What is the Difference Between a Midwife and a Doula?

I get asked this question about once a week. Many people don't know that there is a difference and often confuse the two. Here it is, plain and simple:

A midwife is a primary care provider. She provides clinical care for the healthy mother and baby. For many women, as long as their pregnancy progresses normally, they will have no need to ever see another primary care provider, say for example, an obstetrician. The midwife oversees the general health of mom and baby throughout pregnancy and manages the delivery and postpartum period as well. You could say that the midwife delivers the baby, but I think most midwives would disagree. It's the mother who delivers the baby! 

A doula is an extremely valuable person to have on your birth team, but she doesn't have a clinical role. A doula's job is to support the mom and her partner in labor. She provides physical support (massage, labor coping techniques, etc.) and emotional support. She can help the parents navigate the hospital system if they are delivering in a hospital by educating them on different procedures and holding space for them to make informed decisions. The doula does not take the mother's blood pressure, assess the baby's heart rate, or do anything else clinical. 

 
Doula Yien supports a mama having a natural delivery at home by keeping her calm, focused, and on top of her contractions. Yien provides continuous physical and emotional support until the baby is born, never leaving the mom's side.  Photo by Pam Ellis

Doula Yien supports a mama having a natural delivery at home by keeping her calm, focused, and on top of her contractions. Yien provides continuous physical and emotional support until the baby is born, never leaving the mom's side.
Photo by Pam Ellis

 

Midwives and doulas often work in tandem. It is common to see both a midwife and a doula supporting a birthing mom together, each bringing her own set of skills to the process. 

In her blog, A Wondered Life, Rebecca Coursey explains the difference from another angle:

"Midwives are not just trained, and medically-board certified, to deliver babies and provide well-woman care, they are also trained in care of the newborn. They make sure all is well, checking for any abnormalities that are not caught during prenatal testing, making sure that everything is working properly and that baby is thriving. Often people confuse midwives and doulas, thinking that midwives are just doulas who decide they want to start helping women birth their babies at home. It is quite the contrary. Doula training is typically just a certification process from a 3-4 day class. On the other hand, Midwives have 3-4 years of schooling that is not only academic, but clinical as well. They bring with them a "mini-hospital" to home births (or at their birth centers)-- and have advanced training in life-saving support skills. They must pass national medical boards (the NARM) and be licensed through the state where they practice in."

 
Midwife Amy assesses a healthy newborn. The midwife works to keep mom and baby safe and healthy throughout pregnancy, birth and postpartum. To do that she monitors vital signs, draws and interprets labs, educates clients on tests and interventions, and is trained in normal birth, as well as emergency techniques. She works within the medical community and refers clients to outside providers as needed.  Photo by Sandor Weisz

Midwife Amy assesses a healthy newborn. The midwife works to keep mom and baby safe and healthy throughout pregnancy, birth and postpartum. To do that she monitors vital signs, draws and interprets labs, educates clients on tests and interventions, and is trained in normal birth, as well as emergency techniques. She works within the medical community and refers clients to outside providers as needed.
Photo by Sandor Weisz

 

Midwives in the United States deliver babies in hospitals, in freestanding birth centers (not attached to a hospital) and in homes. There are a few different types of midwives, and although there is some crossover, you will generally find Certified Nurse-Midwives in hospitals and Certified Professional Midwives in freestanding birth centers and homes. Doulas work and provide a valuable service in all settings and for all different types of births, including Cesarean sections.

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