Doulas and midwives are experts who play intimate, supporting roles in the pregnancy and birthing process — but their training and individual roles are very different.
Here’s what you need to know about these two types of experts at your disposal if you’re expecting a child and want a natural birth, or even if you simply desire some extra support throughout the prenatal and/or postnatal process.
What makes a doula different from a midwife?
In short, midwives are highly trained medical professionals whose main duty is to help you deliver a baby, especially if you want a natural and/or home birth. They are able to handle your medical care completely on their own if your birth is low risk.
Doulas aren’t health care providers and don’t replace a midwife or doctor, but they instead serve as a coach, a wealth of knowledge and a source of emotional and physical support during pregnancy and childbirth. Some doulas provide postpartum services to help you care for your newborn baby.
When should I use a midwife?
Midwives — who are called nurse-midwives if they are officially trained — are often utilized in place of a traditional OB-GYN doctor. This is because a nurse-midwife is a health care professional who is medically qualified to do many of the same tasks as OB-GYN doctors. This typically includes overseeing prenatal care and doing all of your gynecological check-ups leading up to the birth. Then, once you go into labor, midwives help you through the process, give you pain-reducing or labor-inducing drugs, if necessary, monitor your health and the health of the fetus and can give you an episiotomy or stitch any tears.
While a trained nurse-midwife is qualified to care for you from pregnancy to birth on their own, they can work in tandem with a doctor, especially if your pregnancy or birth is high risk or develops complications. Certified midwives are authorized to work in any type of birthing atmosphere, from hospitals to your home. However, midwives place value on having as natural a birthing experience as possible, so they are often used when someone wants a natural birth, whether at home or in a standalone birthing center. This means midwives aim to use as few medical interventions as possible, including epidurals and inductions.
When should I use a doula?
A doula isn’t a replacement for a midwife or a doctor, as they can’t actually deliver the baby or give you an epidural, and they don’t have as much medical training. Instead, think of them as your personal support system and coach before, during, and after the birth. Doulas serve as a source of knowledge and continuous emotional and physical support, according to DONA International, the largest doula-certifying organization.
Doulas typically focus on one of two specialties. There are birth doulas, who you begin working with well before you go into labor to create a birth plan. Once you enter labor, they are there to help you through it, and they may even come to your home when you’re in early labor to assist you through contractions. Doulas can make you feel more comfortable, ease pain, and progress your labor naturally.
Doulas bring wisdom and steadiness that can make the process of childbirth less stressful and painful, especially if your partner isn’t particularly knowledgeable or helpful (or if you don’t have a partner). Doulas are also there to support your partner. According to DONA International, women who use birth doulas are less likely to use pain medication, less likely to require Pitocin or a Caesarian section and are more likely to rate their birth experience as positive.
However, the American Pregnancy Association says doulas are helpful in all types of birthing situations, even traditional hospital births. They can help medicated moms deal with side effects, and if you have to get a C-section, they can offer invaluable support throughout the emotional process.
Postpartum doulas specialize in checking in on your new family and supporting you in the days and weeks immediately after the birth — something that midwives and OB-GYNs typically don’t do. This period right after your child’s birth is often referred to as the fourth trimester, and during this time, new parents often need extra support. According to DONA International, postpartum doulas offer emotional support and encouragement to new parents, can help with baby-soothing techniques, breastfeeding or bottle feeding troubles and assist with any other concerns around caring for newborns. Postpartum doulas can even help you with household tasks, like preparing food or doing laundry or dishes, and they’re also skilled at helping siblings and other family members adjust to the new baby.
According to medical research published in The Journal of Perinatal Education, postpartum health care is often neglected in America. New moms who receive social support during this time are less likely to develop postpartum depression, and health outcomes are better for both mom and baby. Postpartum doulas are an ideal way to get that much-needed support from a professional.
Can I have both a doula and a midwife?
Since doulas and midwives offer different yet complementary services, it’s entirely possible to hire both types of experts for your birth. In fact, having both a doula and a midwife can be incredibly helpful, as they bring different skill sets to the table and can work as a team to make your labor and birthing process more supportive and joyous. Midwives serve as your health care provider and deliver your baby, while your doula will be your trusty sidekick and dedicated coach, because let’s face it — if your partner faints, you need a hand to squeeze.
Read next: How much money does a doula make?
