The journey through pregnancy, birth, and postpartum is a profound and transformative experience, and having the right support can make all the difference. Two essential figures in the realm of pregnancy care are doulas and midwives. While their roles may sometimes overlap and they are sometimes confused, they bring distinct skills and perspectives to the birthing process. In this blog, we will explore the key differences between doulas and midwives, shedding light on the unique contributions each makes to the childbirth experience and help you decide what might be best for your individual situation.

Doulas and midwives are often confused because typically they both approach childbirth with the mindset that bodies are capable of birthing, that you are the expert on your body, and have a holistic approach to pregnancy and birth. 

Doulas: Nurturing Support Beyond Medical Care

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Doulas are trained professionals who offer emotional, physical, and informational support to expectant mothers before, during, and after childbirth.

Their focus is on providing non-medical, holistic support to enhance the overall birthing experience.

Doulas often help create birth plans, offer comfort measures during labor, and provide continuous emotional reassurance to the birthing individual and their partner.

They also check in with clients postpartum to help process the birth and brainstorm solutions for problems that have come up postpartum. Many doulas have a variety of specialties that they have added to their repertoire.

Some doulas pursue certification in lactation, acupressure, aromatherapy, create birth keepsakes, placenta encapsulation, or work with specific populations. 

Midwives: Healthcare Professionals for Pregnancy and Birth

Midwives, on the other hand, are healthcare professionals trained to provide medical care throughout the pregnancy, labor, and postpartum period.

Midwives can have varies certifications including a Certified Nurse Midwife (CNM), Certified Midwife (CM), Certified Professional Midwife (CPM), Direct-Entry Midwife, and Lay Midwife.

Depending on the certification they have qualifies them to do different interventions.

Generally, they are qualified to perform physical exams, offer prenatal education, assist with childbirth, and provide routine gynecological care.

Midwives aim to promote the natural birthing process. Midwives can deliver babies in hospitals, homes, or birth centers.

Midwives can only work with low-risk clients and will refer complicated cases to an OB-GYN.  The definition of low-risk pregnancy varies, so you will need to ask midwives you want to work with what that means to them.

For example, some midwives have BMI limits, others don’t. Some midwives will not work with clients that have gestational diabetes and others will as long as it is well managed.

Distinguishing Features

Scope of Practice: Doulas primarily offer emotional and physical support, focusing on comfort and well-being during childbirth.

Midwives, in contrast, provide medical care, including monitoring the health of both the birthing person and the baby. The midwives scope of practice can vary state to state or based on the type of certification that the midwife has. 

Training and Education: Doulas receive training in emotional support, comfort techniques, and advocacy.

They may hold certifications or be a community trained doula. Midwives undergo extensive medical training and education, often completing a midwifery program or obtaining a nursing degree with a specialization in midwifery, depending on the type of midwife they are.

Medical Procedures: Doulas do not perform medical procedures but instead offer emotional and physical support.

Doulas will offer hands-on support with physical pressure, massage, or positioning. Midwives, however, are authorized to conduct medical assessments, provide medical interventions, and deliver babies. Midwives can often prescribe medications needed during pregnancy and birth and birth control. 

Do you need a doula if you are planning to have a midwife? 

This question often comes up because some folks think of the doula as only an advocate during hospital births- and this is a very important role that doulas play. However, doulas do so much more.

It’s important to consider how much support you think you might need during your labor. Many parents who choose to use a midwife are also choosing to go without pain medication.

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Doulas are very helpful in these situations for pain management, positioning, and emotional reassurance. Doulas are also skilled in helping support people. They can guide your support person in assisting you and be available if concerns arise. If you have the financial ability to have a doula, they are a wonderful person to add to your support team.

What about insurance? 

Typically, insurance companies will pay for midwifery care, but will not pay for doula support. This varies greatly by state and the type of insurance you have. More insurance companies are seeing the value that doulas bring (including the lower rates of c-sections) and are starting to cover doula services.

Contact your health insurance company to verify the coverage you have. Some state based insurance are starting to cover doula services as well. Oregon does and Washington will be very soon! 

In the journey to parenthood, both doulas and midwives play crucial roles, offering distinct yet complementary support. While doulas focus on emotional well-being and comfort, midwives bring medical expertise to ensure a safe and healthy birthing experience.

Collaboratively, these professionals contribute to a holistic and empowering childbirth journey, highlighting the importance of comprehensive support for expectant individuals and their families. Having both professionals on your care team can add additional support.

Do you have questions about these care professionals? Add your questions to our chat below and we will respond!