Doula vs. Midwife: What’s The Difference?

There are quite a few misconceptions surrounding the role of the doula, but one of the most common is that doulas and midwives are interchangeable terms or have the same role during pregnancy, labor and delivery. In fact - this is false! The two main differences between a doula and a midwife are their scope of practice. The doula’s scope of practice is centered mainly around supporting the birthing person emotionally and physically and helping them advocate for themselves and their baby. The midwife also has this capability, but a midwife is a medically trained professional who is able to administer medical care to the pregnant person and the baby. Whether you’re already pregnant and preparing for birth or you have yet to conceive, knowing the roles of a midwife versus a doula may help you decide if you’d like to hire one - or both! - to attend your birth!

The doula and the midwife: how are they the same?

There are a couple of similarities between the doula and the midwife, and to find them we have to time-travel back into history a little bit! Midwives have existed around the world for centuries, delivering babies and taking care of women in their communities all around the world. Obstetrics and gynecology didn’t even really exist as a professional field prior to the 18th and 19th centuries, and up until then, midwives had dominated the birthing world as the default care providers for women and babies. Similarly, doulas have also been around for centuries, existing as unnamed women who would be present throughout pregnancy, labor and delivery for their female friends and family members. In the 1970’s the term “doula” was coined from a Greek word meaning “servant-woman” and was recognized as someone who could lend supportive, servant-like care to mother and baby and ensure that continuous support was offered to the laboring mom and baby, with the hope of producing the best and healthiest birth outcome.

Knowing this brief bit of history about midwives and doulas, you can see their similarities are simply this: they both are women who provide some level of care and support to women in their community, during the process of pregnancy, labor and delivery.

The doula and the midwife: how are they different?

WebMD defines a midwife as “a trained health professional who helps healthy women during labor, delivery, and after the birth of their babies. Midwives may deliver babies at birthing centers or at home, but most can also deliver babies at a hospital.” There are a few different types of credentials that a midwife may have, such as whether she is a Certified Midwife (CM), Certified Nurse Midwife (CNM) or Certified Professional Midwife (CPM), which is an important thing to research if you are planning on seeing a midwife for your prenatal care, labor and delivery. Midwives (depending on credentials) can prescribe medications, provide medical care, tests and other medical services to mom and baby, as well as deliver the baby. Midwives may be affiliated with a birthing center, a hospital, or if it is legal in your state, may attend home births. Many women seek the care of a midwife if they are healthy and considered “low-risk” during pregnancy, although many midwives are capable of caring for some pregnancy-related issues and complications.

A doula is defined by DONA International as “a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible.” Unlike a midwife, a doula is not a medical professional. A trained doula may have other credentials that supplement her knowledge and expertise, such as training as a childbirth educator, lactation consultant, or aromatherapist. Doulas cannot prescribe medications, administer tests or any kind of prenatal care, OR deliver the baby, but are there to provide emotional support, information, knowledge and physical support to the birthing person and their partner during pregnancy, labor and delivery. Doulas are typically not associated with any particular hospital or birthing center, although some of these venues may have a volunteer program or referral network that will help families get connected with a doula if they wish to hire one. There is evidence to show that continuous support by a trained doula can result in fewer complications and necessity for cesarean section - but you don’t need to have an unmedicated vaginal birth to hire a doula. A trained doula has the knowledge and capability (and hopefully the desire and compassion!) to support any type of birth experience! Doulas have the reputation of attending un-complicated, unmedicated births, but even if these things are not your preference, or if circumstances lead to other birth outcomes such as receiving an epidural or cesarean birth, the support of a doula remains a valuable part of achieving an empowering and satisfying birth experience.

I hope this post helped clear up any of the misconceptions you had about the role of doulas versus midwives! It’s my personal hope that doulas will become more widely used for all types of birth, since there is such overwhelming evidence in their favor. I wanted to become a doula because I believe that women should feel supported and feel excited about birth, especially in a society that portrays childbirth as scary and over-medicalized at times. We see from looking at history that women have been attending births for centuries - it’s in our nature to nurture others of our kind as they lend themselves and their bodies to such a miraculous feat. Whether you are pregnant now or in the future, I hope that you consider hiring a doula to give you and your partner the support you need and deserve, no matter what type of birth you have!