What is a midwife called in Polish, and how is a położna different from a doula in Poland

The English word midwife translates into Polish as położna, and midwives are położne. The Polish Act on the professions of nurse and midwife also has a male form: położny. Both titles are protected by law, so only a person with a licence to practise as a midwife, called PWZ (prawo wykonywania zawodu), may use them.

The International Confederation of Midwives (ICM) describes a midwife as a person who has completed a midwifery education recognised in her country and is licensed to practise. Under this definition a midwife supports women in pregnancy, during labour and after the birth, conducts births on her own responsibility and cares for the newborn. Polish law describes the profession in very similar terms.

In Poland, midwives qualify through a university degree in midwifery (położnictwo). The licence to practise is granted by a regional council of nurses and midwives, and the midwife is entered in a register that you can check online. A midwife is not a doctor's assistant: the law calls midwifery an independent medical profession.

In its main sense, yes. The PWN dictionary of Polish describes akuszerka as an old word for a midwife. Today laws and official documents only use położna, and akuszerka is not a professional title. The dictionary also records a second, historical meaning: a woman who delivered babies without formal training.

You may hear the word akuszerka from people who speak Ukrainian or Russian, because in those languages акушерка is the current word for a midwife. If someone is looking for an akuszerka, they are usually just looking for a midwife.

The scope of a midwife's work is set out in Article 5 of the Act on the professions of nurse and midwife. Among other things, a midwife:

• diagnoses pregnancy and cares for women with a normal (physiological) pregnancy, including the tests needed to monitor it,
• refers you for tests that help detect a high-risk pregnancy as early as possible,
• manages a normal birth, monitors the baby with medical equipment and delivers babies, with an episiotomy if needed,
• in emergencies, takes the necessary action until a doctor arrives,
• cares for the mother and newborn after the birth, examines the baby and recognises signs that mean the mother or baby should see a doctor,
• provides gynaecological care and works on preventing women's health problems,
• teaches: preparation for birth and parenthood, family planning, hygiene and nutrition.

A midwife can also issue prescriptions and referrals, within limits set by law. With at least a bachelor's degree she can refer you for certain diagnostic tests, and after a specialist course she can also issue prescriptions needed to continue treatment ordered by a doctor. A midwife with a master's degree or a specialist title may prescribe certain medicines on her own if she has completed a specialist course or gained this knowledge during her training. The lists of medicines and tests are set by a regulation of the Minister of Health.

Midwives work in hospitals, in primary care (POZ) clinics, in antenatal and gynaecology clinics or in their own practice, either with an NFZ (National Health Fund) contract or privately. A POZ midwife, whom you choose by submitting a declaration, provides free antenatal education, which the NFZ funds from the moment pregnancy is confirmed. After the birth she visits you at home at least 4 times between the 1st and 6th week of the baby's life.

The Polish doula association, Stowarzyszenie DOULA w Polsce, describes a doula as a trained and experienced woman, usually a mother herself, who gives continuous non-medical emotional, informational and physical support to the mother and family during pregnancy, birth and after the birth. A doula can, for example, help you prepare a birth plan, be available by phone before the birth, stay with you during labour and visit your family after the birth.

The key difference is medical care. According to the association's code of ethics, a doula does not perform any medical procedures, does not diagnose and does not give medical advice. The code also forbids doulas to take part in planned births without a midwife. If a doula has a medical background, for example she is also a midwife, the two roles should be clearly kept apart when working with a family.

Doula appears in Poland's official classification of occupations as „asystentka kobiety w czasie ciąży i porodu (doula)”, code 532906, in the group of personal care workers in health services. It is not a medical profession, however: a doula does not need a licence to practise and is not entered in a professional register the way a midwife is.

Midwives and doulas do not compete: they do different jobs. A 2017 Cochrane review found that women who had someone supporting them throughout labour were more likely to have a spontaneous vaginal birth, less likely to have a caesarean and less likely to rate their birth negatively. In these studies support came from hospital midwives or nurses, doulas or family and friends. The review authors rated the quality of this evidence as low.

The Polish Act on patients' rights allows a person close to you to be present, at your request, while you receive medical care. A close person is not only a relative or partner but also anyone you name, so it can be a doula. The Polish perinatal care standard says your birth plan should record your wishes about having a close person with you during the birth.

Staff may refuse the presence of a close person if there is a risk of an epidemic or for the sake of the patient's health and safety, and the refusal must be noted in the medical records. Whether your partner and a doula can both be in the delivery room at the same time depends on the ward's rules. Ask the hospital you have chosen before the birth.

Every woman needs medical care in pregnancy, at the birth and afterwards, so a midwife or a doctor will always be there for you. In hospital a normal birth is managed by the midwife on duty, and once you are home your POZ midwife visits. A doula is extra support you can choose if you want one familiar person with you throughout labour. You pay for her services privately.

A midwife can also give you continuity of care. Some midwives privately care for your pregnancy, accompany you at the birth or come for extra home visits after the birth, combining medical care with support. You can find such midwives on MyMidwife, among other places, and each profile shows the types of visits and the area she covers.

You can check a midwife's licence to practise for free in the search tool of the Polish Chamber of Nurses and Midwives (Naczelna Izba Pielęgniarek i Położnych) at nipip.pl/weryfikacja-pwz. You need her surname and PWZ number. The number has 7 digits and a letter at the end: A means a midwife and P a nurse. The result shows whether the licence is current or, for example, suspended.

Our article on how to check a midwife's licence to practise explains the search tool, the statuses in the register and the RPWDL register of private practices in detail. You can check the CDL lactation adviser title on the list kept by the Centrum Nauki o Laktacji, and a separate article explains the differences between CDL, IBCLC and a midwife.

If you are having a baby in Poland and are more used to English terms, these Polish equivalents will help you when talking to staff or filling in forms: