Understanding the Difference Between a Doula and a Midwife

“What exactly is a Doula”?

“I didn’t know there was a difference between a Doula & a Midwife”

“I thought when I hired my Midwife, she would also be my Doula”

“My Midwife said, I don’t really need a Doula, because she will be there”

“I didn’t realize how much work my Midwife wanted me to do on my own before she will be present”

I often am asked about the difference between a midwife and a doula. It seems, that many are under the impression that you need to either choose a midwife or a doula, or that you do not need a doula if you have a midwife. However, a midwife and doula have distinctly separate roles when it comes to the kind of support and care you receive during your pregnancy, your birth, and during the postpartum period.

Let’s take a glance at some of the specific roles of a Doula & a Midwife during your very special journey…

Your Midwife: Personalized Maternity Care

  • Oversees the medical safety of your pregnancy and birth
  • Runs prenatal tests
  • Advises you on health & nutrition during pregnancy, birth and postpartum
  • Monitors you and baby during labor and birth
  • Clinical tasks such as, temp, pulse, BP, and FHR
  • Performs physical examinations prenatally, during labor and postpartum
  • Consults with an obstetrician if a medical complication arises which is out of the midwifery scope of practice

Doulas, on the other hand, are not medical professionals. Doulas provide physical, emotional & informational support during pregnancy, birth, and the immediate postpartum period.

Your Doula: Physical, Emotional, & Information Support

  • Establishes a prenatal relationship with you
  • Helps you and your partner articulate your ideal vision for your birth
  • Directs you to outside resources within your community for pregnant women and families
  • Ensures you and your partner feel calm, informed and supported during labor
  • Guides your partner in engaging and supporting during the labor and birth process
  • Uses natural tools and hands-on techniques to help you manage and cope with the intense physical sensations of labor and birth
  • Makes suggestions regarding laboring and birthing positions depending on how your labor is progressing
  • Makes sure you understand all of your options so you can make informed decisions every step of the way
  • Ensures you feel confident communicating your needs to your health care provider
  • Provides postpartum emotional support and help with breastfeeding initiation

While doulas do not provide medical care, research shows they do increase your likelihood of avoiding unnecessary medical interventions, greatly decrease your chance of a cesarean birth, and significantly decrease a woman’s need for analgesia, compared to usual care.

Do I need BOTH a Midwife and a Doula?

Doula support is an amazing complement to the care you will receive from your midwife. It is important to understand that the ultimate responsibility of your Midwife is the health and safety of you and your baby. Your midwife needs to be present, alert and at the top of their game during the active stage of your labor, pushing and the birth of your baby.  If your Midwife were to provide 12+ hours of physical and emotional labor support, they are going to be tired, spent, and not have the level of alertness necessary should their be a medical emergency at any point of your labor and birth process.

Most Midwives want you to labor on your own as long as possible, and they only come (or check you into the birth center), once labor has been well established and you are nearing the home stretch. They call it the 511. When contractions have reached 5 minutes apart, lasting 1 minute or more in length, for 1 consistent hour. For many women, this can mean laboring for 12, 24, 36 hours on their own.

They will check vitals, asses Mother and Baby for the medical safety and progression of the labor process, and then hang back, and let you labor on your own. They will occasionally provide physical and verbal support, but it is not given in a manner that will hinder their role as the medical care provider of you and your baby.

Your doula, however, comes to you early in your labor, when you first begin to feel that you are in need of support and guidance, and she will stay with you until after the birth of your baby. Doulas love being part of the early labor stage and following your journey to the end. Their continual support can make such a difference on the overall experience of the birth process for both you and your partner!

When you seek out a Midwife, it is because you want to have a natural, un-medicated, un-intervened upon childbirth, with the freedom to birth your way, on your terms. Using both a midwife and a doula will give you the full spectrum of support and medical care you need, to achieve the birth you want, and ensure that you are able to naturally cope every step of the way.

Together, having BOTH a midwife AND a doula, means you will be supported and nurtured in every way as you birth your baby. Your partner, your midwife, your doula … They create your birth team, your village…

Midwives and doulas work hand-in-hand together, with a great respect for each other’s roles in supporting the birth you desire. However, they are very different professions, with different roles and responsibilities to you, as the birthing family.


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