting to know exactly what they need and how she can provide them with the tools to feel safe, nurtured and held. Regardless of how they birth, where they birth or how they feed their baby, families are supported to feel loved, heard and empowered. Their decisions remain their own, and Victoria helps ease them through this delicate process in a way that allows them to identify the path that feels most right for them, without making decisions based on fear or judgement.
Working together has transformed us from juggling the responsibility of trying to be everything for women into an effortless, energising partnership that we build together, tailoring our support to each family's individual needs and utilising our different skills. Discussing and defining clear roles with one another, as well as our boundaries and what we each feel confident and comfortable doing, makes for seamless teamwork. It allows us both to focus wholly on the tasks and responsibilities within our respective roles.
For Victoria, as a doula, she doesn't need to focus on acting as an advocate or negotiating how to protect the space and wishes of the person she is supporting. She can give her full attention to the client's emotional and physical needs because there is already a clear understanding and trust between the IM and doula. She can simply be fully present. We know we are on the same page and that we share the same aim. We know that everyone in the space is respected and supported. We become a unit, working together in harmony, with clearly defined professional roles. The most powerful thing about the IM and doula team is the sense of safety and trust it can bring into the birth space. We know each other. We support each other. We don't need to spend time assessing how to navigate the different people in the room, because we already understand what is required of us and where our individual responsibilities lie. This creates space for the birthing person to feel held, supported, and safe, allowing oxytocin to flow more freely and everyone to think, feel, and respond from a place of greater calm and clarity.
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