Doula vs Midwife: What’s the Difference?

Hiring the right people for your birth squad is crucial for finding an ideal balance of medical advice and emotional support for your pregnancy and postpartum period. Whether you’re planning to deliver at a birth center, hospital or opting for a home birth, your health care providers may include a doula or midwife (or both). While the two hold important roles in the birthing process, their positions are quite different. Here’s what you need to know.

Midwifery is unique in its holistic approach to prenatal care, meaning they care for pregnant women in all facets, from physical, emotional and mental wellness. There is an emphasis on natural birth, and often midwives allow for a hands-off birth experience with little intervention if desired by the mother. (Note that midwives generally only work with low-risk pregnancies but work with medical doctors and hospitals should an emergency arise.)

A midwife is a professional you would see for your regular appointments in place of an obstetrician. They are often employed by birthing centers and hospitals but also work independently. You’ll want to look for a certified nurse-midwives (CNM) group (or individual if pursuing a home birth). These are licensed health care professionals who specialize in women’s reproductive health and childbirth.

In addition to handling your prenatal care and monitoring fetal development, midwives can offer the following services:

1. Attend and assist with birth. Midwives help deliver babies and the placenta. They can administer Pitocin if needed for postpartum hemorrhage and perform post-delivery care procedures, such as stitching up a perineal tear.
2. Educate new parents on newborn care.
3. Give postpartum support to new moms, often in the form of a home visit(s).
4. Perform gynecological exams and help with family planning.
5. Prescribe medication and order tests for patients.

A doula is a professional labor support assistant that provides physical and emotional aid to mothers and their partners during pregnancy, childbirth and postpartum. Birth doulas who attend actual births become certified through proper training, such as DONA International. Sometimes doulas specialize in only one area of the process, like a breastfeeding or postpartum doula, but more often than not, they are hired to walk alongside moms-to-be and work together with physicians for the full 40-week journey and beyond.

Doulas are not medical professionals, meaning they will not perform any facets of your prenatal or gynecological care, assist with the actual birthing of your child and are not licensed to prescribe medication or give medical advice of any kind. Instead, they help gather resources and tools to help you make informed decisions with your OB-GYN or midwife.

Doulas make an excellent addition to any birth team because their full focus is on mom and her budding bump the entire time, not only at appointments or when baby is ready to arrive. Their encouraging, companionship-like contribution helps mom to feel well supported through the total process of pregnancy, labor, delivery and postpartum. What’s more, because a doula does not provide medical care, they are able to work with high-risk women and pregnancies, when a continuous presence of emotional support is often needed most. Some of a doula’s additional offerings may include:

1. Provide a wealth of information to clients, such as finding birth classes, at-home exercises for optimal fetal positioning, birthing positions, techniques for pain management (aside from pain medication), breathing exercises and more.
2. Communicate a mother’s birth plan to the hospital or birth center staff and advocate for her preferences when possible. This also includes creating a calming environment for mom and helping protect her ability to be left alone.
3. Offer comfort techniques during labor, including touch and massage and breath work to assist with pain management.
4. Assist with infant feeding.
5. Attend home visits after birth. These visits can involve new-parent support, newborn soothing, light housework, meal prep, helping an older child with the transition and more.

While any soon-to-be mom can benefit from hiring a doula, a first-time mom or a mom pursuing her first natural birth may benefit even more if they desire a knowledgeable and experienced partner throughout the entirety of their transition into parenthood. What’s most important is that a mother feels supported and cared for, no matter her decision.