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Preparing for Pregnancy

Your belly is becoming rounder, and your excitement is mounting – childbirth is approaching. You can find here answers to important questions: what is learned during the childbirth preparation course, what should you prepare in advance for the maternity department, what rooming-in options are available after delivery, how important it is to prepare a delivery plan, what an epidural is, and more.

Selecting Your Labor Support

Osher Ben Or, Certified Midwife

22 June 2024

A personal midwife, a doula, your partner, mother, sister, or friend, or anybody else who is with you during labor can provide you comfort and confidence. Depending on how many companions the medical center allows, you can decide who will accompany you during childbirth. Your labor support's job is to assist you through delivery without getting in the way of the medical team's duties.

Doula or personal midwife

Doula: a doula is someone who helps during labor. Usually, the doula meets the patient during pregnancy, and occasionally, they give her a labor preparation class and accompany her during childbirth. Some doulas combine reflexology, aromatherapy, acupuncture, and more. Their role is to support the pregnant woman but not to take therapeutic decisions, interfere, or consult regarding obstetric considerations.

Personal midwife: a registered nurse who has undergone an additional 18 months of training and received a license from the Ministry of Health to practice obstetrics. The nurse offers personal services for pregnancy and labor accompanying. All registered midwives in Israel who hold a valid license appear in the registered midwives database (HE). It is important to know that the labor room’s midwife is also responsible for your physical and emotional needs.

Labor support services covered in the health care basket: the cost of labor support services can range from 2,000 NIS and can go significantly higher. It is important to note that HMOs offer a pregnancy and childbirth package that includes partial reimbursement for the services of a midwife or doula for labor support. It is advisable to inquire beforehand about the specific amount of reimbursement available.

Childbirth can be an exceptionally intense moment for a woman, often considered one of the most significant experiences in life. However, it can also be a very stressful and complex experience. This is true for every labor, and especially the first, when all sensations are new. During these moments, having a partner or another supportive person with you can provide a greater sense of security and comfort. The presence of a companion and support during childbirth is essential because it contributes to the intimate atmosphere in the delivery room, which is crucial for the smooth progression of the delivery.

How to choose your labor support

There is no one correct answer. Some prefer that their partner accompany them; some ask their mother, sister, or a good friend to be there during childbirth; and some choose a paid companion, a midwife (external to the hospital), or a doula. Regardless of the choice you make, your comfort should be your top priority, and you should not hesitate to express your dissatisfaction if a particular companion does not suit your preferences. It is essential that you feel comfortable with the person you want as a companion and know they can support you during the challenging moments in the delivery room according to your wishes and needs.

You should know that even if you have not chosen a paid companion, such as a personal midwife or a doula, the hospital midwife will attend to your physical and emotional needs throughout labor and stay with you every step of the way.

More about the delivery room staff

Your rights as a expectant mother regarding labor support

Every medical center determines the number of birth companions they allow to enter the delivery room (most of them allow two companions). It is advisable to find out this information beforehand when making a tour of the relevant delivery rooms so you can choose the most appropriate place for your preferences.
As an expectant mother, you have the right to choose a personal companion, midwife, pregnancy and delivery companion, doula, or any other person you want to be with you in the delivery room, subject to the hospital's policy on the number of people allowed in the delivery room.
The support person of a birthing mother is not allowed to provide any treatment or interfere with the work of the midwives or medical staff. They are not allowed to make professional decisions. This also applies to doulas or midwives accompanying you personally. In this context, there are actions considered natural (such as nipple massage), but occasionally they require fetal monitoring. In this case, you should notify the midwife responsible for your care and consult with her.

The Ministry of Health's policy on labor support can be found here

The difference between a doula and a personal midwife

A doula is a childbirth supporter. In most cases, the doula meets the birthing mother during the pregnancy. Often, she also gives her a labor preparation class and, obviously, accompanies her during the delivery. Some doulas combine their knowledge with topics such as reflexology, aromatherapy, acupuncture, and more, helping them support the birthing mother during childbirth but not taking therapeutic decisions, interfere, or counsel about obstetric decisions.

Doula practice is not officially recognized as a profession in Israel, and the Ministry of Health has not established standardized professional requirements or standards. While several institutions offer doula training courses, there is a lack of uniform specifications for these programs. Typically, these courses involve trainees accompanying childbirths as part of their practical training, but the specific focus and content can vary among different institutions. The educational institutions provide certificates, but there is no official recognition in Israel for these certificates (even though there are institutions that are trying to regulate this training and the recognition of doulas as a profession and establish uniform specifications).

A midwife is a registered nurse who has completed four years of studies and has a bachelor's degree. After her studies, she underwent additional training for 18 months, including practical training, at the end of which she was tested in the licensure examination of the Ministry of Health and obtained a license to practice obstetrics. Midwives working in hospitals are also required to receive knowledge updates every year on a variety of topics, such as newborn and adult resuscitation.

Some midwives provide personal pregnancy and delivery accompaniment. There are some midwives who study and are trained in complementary medicine, such as reflexology, aromatherapy, acupuncture, and breastfeeding consultation. Before childbirth, they practice pregnancy accompaniment, and are engaged in providing guidance, support, and preparation for the upcoming birth.

You can make sure that the person who presents herself as a midwife is indeed a certified midwife with a valid license by checking the registered midwives database on the Ministry of Health website.

Support during delivery is covered by the pregnancy and childbirth basket

The cost of paid accompaniment services can range from 2,000 NIS to significantly higher. It is important to note that HMOs offer a pregnancy and childbirth package that includes expenses related to pregnancy and childbirth, including examinations, devices, and services officially recognized by the HMO. The package also includes partial reimbursement for midwifery or doula services to accompany the childbirth. The devices and services provided vary from HMO to HMO, as do the terms for reimbursement. It is recommended to inquire beforehand about the components included in the pregnancy and childbirth package offered by your HMO.