Doula vs Midwife

Most people are aware of the terms ‘midwife’ and ‘doula’, but a common mistake is to assume these roles are the same. The roles seem similar, since both are people who help women through labour. Many pregnant women also believe they need to choose one or the other for pregnancy and birth support. Yet midwives and doulas have very different roles.

Understanding the differences can help you make important choices about your birth, and understand the roles of your support team.

What Does A Midwife Offer?

Depending on where you live, there might be different kinds of midwives available, and different restrictions placed on their practice.

A midwife is defined as a person who is trained to care for women during pregnancy, birth, and the postnatal period. Midwives support women who have their babies in hospitals, birth centres and at home.

Midwives are health care professionals and can identify and treat complications, or seek medical expertise when needed. They can:

Recommend or order tests during pregnancy.
Give health advice during pregnancy, birth, and postpartum.
Prescribe supplements or medications for pregnancy care.
Monitor you and baby during labour and birth.
Perform physical examinations during pregnancy and labour, and after birth, as needed.
Consult with an obstetrician in the case of a medical complication that is outside the scope of midwifery practice.

What Does A Doula Offer?

A doula is defined as a person who provides physical and emotional support during pregnancy, labour, and the postnatal period. Doulas support women who have their babies in all settings. If a doula is hired by a woman who is birthing in hospital, her responsibility is to the birthing mother; there won’t be any association or link with the hospital.

Doulas are not health care professionals and can’t provide any medical advice, or perform any medical procedures. They can:

Form a relationship with you during pregnancy.
Support you as you work through previous birth experiences.
Help you create a birth plan.
Provide resources to help you make informed decisions.
Discuss labour management options and tools.
Use techniques during labour to provide comfort and relief.
Make suggestions during labour about different positions and techniques.
Support you to feel confident in talking to your care provider about your preferences or medical concerns.
Provide support after birth, as needed.

Doulas won’t monitor you or your baby, take blood pressure or temperature, perform vaginal checks, or any other medical related procedure. Your doula won’t make any decisions about your care or the care of your baby, but will support you to advocate for yourself.

Do I Need A Doula And A Midwife?

Often women who are birthing in hospital are advised to have a doula as well. Research shows that even though doulas don’t provide medical care, their support can reduce your chances of interventions, including c-section birth.

Research also shows the midwifery model of care provides better outcomes for mothers and babies. Despite this, midwifery models of care are the exception rather than the rule in most hospital settings. Even a hands-on midwife working in a maternity hospital might not be able to provide the level of support she’d like to. Maternity wards are busy places and midwives tend to care for more than one woman at a time.

Even if you are able to access primary midwifery care in a group practice, or a home birth midwife, a doula can still be an asset. Doulas offer support that complements the care women receive from hospital midwives. Your doula can come to you at home as early as you like, providing encouragement and support, as you need it.

Choosing your birth support is a very personal decision. Making the right choice often begins with looking at the birth you want to achieve and then choosing the model of care which offers the best care for you. Midwives and doulas are in different professions, but work well together and respect each other’s role in supporting pregnancy and birth as a normal, natural experience.