Midwife Versus Doula: Understanding the Differences in Pregnancy Care

This blog is not intended to be medical advice. Always consult with a qualified healthcare professional for more individualized guidance.

No matter how prepared you are for parenthood, when your due date rolls around, it can’t hurt to surround yourself with trusted supporters. Additionally, keeping someone who’s seasoned in the birthing process in your corner can give you that extra reassurance that everything is going to be okay.

Doulas and midwives are two kinds of care workers qualified to help you navigate childbirth and feel supported before (and sometimes after) your baby is born. Though their roles and qualifications differ, either may be worth considering as an extension of your prenatal care team.

If you’re trying to decide between recruiting a midwife versus a doula, knowing how they compare and what they offer can help you feel secure in coming to a final decision. With a grasp of the factors you’ll want to consider, you can feel confident in the team you’ve gathered when it’s finally time to give birth.

The Role of a Certified Nurse Midwife in Pregnancy Care

What is a midwife? Midwives are certified care providers that facilitate various aspects of childbirth, as well as prenatal and postpartum life. They’ve typically had experience working closely with OBGYNs, though they tend to take a more holistic approach to care that includes physical, psychological, emotional, and even spiritual aspects of childbirth.

Midwives may provide a variety of services and supports, including:

• Reproductive care and procedures, like pelvic exams, pap smears, or birth control counseling
• Prenatal checkups, monitoring, and tests, like ultrasounds or bloodwork
• Prenatal care advice, like nutrition, exercise, and lactation recommendations
• Family planning counseling
• Education and information about childbirth options and birth plans
• Being present for the labor process, ensuring the birth plan is executed (or as close to it as possible!)
• Delivering your baby

Midwives can be an exceptional addition to prenatal care teams, but the services they provide are more limited than what an OBGYN can offer. In particular, midwives cannot administer:

• Cesarean births, though they can assist physicians with them
• Epidurals, though they can prescribe them

Midwives generally stay with the family after childbirth, providing both postpartum medical care and an “emotional scaffold” to the household after the birth of their new baby. Many may offer breastfeeding support as well as advice and guidance for caring for newborns.

Midwife Certifications

Technically speaking, there are three types of midwives:

• Certified nurse midwives (CNMs)
• Certified midwives (CMs)
• Certified professional midwives (CPMs)

The key difference between them boils down to certification. Both CNMs and CMs possess Master’s degrees in Nursing and have obtained a certificate from the American Midwifery Certification Board (AMCB). AMCB certificates must be renewed every 5 years to maintain valid credentials.

On the other hand, certified professional midwife is not required to hold a graduate degree in Nursing. That said, many CPMs have acquired competency occupationally—over time and through experience, rather than formal education. In the course of your search, you may also come across lay midwives: unlicensed midwives who may have been self-taught or underwent non-traditional training. Typically, lay midwives are only brought on to very low-risk home births.

The Role of a Certified Doula in Pregnancy Care

“Doula” is a borrowed term from Greek meaning “female helper.” But what does a doula do? Think of them as a kind of “birth counselor”: they may offer insights and information about what to expect from the late prenatal period and birthing process.

Likewise, doulas offer emotional support during the profound process of giving birth and early postpartum life. While they can’t deliver your baby or provide medical care like a certified midwife can, they can be a supportive, comforting presence in the time before, during, and after labor.

Generally speaking, doulas may be divided into two camps:

• Birth doulas
• Postpartum doulas

Many doulas can provide both birth and postpartum care. Doulas are chiefly there to give:

• Birthing education – Doulas can help decide on and develop a birth plan with tips for childbirth for you. Working with one can put you in touch with important information about your options and what to expect from the process.
• Childbirth support – During labor itself, doulas remain by your side to provide support and advocacy, while cooperating with other care providers in the room. They can also help reassure family members and spouses if concerns arise during labor.
• Emotional support – Doulas are known for their soothing presence and ability to work through your emotions with you. Postpartum doulas in particular can be exceptional in facilitating emotional processing during the taxing and often emotionally turbulent time of the postpartum period. Some doulas even stay with new parents for a few weeks after their baby is born to provide round-the-clock household and emotional support.

Doula Certifications

In general, becoming a doula is a much less rigorous process than becoming a midwife. This is because doulas aren’t required to hold a medical degree. In fact, many young people elect to become doulas sheerly due to an interest in obstetrics and parenthood (often, it’s a first step into the world of healthcare or childcare).

While becoming a doula isn’t as formalized, many organizations thoroughly educate, train, and accredit their students to ensure they’re prepared for the doula care work required during and after birth. If you’re considering working with a doula, keep an eye out for:

• State certifications
• Training program credentials from a reliable institution, like DONA International

Choosing Between Doula vs Midwife: Factors to Consider

With so much to prepare for before your due date rolls around, choosing who will be in the delivery room with you can feel like one of the most momentous decisions in your birth plan. With that, several factors are worth considering when deciding between bringing a midwife and doula onto your birth team.

Your Budget (and Insurance)

For plenty of expecting parents, budget can be the decisive factor in deciding between doulas and midwives. Depending on your prenatal coverage, your insurer may or may not foot the bill for doulas since they’re not technically qualified medical professionals.

Your Prenatal and General Health

It can help to ask yourself why you’re considering hiring a midwife or a doula in the first place: Are you searching for emotional or even spiritual support, or a person who can provide medical assistance in the event of a complication or challenge?

While midwives may provide either service, a doula’s strengths are in coaching you before and during your birth experience. Moreover, try not to underestimate the importance of compatibility when finding true emotional support with a doula—you may have to meet a few before you find your match!

Your OBGYN’s Input

If you’re struggling to come to a decision, your existing prenatal care team—including your OBGYN and primary care provider—may be able to give more insight into the benefits and drawbacks of each. They can also take your prenatal health and any health conditions (e.g. gestational diabetes) into consideration, helping you anticipate what you might need during labor.

Your Birth Plan Preferences

Expectant parents have a range of childbirth options to choose from, from natural births to traditional hospital settings (and access to epidurals). Assuming that your health is in good shape and your OBGYN obliges, choosing between a doula vs midwife may simply come down to personal preference.

If you have the bandwidth for it, you might consider interviewing a few midwives and doulas to see how you feel in their presence. If your personalities mesh well, you can most likely expect to feel supported during that tender time of childbirth and the weeks after.

Can I hire both a midwife and a doula?

Absolutely! In many cases, doulas and midwives work well together to provide a balance of emotional and medical birth support. Having both sets of hands on deck can be especially advantageous in those early weeks postpartum, particularly if:

• You’re expecting multiples
• Your newborn struggles with sleep, feeding, or colic
• You or your newborn have health challenges to navigate
• You’re confronting mental or emotional health challenges in the postpartum period

In short, if it’s within your budget, there’s no reason why you can’t hire both a doula and a midwife to help usher you into parenthood.

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This post has been reviewed for accuracy by:

Priscilla Jeng

Priscilla Jeng is an accomplished digital marketing expert, currently leading as the Associate Director of Digital Marketing at Gateway Genomics, the parent company of SneakPeek. With over four years at Gateway Genomics, Priscilla has played a pivotal role in amplifying the company's mission to develop innovative genetic tests. Her proficiency in digital marketing and her comprehensive understanding of the genomics industry position her as a key contributor to SneakPeek's marketing endeavors.

Sources:

1. Cleveland Clinic. Midwife. https://my.clevelandclinic.org/health/articles/22648-midwife
2. VeryWell Health. Doula vs. Midwife: How to Choose the One That’s Right for You. https://www.verywellhealth.com/doula-vs-midwife-7548849#toc-what-does-a-doula-do
3. Cleveland Clinic. Nurse Midwife vs. Doula: Who Does What? https://health.clevelandclinic.org/doula-vs-midwife
4. DONA International. DONA International Homepage. https://www.dona.org/