Midwives Midwifery is a profession that provides health care to women during pregnancy, birth, and the postpartum period (Ekelin, Kvist, & Persson, 2016; Feijen-de Jong & others, 2015a, b; Reed, Rowe, & Barnes, 2016). Midwives also may give women information about reproductive health and annual gynecological examinations. They may refer women to general practitioners or obstetricians if a pregnant woman needs medical care beyond a midwife’s expertise and skill. Midwifery is practiced in most countries throughout the world (ten Hoope-Bender & others, 2016). In Holland, more than 40 percent of babies are delivered by midwives rather Page 65than by doctors. However, in 2013 in the United States only 7.8 percent of women who delivered a baby were attended by a midwife, a figure that was unchanged since 2000 (Martin & others, 2015). Nevertheless, the 7.8 percent figure for 2013 represents a substantial increase from less than 1 percent in 1975. A research review concluded that for low-risk women, midwife-led care was characterized by a reduction in procedures during labor and increased satisfaction with care (Sutcliffe & others, 2012). Also, in this study no adverse outcomes were found for midwife-led care compared with physician-led care. Doulas In some countries, a doula attends a childbearing woman. Doula is a Greek word that means “a woman who helps.” A doula is a caregiver who provides continuous physical, emotional, and educational support for the mother before, during, and after childbirth (Kozhimannil & others, 2016). Doulas remain with the parents throughout labor, assessing and responding to their needs. Researchers have found positive effects when a doula is present at the birth of a child (Ahlemeyer & Mahon, 2015; Zielinski, Brody, & Low, 2016). A recent study also revealed that for Medicaid recipients the odds of having a cesarean delivery were 41 percent lower for doula-supported births in the United States (Kozhimmanil & others, 2013). Thus, increasing doula-supported births could substantially lower the cost of a birth by reducing cesarean rates.