Midwife vs. Doula: What’s the Difference?

Your care team throughout pregnancy, labor, birth, and postpartum is important for the type of birth you envision. If you’re wondering about the difference between a midwife and a doula, we put together this guide to help.

Doulas

A doula is a wonderful addition to labor and birth support. This non-medical trained professional continuously supports the birthing person emotionally and physically throughout labor, birth, and postpartum while also providing education to help prepare them for labor. The word ‘doula’ means “woman’s servant for a child-bearing woman” in Greek, today it has been translated to “one who mothers the mother.” There are four main roles of labor support that a doula can provide: 

• Physical

• Emotional

• Informational support

• Advocacy

Doulas are trained, and some are certified depending on which path they choose for education.

Doulas support pregnant people in hospitals, free-standing birth centers and home births. They support many types of birth scenarios, including medicated birth, unmedicated birth, inductions, cesareans, stillbirth, abortions and more. The spectrum of the support they provide depends on the training(s) they have done.

Physical Support

• Physical touches such as massage, counter pressure, acupressure, or other techniques.

• Creating and maintaining a calm, quiet and dimly lit environment

• Helping facilitate water therapy (shower, tub).

• Applying warm or cold packs.

• Holding the birthing person’s hands.

• Teaching and guiding breathing and visualization techniques.

• Suggesting and helping with positions, movement, swaying, pelvic rocking, or using a birth or peanut ball.

• Helping with walking to and from the bathroom and/or changing clothes.

• Assisting with food and drinks.

Emotional Support (depending on the birth person’s preference)

• Continuity of support from the beginning of labor to after birth, which can be virtual at the start of labor and change to in-person support when desired.

• Verbal reassurance and encouragement, including words of praise

• Helping the birthing person to feel more in control, confident, and aware of progress

• Calmly describing and validating what is being experienced

• Supporting the birth person’s choices and decisions

• Showing sensitivity to emotions and helping work through fears and self-doubt

• Spiritual support, if requested, such as sharing prayers or reading from inspirational texts

• Processing after the birth and listening with empathy.

Educational Support

• Education about the birthing process, the stages of labor

• Talking through what the process looks like, specifically at the chosen place of birth

• Going over interventions and medical procedures before they may occur

• Suggesting helpful techniques such as breathing, relaxation, movement, and positions that are helpful with or without an epidural

• Helping you find evidence-based, unbiased information

• Helping your partner or support person understand

• Assisting with communication between the birthing person and medical providers about medical decisions or interventions and ensuring that the birthing person understands medical thas and have their questions answered, and that the medical team understands the person’s preferences

What Doulas Don’t Do

Because doulas aren’t medical professionals, these are tasks they don’t perform: 

• Cervical exams or fetal heart monitoring

• Medical advice or diagnoses

• Medical decisions

• Catching the baby

Extensive studies show that doulas help significantly reduce the need for unnecessary interventions, including:

• 25% decrease in the risk of Cesarean

• 8% increase in the likelihood of a spontaneous vaginal birth

• 10% decrease in the use of any medications for pain relief

• Shorter labors by 41 minutes on average

• 38% decrease in the baby’s risk of a low five-minute Apgar score

• 31% decrease in the risk of being dissatisfied with the birth experience

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MIDWIVES

Now, let’s examine a midwife’s role. The word midwife means “with woman.” A midwife's philosophy views pregnancy and childbirth as normal life events. Midwives specialize in low-risk, physiological birth, but they do not perform surgery. Their care expands to general women’s health from puberty through menopause.

Midwives see birth as a normal part of life and see the choices and authority of pregnancy and childbirth as belonging to the birthing person and their family. They help empower people through an informed and shared decision-making process. Midwifery care is about the individual/family and the care providers, who build a trusting, caring bond that supports a positive childbearing experience.

Midwife Types and Training 

Three types of midwives practice in Minnesota. Their training and services may differ slightly. 

Certified Nurse Midwives 

Certified nurse midwives (CNMs) have a college degree in nursing and a master’s degree in nurse-midwifery. This category represents most American midwives. They:

• Graduated from an accredited nurse-midwifery education program. 

• Passed a national certification exam.

• Are licensed to practice midwifery in the state where they work and all 50 states license CNMs.

• Work in all healthcare settings, including hospitals, free-standing birth centers, and clinics.

• Provide general women’s healthcare throughout a woman’s lifetime.

• Can prescribe most medications.

Certified Midwives 

Certified midwives (CMs) have a bachelor’s degree in a field other than nursing and a master’s degree.  

• Same midwifery education and pass the same national certification exam as CNMs.

• Provide the same services and can work in hospitals, free-standing birth centers, and home birth settings.

• Licensed to practice in the state where they work, but not all states license CMs.

Certified Professional Midwives 

Certified professional midwives (CPMs) either receive apprenticeship training or graduate from an accredited formal education program and: 

• Take a national certification exam but not the same exam taken by CNMs or CMs

• Provide pregnancy, birth, and postpartum care only

• Provide care outside of the hospital setting, often in birth centers or homes

• Cannot prescribe most medications

Midwife vs. Doula: How to Decide

The biggest differences between a doula and a midwife are their education and medical care. A doula solely offers support, while a midwife offers supportive medical care.

If you’re looking for a more clinical approach with medical expertise, a midwife might be the right choice. However, if you seek continuous emotional support and advocacy, a doula could be the better fit.

One option to keep in mind: Some families find that a combination of both a midwife and a doula can provide the most comprehensive support during this transformative time.

Birthing Options That Fit Your Needs

At the Twin Cities Birth Center, we want to empower you to find the best fit for your health. Our library of helpful articles delves even deeper into more topics.

You can also call us for questions, learn more about our midwifery care, or meet our midwives. No matter what you need, we’d love to get you the care you’re looking for.