OB, Midwife, Doula – What Is the Difference?

Parents today have more options than ever before when deciding who will provide their prenatal care, who will attend their baby’s birth, and where the birth will take place. Many of these options indicate a positive shift in the way our culture views maternity care: Parents can (and should) be actively involved in selecting the type of birth they want for their family. Unfortunately, the overwhelming number of choices, combined with a lack of cultural familiarity with birth itself, sometimes leads parents to choose a “default” birth (read: OB-attended birth in a hospital with standard medical interventions) rather than thoroughly exploring their options.

The primary goal of Healing Hands Chiropractic’s pregnancy and childbirth workshops is to demystify the process of birth and the choices involved, allowing parents to choose the options that are best for them and for their baby. Understanding the difference between types of care providers is an essential part of planning the birth you want.

In the United States today, the vast majority of births are attended by an obstetrician (OB), a medical doctor who specializes in pregnancy and childbirth. Obstetricians are trained to manage low-risk pregnancies and deliveries, but are especially skilled at handling complications. They can attend vaginal births as well as perform cesareans. Among OBs, there may be a wide variety of attitudes toward pregnancy and birth. If you are considering care with an obstetrician, it is important to make sure that his or her philosophy on birth is similar to your own.

Midwives are extensively trained in providing care for low-risk pregnancies and deliveries. A midwife practicing in a hospital is usually a certified nurse-midwife, or CNM. CNMs are registered nurses who have additional training and experience with maternity care. CNMs in hospitals generally work in conjunction with one or more obstetricians, and can consult with them or even transfer patients to their care should complications arise. Many CNMs tend to have a more hands-off, holistic attitude toward pregnancy and birth, though this is not always the case. A CNM practicing in a hospital is often subject to institution policies, including standard procedures for length of labor after admission to the hospital, eating and drinking in labor, and management of complications.

Midwives who practice outside of the hospital have different credentials depending on licensing regulations in each state. (In New Hampshire, the designation is CPM, or Certified Professional Midwife.) Unlike hospital-based professionals, Direct Entry Midwives are trained in birth first, medicine second. Even more than a CNM, a CPM tends to regard pregnancy and birth as a natural, healthy process that requires little to no intervention. (Midwives have been known to say that they do not “deliver” babies, they just “catch” them.) Direct Entry Midwives attend births in free-standing birth centers and at home. They are trained to watch for and manage complications, and to transport clients to the hospital when necessary. Their labor bags include medical equipment to prevent or manage maternal hemorrhage, to provide sutures in the event of a perineal tear, and to resuscitate a newborn. An out-of-hospital birth for a healthy, low-risk mother is neither dangerous nor irresponsible. In several studies, home birth has actually been shown to be safer than hospital birth, because the mother is not subject to standard procedures that may lead to complications.1

Doulas are labor support professionals. They are not responsible for the medical aspects of birth, but provide emotional and psychological support for the mother and her birth partner. A doula is also trained to interact professionally with hospital staff, and can act as an advocate for the mother should the need arise. A doula generally arrives earlier in labor than other birth attendants, often supporting the mother while she labors at home and then traveling to the hospital with the parents. She can help with the initiation of breastfeeding and may also offer additional postpartum support. (For more information, including the distinction between labor doulas and postpartum doulas, please check out Doulas of North America: http://www.dona.org/mothers/index.php)

Practitioners at Healing Hands Chiropractic regard pregnancy and childbirth as natural processes in which both parents should be involved and educated. For more on birth choices, consider an upcoming childbirth series or early pregnancy workshop. Email jenny@healinghandsnh.com for schedule, rates, and registration information.

Prenatal Yoga Class by Donation

Healing Hands Chiropractic is a full service family wellness center in Londonderry, NH that offers prenatal & family chiropractic care, integrative therapeutic & pregnancy massage, prenatal yoga & multi-level asana yoga, reiki therapy, meditation classes, acupuncture and pregnancy & childbirth classes.

We have new yoga classes for the spring.

We have further fine-tuned our yoga schedule to better suit the needs of our students. Beginning May 1, 2009 changes include a later time for Prenatal Yoga on Mondays, a brand-new Vinyasa Flow class on Tuesday mornings, and an additional Prenatal Yoga class on Fridays. 

In an effort to make prenatal yoga classes accessible to all, we’ve chosen to make this Friday class available on a sliding fee scale. The suggested donation for one class is $15. Those who can afford less pay what they can for each class. (Please note the sliding scale is available for single classes only and cannot be used to purchase a 6-class package.) 

Healing Hands Chiropractic is proud to welcome our newest yoga instructor, Liz Croteau. Sign up for an upcoming Vinyasa Flow class to experience Liz’s dynamic teaching style for yourself. 

For our complete spring and summer  yoga schedule please visit our website or call (603)434-3456.  For further information on Healing Hands Chiropractic’s prenatal and yoga program please contact assistant director, Jenny Everett King, CYT, CBE at jenny@healinghandsnh.com.

Prenatal Massage: Massage During Pregnancy

Therapeutic massage has been used for centuries to improve overall health, reduce stress, and relieve muscle tension. Research has shown that pregnancy massage can be very beneficial in reducing anxiety and depression, relieving muscle and joint aches and possibly even improving labor outcomes.

Swedish massage is the recommended prenatal massage method aimed at relieving the usual discomforts brought on by hormonal and musculoskeletal changes in the body during pregnancy. Pregnancy massage may help relax muscle tension and improve lymphatic and blood circulation.

Studies done in the past 10 years have shown that hormone levels associated with relaxation and stress are significantly altered, leading to mood regulation and improved cardiovascular health, when massage therapy was introduced to women’s prenatal care. Hormones such as norepinephrine and cortisol (“stress hormones”) were reduced and dopamine and serotonin levels (low levels of these hormones are associated with depression) were increased in women who received bi-weekly massages for only five weeks. These changes in hormone levels also led to fewer complications during birth and fewer instances of newborn complications, such as low birth weight. The evidence points strongly to maternal and newborn health benefits when relaxing, therapeutic massage is incorporated into regular prenatal care(www.americanpregnancy.org).

Massage therapy also helps reduce the collection of excess fluid in the joints and soft tissues that leads to edema, or swelling of the joints-like your ankles.

Many women have also experienced a marked reduction in sciatic nerve pain during pregnancy when receiving regular massage therapy.

Other potential benefits of prenatal massage:

  • Reduced back pain
  • Reduced joint pain
  • Improved circulation
  • Reduced edema
  • Reduced muscle tension and headaches
  • Reduced stress and anxiety
  • Improved oxygenation of soft tissues and muscles
  • Better sleep

Healing Hands Chiropractic in Londonderry, NH offers a full spectrum of prenatal services. These services include: Prenatal Chiropractic Care using the world renowned Webster Technique, Prenatal Yoga, Pregnancy Massage and Reiki, Acupuncture, and Celebrating Your Pregnancy and Honoring Your Birth classes with our childbirth educator, Jenny Everett King.

Healing Hands Chiropractic is located at Landmark Crossing, 25 Nashua Rd., Suite F2, Londonderry, NH 03053. Phone: 603-434-3456 Web: http://www.HealingHandsNH.com

Massage Therapy: http://www.healinghandsnh.com/massage_hours.html

Birth, Naturally

Posted by: Jenny Everett King


Natural childbirth” is a term that is frequently tossed about without the speaker clarifying his/her meaning. One person may use “natural” in reference to vaginal birth, rather than birth by cesarean. Another may use natural in place of “medication free.” Still others think of the spontaneous onset of labor, homebirth, or hospital birth with a nurse midwife rather than an OB. In reality, proponents of true natural childbirth encourage a birth experience that not only is drug-free, but one that incorporates a variety of positions and coping methods for all stages of labor. Above all else, the birthing mother is encouraged to trust, rather than question, her own body.


Natural childbirth is not for everyone, and should not be presented as such. No matter what our personal philosophies, no one has the right to tell another woman how to birth her baby. With that said, many women do not consider birthing naturally, or are skeptical about their ability to do so, simply because they have never been offered the proper tools. Every woman deserves to be educated about the option of natural childbirth, and the vast majority of women should be offered the opportunity to birth in this way.


An epidural-free labor that does not incorporate tools for coping with pain is nearly impossible. “Natural” childbirth does not equal un-medicated childbirth. Rather, natural childbirth offers an alternative philosophy of the birthing process and, in doing so, incorporates an alternative set of coping tools. I have spoken with so many women who tell me, “I wanted to have a natural birth, but it was just too painful.” As the conversation continues, I usually hear that she spent the most difficult parts of labor in bed, hooked up to machines, often surrounded by nurses who were strangers to her, or a doctor / midwife she met once before. What woman has a pain threshold high enough to withstand the intense contractions of transition in this environment?


Birthing naturally does not just mean the absence of an epidural. It requires freedom of movement, emotional and sometimes physical support from the birth partner and from care providers, and confidence in birth itself. Most women who have had positive experiences with natural birth also credit mental preparation and relaxation techniques. Partners often mention the benefits of close communication with the laboring mother, and the ability to understand her needs and desires. These are important skills that come with training and practice – they don’t simply manifest in an instant in the labor and delivery room! All pregnant women and their partners who desire natural childbirth should be encouraged to communicate openly with one another, to educate themselves about the birth process, to practice relaxation exercises, and to strive for a naturally healthy and fit pregnancy. These four principles are the basis of Healing Hands’ new Empowered Birth series. We believe that you deserve to know the power and beauty of natural birth!