~What is a Monitrice?~
In short, a midwife is your primary care provider during your pregnancy. A doula is a labor support person. And a monitrice is an interesting blend of these two roles.
A monitrice’s primary role is that of labor support. Just like a doula, a monitrice offers continuous, hands-on support during labor. Unlike a doula, whose scope of practice generally prevents her from providing any clinical services (by their certifying organizations), a monitrice will perform limited clinical assessments such as monitoring the baby’s heart rate during labor, mom’s vital signs, and assessing cervical dilation. This means that the monitrice is usually employed to labor with you at home–before going to the hospital. It would be very unusual for someone to hire a monitrice if they are planning a homebirth–I would imagine this would blur roles a bit.
That being said, some doulas will come and labor with you at home. But if your goal is to labor at home as long as possible, you may prefer the reassurance of the assessments a monitrice performs.
The best candidates for hiring a monitrice rather than a doula are first-time mothers and women planning VBACs (vaginal birth after cesarean), in my opinion. It can be very tempting to leave earlier for the hospital in both of these situations, and once you get to the hospital too early, you may very well find yourself confronted with interventions you were hoping to avoid.
There are few avenues of study for monitrices, and no widely recognized certification that I know of. Most monitrices are either midwives who do some doula work (like me), or apprentice midwives who have learned some clinical skills. You will want to ask specific questions about where your (potential) monitrice gained her clinical skills and what her practice guidelines are. For instance, it is all well and good to say that she monitors fetal heart tones during labor, but does she know how to do it properly and what she’s listening for?
Though everyone has their own pricing structure, my fees as a monitrice are higher than my doula fees. One reason for this is that it is more time consuming. As your monitrice, I am with you from the end stages of early labor through the first hour or so postpartum. When I’m your doula, I providing phone support, but meet you at a later time, normally once you’re well into active labor. Most importantly, though, you are paying for my clinical experience in order to safely assess you and baby during the time we are together.