How to Build Your Birth Team
Design a support system that protects your safety, honors your values and aligns with the birth you truly want.
No matter where you give birth — hospital, birth center or home — the people on your team will greatly impact your experience. Who you choose to surround yourself with can make all the difference in how seen, heard and supported you feel — before, during and after birth.
I’ve attended births in all three settings as a doula and birth assistant, and have personally given birth in a hospital and at home (twice). And outside of the simple (yet admittedly, not always easy) understanding that your birth belongs to YOU; having the right people in the room is arguably the most important set of choices you can make for your birth experience. There is no substitute for an aligned system of care, advocacy and support around you through this life-changing rite of passage.
Maybe a Black midwife or OB is nonnegotiable for you. Maybe you want all five of your sisters nearby as you labor at home. Or maybe you want your partner by your side as you deliver, and no one else. Maybe your vision isn’t clear yet (if that’s the case, read this). But if you can, aim to identify and communicate your needs as early as possible, so you can avoid last-minute stress, changes or unnecessary conflict close to your due date.
Here’s the truth: your team matters as much as your setting — and sometimes even more. A supportive, aligned team can help you avoid unnecessary interventions, reduce complications and reinforce your confidence to birth in your power.
Let’s take it step by step, and clarify who you want to join you in your sacred birth space.
Your Birth Partner: Who Should Be in the Room?
A birth partner can be a spouse, significant other, family member, friend or chosen support person. What matters most is not the title, but the trust. They should make you feel safe, grounded and respected. They don’t need to know everything about birth — but they should be emotionally present, supportive of your choices and ready to advocate for your needs when you can’t.
Your birth partner should:
Be supportive of your birth vision.
Be reliable, and willing to show up for you.
Be able to stay calm under pressure (bonus points if they operate well with little sleep!)
Be able to advocate when needed.
Be someone who can stay grounded while you do the work of labor.
And let’s be real: your birth partner doesn’t have to be your life partner. If your partner isn’t aligned with your plan, doesn’t handle medical settings well, adds stress instead of support, of if they’re not in the picture, it’s okay to choose someone else. This is your birth — your initiation into motherhood — and your peace comes first. The wrong energy in your birth space can slow labor, and even contribute to less favorable health outcomes for yourself or baby. This forever mark the way your child was brought into this world. This is not the time to be diplomatic or to “feel bad” — get the support that you and baby need.
And remember: birth is not a spectator sport. Less is more.
Choosing Your OB or Midwife
Whether you’re working with a midwife or an OB-GYN, it’s important that you feel comfortable asking questions — and that your provider listens and responds with care. If possible, meet with multiple providers until you find the right fit. Trust and safety are core components of a positive birth experience.
Above all, I believe that mothers and families should have agency throughout their preconception, prenatal, birth and postpartum process; and should be supported in the choices that are right for them. That said, I am proudly Team Midwife for low risk pregnancies. And even if you’re categorized as “high risk” within the medical system, it’s worth consulting with an experienced midwife to confirm whether this “risks you out” of their practice. Often, health circumstances that are viewed as high risk by the medical system can be monitored under a midwife’s care, and you may still be able to give birth in a free standing birth center or even at home, if that’s a priority for you. As always, do your research according to your state laws and what’s available in your local community.
Because 98% of us give birth in hospitals, most often with an OB-GYN, I want to share what most of our families don’t hear:
If you’re low-risk, midwives are statistically safer. Midwife-led care for low-risk pregnancies is linked to fewer interventions, fewer cesareans and healthier outcomes for both mother and baby — without sacrificing safety.
OBs are trained to manage emergencies and surgery. This is lifesaving when complications arise — but in low-risk births, that training often leads to higher rates of intervention.
Continuity matters. In a midwife-led model (at home or in a birth center), you’re far more likely to know the person who attends your birth. In hospitals, your provider may change with each shift.
When interviewing providers, ask about their philosophy of care and how it aligns with your values.
Some sample questions to get you started:
What is your philosophy of pregnancy, birth and postpartum care — and your role in it?
What made you want to become an OB-GYN or midwife?
What care model(s) do you follow?
Do you support unmedicated delivery?
What has been your experience with [insert type of birth or preexisting condition]?
What is your approach to complications?
What is your approach if a mother goes past her estimated due date?
What is your approach to interventions like induction or cesarean?
Do you support my preference to [insert birth or postpartum preference]?
Do you recommend a doula? Why or why not?
Can you walk me through your process and systems? For example, when I have blood work done, how and when do we review results?
What is your philosophy on weight gain, nutrition, prenatal supplements and exercise during pregnancy?
What prenatal screenings and tests do you offer or require?
When are you on-call?
Do you offer, or can you recommend, breastfeeding support?
How should I get in touch between appointments if I have questions or concerns?
Do you work with backup providers, and can I meet them?
Questions specifically for midwives:
What factors would “risk me out” of your practice? Are you able to help me create a plan to prevent these?
If I went past my estimated due date, what protocol do you follow? How “late” can I be and still birth under your care?
Do you work alone or as part of a team?
How many clients do you take on at any given time?
Are there any doulas that you’ve worked with and can recommend?
What postpartum care do you provide, including newborn procedures?
Whether you choose an obstetrician or a midwife, remember that individual providers may follow a traditional model or incorporate elements from multiple approaches. No matter what, you should feel considered and well cared for.
You can explore state midwifery associations, local community birth worker networks and trusted referrals.
Sista Midwife Productions’ directory is a great resource for finding Black midwives (this is how I found my amazing midwife-turned-sister, Ashley Greene of Serenity Midwifery & Birth Center).
If you’re a Black woman planning to work with an OB, either because of your health needs or simply your preference, I highly recommend getting a copy of Dr. Tiffany Woodus’ guide,The Mocha Maternity Survival Guide: Choosing The Right OBGYN: Helping You Safely Navigate The Black Maternal Health Crisis.
But Wait…What’s the Difference Between a Midwife and a Doula?
There are common misconceptions about midwives and doulas, their roles and how they complement each other. Many people think the two are interchangeable (they’re not), and some assume midwives only attend home births (they don’t). Let’s take a moment to clear that up.
What is a Midwife?
Midwives are licensed healthcare providers who deliver babies and provide prenatal and postpartum care. They can practice in hospitals, birth centers or homes, depending on their training and license. In hospitals, you’ll most likely encounter:
Certified Nurse-Midwives (CNMs): registered nurses (RNs) with advanced training in midwifery. They can practice in hospitals, birth centers and homes, and are licensed in all fifty states.
Certified Midwives (CMs): non-nurse professionals who complete graduate-level midwifery education and pass the same board exam as CNMs. CMs are licensed in select states and often work in similar settings as CNMs.
There are other types of midwives you may find in out-of-hospital settings:
Certified Professional Midwives (CPMs): midwives trained specifically in out-of-hospital birth, including homes and freestanding birth centers. They complete accredited midwifery education or a structured apprenticeship and must demonstrate extensive hands-on experience in community birth before certification through the North American Registry of Midwives (NARM). CPMs are the only U.S. midwives whose credential requires home birth experience. They are licensed or regulated in many, but not all, states.
Licensed Midwives (LMs): midwives who hold a state-issued license to practice midwifery, most often in homes and birth centers. Training routes vary by state but typically include accredited midwifery education and supervised clinical practice, sometimes overlapping with CPM requirements. Some states license CPMs under the LM title, while others issue a distinct LM license. Scope of practice and regulation depend on state laws.
Traditional/Community Midwives: midwives who train outside formal medical or academic pathways, often through apprenticeship, community mentorship or lineage-based traditions. Their care may be rooted in cultural, spiritual or ancestral practices — such as those of African American “Granny Midwives,” Indigenous birth workers or midwives serving immigrant communities. Traditional or community midwives may or may not hold a state license depending on local regulations, and primarily attend births in home or community settings.
Because licensing laws and training pathways vary by state, take time to research who is available in your area, what their credentials mean where you live, and how their philosophy aligns with your own. The right midwife is the one who supports not just your safety (that goes without saying), but your values, your autonomy and the kind of birth experience you want to create.
What is a Doula?
Doulas are trained birth professionals who provide continuous support throughout pregnancy, labor and postpartum. Their care is rooted in emotional, physical and informational support — helping you prepare, advocate for your needs and stay connected to your vision throughout the experience. Doulas aren’t medical providers, but their steady presence can make a powerful difference: they offer comfort measures, translate complex information and help families navigate options with confidence. They support the whole family — not as a replacement for a partner, and not to fix family dynamics, but to offer grounded, compassionate reinforcement during a life-changing transition.
Continuous support from a doula has been shown to significantly improve birth outcomes, including lower cesarean rates, reduced need for pain medication, shorter labors and more positive birth experiences.
Both midwives and doulas play vital, complementary roles — but they serve very different purposes. A midwife provides medical care. A doula provides unwavering, human-centered support. I hope you can find exactly what you need.
Do I Really Need a Doula?
Only you can decide what support feels right for your birth — but I strongly encourage considering a doula, no matter which birth setting you choose. The right doula offers steady, informed, nonjudgmental care throughout your journey. They help you stay connected to your voice, your body and your plan — especially when things move fast or feel overwhelming.
Both the American College of Obstetricians and Gynecologists (ACOG), and the American College of Nurse-Midwives (ACNM) acknowledge the role of doulas in supporting better birth outcomes. ACNM’s Position Statement on Birth Doulas is a valuable read, and ACOG’s website has some helpful information and articles in support of doulas.
Continuous support saves lives. Research shows doulas lower the chance of cesarean, shorten labor and increase satisfaction.
Hospitals move fast. Staff rotate, timelines are tight and interventions are common. A doula offers continuity and calm in that environment.
Out-of-hospital, doulas still matter. Even in the most supportive midwife-led setting, the right doula can help you and your partner stay grounded, connected and nourished. Their presence allows your midwife to stay locked in to you and your babies’ health status and any needs that arise, while your doula can serve as translator, guide and moral support, as needed.
Both the American College of Obstetricians and Gynecologists (ACOG) and the American College of Nurse-Midwives (ACNM) recognize doulas as improving outcomes. This isn’t about luxury — it’s about care.
If cost is a concern, look into community programs, sliding scale options, or pro bono services. Start with:
Local community-based collectives
Black Doula Network (BWPC)
Choosing the Right Doula for Your Setting
Hospital Birth
Find a doula skilled at navigating medical systems, communicating with staff and protecting your voice when things move quickly. Some hospitals welcome doulas with open arms. Others may have restrictions, especially during busy periods or due to COVID-era policies. Talk with your provider and hospital ahead of time about your intention to bring a doula, and make sure your doula is comfortable advocating within that setting.
Unfortunately, doulas are often undervalued or dismissed in medical settings, despite being a vital part of the birth team. As a client, your advocacy for their presence and role can help shift the culture toward more collaborative, family-centered care.
Birth Center/Home Birth
For out-of-hospital (OOH) birth, you’ll want a doula who understands physiologic birth — the body’s natural rhythm when labor is undisturbed — and who knows how to work in partnership with midwives rather than in parallel with them.
OOH births tend to be quieter, more intimate and more mother-led (you can find a detailed post I wrote about OOH birth here). Your doula becomes part of the rhythm of the room:
protecting your sense of safety
helping you stay grounded in your body
supporting you through position changes
reading the energy and intensity of labor
reinforcing your confidence as your midwife monitors you and baby
In this setting, a doula isn’t just a buffer between you and the system — they’re a companion, a mirror and a calming force in a space designed for slowness and trust.
Because many families choose OOH birth specifically to avoid unnecessary interventions, your doula should be deeply attuned to supporting labor without disrupting its natural flow: offering techniques like counterpressure, breathwork, movement, massage and emotional reassurance that help your body do what it’s designed to do.
A doula experienced in OOH birth will also understand:
how to maintain a peaceful environment
when to step back and when to step in
how to collaborate fluidly with midwives
how to support you (remotely or in person) through long early labor at home before active labor intensifies
This synergy — midwife + doula + partner + your own inner wisdom — is one of the reasons many families describe home and birth center births as deeply empowering, and even healing.
Across All Settings
Wherever you give birth, ask your doula:
How do you advocate for clients when things shift?
How do you support partners as well as birthing parents?
What is your approach when unexpected changes arise?
How do you help protect physiologic birth?
How do you collaborate with medical staff or midwives?
The right doula will not only share your values — they’ll help you hold onto them when it matters most.
Insurance Considerations
Some insurance plans, Medicaid programs, or health savings accounts (HSAs) cover midwifery and doula services — but not all. In California, Medi-Cal now covers doula care under the California Momnibus Act (SB65), an important step toward making support more accessible. Check your benefits early, ask your midwife or doula if they offer sliding scale or payment plans, and see whether your hospital has community doula programs. It’s worth looking into — the support can be game-changing.
If you made it this far, thank you so much for reading and I pray this is a useful resource for you, your client or someone you love. This entire body of work is meant to be a living, growing community resource and knowledge base.