Doula vs. Midwife: What’s the Difference?

What is a doula?

A doula is a non-medical assistant for a woman before, during, and after the childbirth. Doulas can provide informative, physical and emotional support to a birthing woman, her partner and family. You can think of a doula as your advisor or a counselor in childbirth.

What does a doula do?

A doula will help you:

• Learn as much as you can about childbirth and newborn care.
• Choose among different options when it comes to childbirth and epidural.
• Show you how to tell if your contractions are real.
• Birth doula guides you through the labor and assist with breathing and changing positions. She will also:
• Provide emotional support and help you feel safe.
• Help you stay calm in situations that draw anxiety or fear.
• A postpartum doula helps you recover from the labor and care for the newborn.
• She will also assist with housework and other children in the home.
• Postpartum doula will also pay attention to your postpartum health, healing, and nursing/breast issues. She is one of the first people to contact if you're uncertain about getting medical help for yourself or the baby.
• Help you cope with baby blues and postpartum anxiety.

Doula training and certification

Doulas are typically certified with some courses. However, there is no law requiring doulas to be certified but undergoing special training and being certified is beneficial for professional doulas.

What you need to know is, although having a doula by your side is calming and pleasant, she can't provide you with maximum assistance as the midwife can. Doulas don't have any official medical training, and their role is strictly advisory. 

Your doula won't be able to order any medication or advise medical staff on any aspects of the labor. She serves as your advocate and she is there to make you feel better and assure that your opinions are being heard.

What is a midwife?

Unlike doula, who can only assist and support you physically or emotionally during labor, a midwife's role is more medical. Midwives are medical professionals - either men or women - who have special education and training and are certified for their job. 

What does a midwife do?

Midwives are medical experts. They are equipped and qualified to assist doctors during childbirth, but they also deliver babies on their own with home births. As you can see, a midwife is a highly skilled professional who possesses medical and practical knowledge in childbirth. However, what is expected of a midwife may vary significantly depending on the country you live.

Typically, a midwife is qualified to:

• Perform a gynecological exam.
• Care for you before labor.
• Prepare you for a cesarean section delivery.
• Do an ultrasound.
• Operate CTG and other machines used to monitor the mother and a baby.
• Give you pain medication.
• Give you epidural.
• Deliver your baby vaginally.
• Perform an episiotomy and stitch your tears, etc.

Midwife training and certification

As you can see, the midwife's duties are far more complex and medically demanding than those of a doula. 

A midwife needs to be able to 'step in' during any time of the delivery process and assist the doctor with the close-to-equal degree of expertise. However, a midwife isn't as same as an obstetrician. 

A midwife doesn't have the qualifications to diagnose other conditions related to childbirth and prescribe treatment. She is also unqualified to perform an emergency C-section or make decisions in case of complications during delivery. 

However, midwives, doctors, nurses, and doulas work as a team during childbirth. This is why it's not unorthodox to see a doctor exchanging opinions with midwives or asking for their advice.

Do you have to make a choice between doula and midwife?

No. You can choose to have both, none or only one of the two.

 What's important for you to understand is that midwives and doulas do two completely different jobs. The confusion most likely happens due to overlap in knowledge and close communication between the two before and after delivery. 

If your midwife and doula work closely to provide you with the best care, that is an example of the highly professional practice. It could happen that, due to years, or even decades of experience, midwives and doulas know a lot about each other's jobs and areas of other's expertise. 

Still, consulting and acknowledging each other's opinions and being qualified to perform medical/postnatal care are two different things. The difference between midwife and doula can be summed up in a couple of points:

• A midwife is a medical professional whose expertise is similar to that of a doctor.
• A doula is an assistant and an advisor who works solely in the purpose of providing physical and emotional support to a woman, her partner, and family.

While you don't have to have doula's assistance during delivery and postpartum, having a midwife is wise for numerous reasons. Midwives are often more available than doctors and free to pay you a visit/talk over the phone whenever you have any medical concerns.

Midwives are by your side when the doctor is absent and can check on you and the baby. In many countries and hospitals, doctors work with multiple patients and can't always be there when you need them. 

Very few doctors are available to stay by the mother's side throughout the entire labor, which can last for very long. Your midwife can provide assistance when the doctor is absent, and get through to them fast in case you need them urgently.

How do I choose my birthing option?

Understanding the difference between doula and midwife will help you make the best decision. When planning your labor, keep in mind the following:

You don't have to choose

You can have both a midwife and a doula. If you want a supportive team on one of the most important days of your life, you deserve staff who will answer all your questions about labour, ease your fears, and be there to alleviate your pains. 

That being said, you don't have to have both experts if you feel like you don't need them. Having a midwife is recommended because they are highly qualified to provide medical care. However, you can decide whether or not you want/need a doula. 

If you're very confident in your knowledge and emotional state, and you have enough help at home than perhaps you don't need a doula. 

Make sure to base your decision on what you want and your own comfort more than on others opinions.

Midwife and doula must be a good match for you

Regardless of their expert level of skill, both of them must be kind and understanding towards you. 

You and the doula/midwife must be on the same page regarding delivery and newborn care options, and they are the ones who have a duty to respect your opinions. Aside from what's medically appropriate, your midwife and doula should be respectful of your choices and have an empowering attitude regardless of their personal feelings.

Both midwife and doula must be respectful of your choices

If you have the option to choose your staff, don't be afraid to turn down those who are disrespecting you. This particularly goes for epidural, breastfeeding, other pain medications, postnatal care, and all other aspects. Experts should share their views on most appropriate options but also respect your decisions regardless of their own agreeing.

You can always change your mind

You can always let go of those experts who are disrespectful and have a negative attitude towards you. The role of both the midwife and the doula is to help you feel confident and comfortable, not to install insecurities and discomfort. If either of the two is making you feel bad because of your breastfeeding decisions, desire to take epidural, pain medication, or any other aspects of the postnatal care, you have the right to choose someone else.

Conclusion

Knowing the difference between a midwife and a doula will help you understand what each of the experts can do to support you and your baby during delivery and postnatal recovery. You can decide which expert to get based on your needs, budget, and available resources. Perhaps, defining the right qualities for your support medical staff is more important of an issue than making a choice. List all of the qualities you want in your midwife and doula, and make your choice based on them. This is a way for you to balance between desired and available, and assure that most supportive staff is on your team.