Preconception Care with Midwives and Doulas

Trying to conceive can be…well…trying. Too often our most well-laid plans backfire. Maybe we have fertility struggles. Maybe the donor we had our heart set on suddenly changes his mind. Maybe our relationship faces challenges because of it.

In all the possible dilemmas we encounter while trying to conceive, one thing is certain—we don’t have to go through this alone. There are tons of midwives and doulas who specialize in supporting people through their fertility journeys. In this article, you’ll learn all about what these different providers do (and don’t do), and how you can find the right support person for you.

What is a doula?

A doula is a person in your community who specializes in providing support during the reproductive years—preconception, pregnancy, birth, and postpartum. There are also death and miscarriage doulas. The word “doula” is a Greek word that can be translated to “one who serves.”

Doulas are essentially providers who specialize in emotional, physical, and informational support during times of transition. Doulas specializing in preconception care may offer fertility/nutrition advice, tools for decision making, handholding during inseminations or fertility treatments, and support for navigating miscarriage or pregnancy loss.

What is a midwife?

Midwives are trained, autonomous health care providers who specialize in holistic reproductive care. Most midwives specialize in caring for pregnant people during pregnancy, birth, and the postpartum, and many midwives do other things as well: fertility and/or preconception care, Pap smears, blood tests, sperm count testing, and IUIs (intrauterine inseminations). 

In the United States, there are two different licenses for midwives. Some midwives are trained in hospitals and work in clinic settings. Other midwives are trained out of hospitals and work on their own, in a midwifery partnership, or at birth centers.

Midwives (depending on where they practice) can order lab tests to check your hormone levels relative to fertility and provide holistic nutrition/supplement counseling before you are ready to conceive. Midwives can also assist you in tracking your ovulation and determining your ideal insemination window. Some midwives also offer in-home IUI with both fresh and frozen sperm. 

Why Would I Need to Hire a Midwife or Doula?

Too often people trying to conceive feel like they are struggling alone. Sometimes partners can’t understand what it feels like, so they don’t know how to offer the right support. Sometimes our friends had no hurdles in trying to conceive and we don’t feel like sharing our own struggles with them. Sometimes, even if we have a wonderful and supportive partner and community, we just need a professional who can hold our hands during the process and help guide us through the many decisions that need to be made.

Midwives and doulas can help provide much needed emotional support as well as guide your decision-making process. It can be confusing to know how many times to try inseminations before moving to other fertility treatments, or to know when to get your hormone levels tested, or whether it’s the right time to try IVF. Midwives and doulas can offer you the information you need to make the right decisions for yourself and for your growing family. There’s no formula for making these decisions, but the right provider can offer you the information you need to proceed in your fertility journey feeling empowered and hopeful about the process.

How Midwives and Doulas Help People who are Pregnant and Postpartum

Building a relationship with a doula and/or a midwife not only supports you during your conception process— it is also hugely supportive during pregnancy, birth, and the postpartum period. One of the most compelling reasons to start building a relationship with a doula or a midwife now is so that this person can then accompany you during your entire pregnancy, birth, and postpartum experience. Doulas can help you decide where you want to give birth, offer emotional, physical, and informational support during that process, as well as take care of you in the postpartum. Midwives can do all of this as well, including even helping you give birth to your baby either in a hospital, home, or birth center setting. Starting these relationships now will deepen your trust in your support person which has boundless benefits: including lowering your risk of experiencing postpartum depression.

What can a midwife or doula help me with that my fertility doctor can’t?

Fertility doctors are great. They can order lab tests, offer statistics on which fertility treatments make the most sense for your situation, and provide information with kindness and care. But most fertility doctors don’t have a ton of time to sit with you while you cry, or work through the finances involved in your decisions, or hear about the deep emotional issues that fertility struggles can bring up. Through no fault of their own, most fertility doctors don’t have the kind of time in their practices (or the training) to offer holistic, emotionally oriented preconception or fertility care.

This holistic care is the foundation through which many midwives and doulas have been trained to support people. It comes naturally to these providers, and they set up their practices so that they can spend enough time getting to know you and your family, and to understanding your personal struggles and triumphs. They are invested in getting to know you as an individual beyond your lab test results. Midwives and doula offer truly personal and individualized care.

Ok, midwives and doulas sound awesome. How can I find the right provider for me?

Here are some links to preconception doulas and midwives:

Doulas

• Virtual Preconception Doulas 
  
• Nested Mama
• Spectrum Doula Collective

To find preconception doulas based in your local area, we recommend googling “preconception doulas near me.” Most of the doulas you find will specialize in pregnancy and birth, but the ones who offer preconception and fertility care will state it clearly on their websites. 

Midwives

Many midwives we know offer preconception care and counseling. Here is a list of a few of them—but there are also so many more!

• Willow Midwives, based in Minneapolis, MN
• MAIA Midwifery, based in Seattle, WA. Kristen Kali of MAIA Midwifery specializes in helping queer and trans people create families.
• Refuge Midwifery, based in Philadelphia, PA. Ray Rachlin also specializes in helping queer and trans people create families.

To find a midwife in your local area who provides preconception support and/or insemination support, a quick google search should point you in the right direction.

Remember: if you’re struggling during your trying to conceive journey, you are by no means alone. Midwives and doulas provide a necessary anchor to the often turbulent and destabilizing process of trying to conceive. We all deserve enough support in our lives, and sometimes having a professional’s hand to hold is exactly what we need.

Parenting starts even before a child is born. It starts in the decision to have a child, in the wanting, the planning, and in all the changes that happen in your life when you start trying to conceive. We know that parenting takes a village. Sometimes, so does getting pregnant.