Doula vs. Midwife

Doulas and midwives both assist with childbirth and provide support to a pregnant mother.

A doula provides physical, emotional, and informational support to an expectant mother before, during, and after childbirth. A doula focuses on an expectant mother’s own needs, which enables her to have a memorable and empowering experience while giving birth.

During pregnancy, a doula assists expectant mothers by helping them prepare for labor and delivery. This support includes creating a birth plan, discussing pain management preferences, and providing education about the birthing process. Doulas often meet with clients several times before labor to build rapport and understand their needs and desires for the birth experience. While the term "doula," meaning "woman's servant" in Greek, typically refers to a professional present during birth, there are also doulas who specialize in antepartum (before birth) and postpartum care.

Doula pregnancy professionals can be categorized into two main types:

• Birth doulas: They provide continuous support during labor, assisting with relaxation techniques, breathing exercises, massage, and positioning. They work alongside obstetricians, midwives, and nurses to enhance the birthing experience but do not perform medical tasks. Their role is to ensure the mother feels safe and supported throughout labor.
• Postpartum doulas: After the baby is born, these doulas support new parents with infant care, breastfeeding assistance, and household tasks, helping families transition into parenthood.

Doulas are not medically trained and cannot deliver babies, which distinguishes them from midwives, who are medically trained and can perform deliveries. Additionally, a doula is not a substitute for the mother's partner during birth but encourages their participation and offers support and reassurance to them as well.

A midwife is a health care professional. Depending upon the laws of the US state in which the midwife practices, a midwife may perform gynecological examinations (for example, Pap smears, pelvic exams, and breast exams), write prescriptions, care for a woman during labor and delivery, perform fetal monitoring, and provide information about contraception. A midwife usually seeks to eliminate or minimize unnecessary technological interventions, believing that pregnancy and birth are normal life processes. However, a midwife is also skilled at identifying and referring women who need the services of an obstetrician during the birth. A midwife is medically trained and qualified to deliver babies.

Some midwives are also trained as nurses. A nurse-midwife usually can offer the greatest variety of healthcare services to women.

The American Midwifery Certification Board (AMCB) is the US national certifying body for certified nurse-midwives (CNMs) and certified midwives (CMs). Midwifery education programs involve graduate study and usually require a Bachelor's degree for entry. Some programs will accept applicants with a Bachelor’s degree in a field other than nursing, while others require a Bachelor’s degree in nursing. Midwifery education programs in the United States are accredited by the Accreditation Commission for Midwifery Education (ACME). According to the AMCB, legal recognition for CNMs and CMs varies among states.

A doula does not necessarily have medical training, and there is no formal licensing required. However, many doulas choose training and certification by organizations that oversee doula training programs, such as DONA International™ and the Childbirth and Postpartum Professional Association (CAPPA).

When it comes to childbirth and pregnancy care, both doulas and midwives offer valuable services. However, their training, roles, and responsibilities differ significantly.

Doula vs. midwife: An overview

A doula is a trained companion who provides emotional, physical, and informational support to a mother before, during, and/or after childbirth. Doulas focus primarily on the nonmedical aspects of care.

A midwife, on the other hand, is a health care professional with specialized medical training in pregnancy, childbirth, and postpartum care. Midwives provide medical care and can manage deliveries, handle complications, and offer prenatal and postnatal care.

Doula vs. midwife: Training requirement

Understanding doula vs. midwife differences helps expecting parents make informed decisions about their birthing support team. While both provide essential services, the extensive medical training of a midwife contrasts sharply with the more focused nonmedical role of a doula.

Both a doula and a midwife are professionals that assist a woman in the pregnancy and birthing process.

A doula and a midwife offer different types of services, even though both may support the childbirth experience.

Midwives have medical training and during the birth process, focus on delivering a healthy baby.

Doulas, on the other hand, focus on the needs of the mother, offering mental, physical, and emotional support. Doulas do not have medical training or experience and cannot be used a substitute for a midwife or doctor.

Yes, many women opt to use both a doula and midwife, although it is not required that a woman use either or both, if using one or the other.

A midwife is trained to recognize an emergency or situation that requires medical care from a doctor. Midwives are trained to handle normal pregnancies, but obstetrical care is required for certain situations, and for pregnancies deemed to be at high risk. Many doctors have nurse-midwives in their practices that work alongside your doctor’s team and may manage normal pregnancies if the woman wishes.

Obstetricians (ob-gyn physicians) can manage high-risk pregnancies and perform surgeries, including C-sections, when necessary. Midwives are prohibited from performing C-sections or using forceps and vacuums during the delivery process. The midwife will seek obstetrical care from a doctor if a birth complication arises that requires one of these interventions or in an emergency that threatens the mother or baby.

The costs for doulas and midwives, as for any health care service, vary according to the specific provider and the geographic location. A doula typically charges a flat fee for service, meaning an agreed-upon number of prenatal visits, being on-call for support during your pregnancy, support during your labor and birth, and at least one postpartum visit. Other services may be included in the package. The costs for a doula can be $1,000 or more in major cities and substantially less in other areas.

For a midwife, the cost also varies by location. The average cost of a midwife starts at around $2,000, but midwives’ fees may be covered by some insurance policies. These fees typically cover all prenatal visits, the birth, and postpartum visits. Some midwives may offer sliding scales, reduced fees, or payment plans for some women.

When comparing doula vs. midwife, it's clear that midwives generally have higher costs, as they often provide more comprehensive medical care.

• Do I need both a doula and a midwife for my birth? Having both a doula and a midwife for your birth can be beneficial, but it's not necessary. In the doula vs. midwife comparison, a midwife is a trained medical professional who provides prenatal care, delivers the baby, and can manage medical emergencies. In contrast, a doula offers emotional and physical support during labor, focusing on comfort techniques and advocacy without performing medical tasks. Many people choose to have both to benefit from the midwife's medical expertise and the doula's continuous support, enhancing the overall birthing experience. Ultimately, whether you opt for a doula vs. midwife or both depends on your personal preferences and needs during childbirth.
• Can a doula provide medical care during childbirth? No, a doula cannot provide medical care during childbirth. Doulas offer emotional, physical, and informational support to the birthing person and their family, but they are not medically trained to perform clinical tasks or make medical decisions. Their role complements the care provided by medical professionals such as doctors and midwives.
• What are the benefits of having a midwife vs. a doula? A midwife provides comprehensive medical care during pregnancy, childbirth, and postpartum, including delivering babies and managing complications. In contrast, a doula offers nonmedical support, focusing on emotional, physical, and informational assistance throughout the birthing process. Both roles complement each other, with midwives ensuring medical safety and doulas enhancing the birthing experience through continuous support.
• Is a doula or midwife better for a home birth? When considering doula vs. midwife for a home birth, only a midwife is trained and able to manage the delivery of babies. Midwives have medical training and can handle complications during labor and delivery. Doulas provide emotional and physical support but lack medical expertise; doulas do not manage the delivery. Ideally, having both can offer comprehensive care and support.
• What roles do doulas and midwives play during labor? Doulas and midwives support women during labor, but their roles differ. A doula provides emotional, physical, and informational support, offering comfort techniques, encouragement, and guidance. They do not perform medical tasks. A midwife, on the other hand, is a trained health care professional who manages the medical aspects of childbirth, including monitoring the mother and baby, assisting with delivery, and handling complications. While both focus on empowering the mother, midwives handle clinical care, whereas doulas focus on nonmedical support.
• Can a midwife also act as a doula? Yes, a midwife can also act as a doula. While midwives are medically trained to deliver babies and provide prenatal and postnatal care, doulas offer emotional and physical support during childbirth. Some midwives choose to provide both types of care, combining their medical expertise with the supportive role of a doula.
• How do the costs of hiring a doula compare to those of a midwife? Hiring a doula typically costs between $800 and $2,500, depending on location, experience, and services provided. Midwives generally charge around $2,000-$6,000 for comprehensive care.  This doula vs. midwife cost comparison reflects the higher cost of midwifery due to its comprehensive medical services.
• What should I consider when choosing between a doula and a midwife? When considering doula vs. midwife, remember that while both provide vital support, their roles differ significantly. So before you choose, consider their roles and the type of support you need. A doula provides continuous emotional and physical support during labor and delivery but does not offer medical care. A midwife, on the other hand, provides both medical care and emotional support throughout the birth process. If you need medical expertise and care, a midwife is essential; if you’re seeking additional emotional support and guidance, a doula can complement your care team.