Midwife vs Doula: Understanding the Differences


Midwife vs Doula: Understanding the Differences 

Should you have a midwife vs doula? What’s the difference? One of the most common questions we get is for us to explain the difference between Midwife vs. Doula. A midwife is a professional with training and education in pregnancy, labor, and birth. Our competencies include family planning, pregnancy, labor, birth, the postpartum period, newborn care, and women’s health. A doula, by contrast, is a professional typically without formal obstetric training who provides guidance and support to a person during labor. When you are deciding who will support you during your pregnancy and birth, you will be given the option to decide whether you want a midwife vs doula. 

Midwife vs Doula: Distinct Responsibilities and Training 

One of the major differences between a midwife vs doula is that a midwife is the medically responsible party present at appointments and during the labor. A midwife is someone who is trained and educated in the midwifery model of care and is able to draw labs, order ultrasounds, make recommendations, monitor fetal and maternal well-being, perform vaginal exams, and do deliveries. Another difference between a midwife vs doula is that the midwife is licensed to take care of the newborn through six weeks postpartum. In our practice, we provide home visits at days one, three, and seven, and fourteen. We also offer an office visit at four weeks and six weeks postpartum to assess the well-being of both the birthing person and the baby. A midwife will continue to be very involved in your life for the first six weeks after the baby is born, including offering support with breastfeeding, pelvic exams, nutritional and lifestyle support, a Pap smear if indicated, and recommendations and referrals for further medical treatment if that’s necessary. A doula will likely be present for the birth and for one or two appointments afterward to try and help with non-medical procedures and offer support in the way that a very experienced family member or friend would. They might have helpful tips for recovering and newborn care, but again, they are not offering medical advice. This is a very important difference between a midwife vs. Doula. 

Midwife vs Doula: What they do at the Birth 

A distinction between a midwife vs doula can also be found in what the person is doing during any given birth. A midwife will be assessing fetal heart tones, monitoring the well-being of the mom and baby, “catching” the baby, and doing any resuscitation, suturing, and management of excessive bleeding. A midwife vs doula, in essence, is the care provider present for a low-risk, healthy pregnancy and baby. So that answers the question of a midwife in the “midwife vs doula” question, but what about a doula? A doula is someone who is trained in giving emotional and physical support during the birth. They provide comfort measures, support, and presence to someone as she is going through the hard work of having a baby. Doulas do not have any medical training or licensure, and while their work is very important, it is less technical than the world of a midwife. 

Midwives and Doulas Work Together 

One great thing to note is that you do not have to choose between a midwife vs doula! You can have both a midwife and a doula at your birth. As Midwives in Portland, Oregon, we love to work with doulas, because we want every laboring person to be well supported during their birth. While we always strive to be emotionally present for women, sometimes we have to prioritize providing safe care, and it can be wonderful to have a person present whose only job is to be present for you emotionally. You do not have to select between having a midwife vs doula; you can have both if that’s what you want. 

What About Midwife vs Doula vs OB? 

Another question people sometimes have is what is the difference between a midwife vs doula vs OB. Let’s break that down. A midwife vs doula vs OB can basically be summarized this way: the midwife is the expert in normal, low-risk pregnancy and birth; the doula is a trained professional responsible for the emotional and physical support of the laboring person; and an OB is a medical surgeon who is trained in higher-risk pregnancies and qualified to practice in obstetrics. Usually, people choose between having a midwife or an OB, and they can have a doula present at a birth attended by an OB or a midwife. To recap, while you do not have to choose between a midwife vs doula, and you do not have to choose between an OB vs doula, you do typically have to choose between an OB vs midwife. If your pregnancy ever becomes complicated or high-risk either prenatally, in labor, or postpartum, your midwife can transfer your care to an OB and accompany you as a support person. For most people who are low risk, a midwifery-attended birth is very appropriate and safe. 

What Qualities Should I look for in a Midwife vs Doula? 

The most important thing to consider will always be how well you trust the person and how at ease you feel with them. You should always have an opportunity to have your questions answered to your satisfaction. Ideally when selecting a midwife vs doula, you will select someone that you feel has your advocacy and best interest at heart, and with whom you can communicate and feel safe and heard. Remember, whether it’s a midwife or doula, they are there for you and they are there to help you have the best birth you can possibly have.