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The Differences and Similarities
Note: It’s important to be aware that regardless of the kind of doula that is employed, doulas usually do not have academic training, and most of the time, they are not certified. This is because certification requirements are location specific and vary by state and region.
Since no formal academic certification or background is necessary, the title of doula can sometimes be given to a very involved family member or a close friend. They may likely not have as much knowledge as an experienced doula.
Doulas are not medical professionals and are not medically trained. They should not be depended upon as a replacement for a licensed provider such as a midwife. They are not directly involved with the actual delivery of the baby. This does not have to be a reason to dismiss their potential usefulness and help.
As you start to plan for the birth of your baby, you will come across the terms midwife and doula. Midwives and doulas are extremely valuable for all births but can be especially valuable when preparing for an unmedicated, natural birth.
Here we will discuss the difference between doula and midwife, and give you the information you need to choose who you need on your birth team.
Though some of their tasks overlap, it is important to understand the differences in their abilities, the scope of their knowledge, and their priorities throughout the duration of childbirth. Knowing this can aid you to decide what might be more helpful to you, and whether you would like to employ the help of either or both throughout the time of your pregnancy.
Examining the roles of each can help you understand what you need as well as what you want.
Midwives vs Doula: Similarities
Midwives and doulas have quite a few similarities. Midwives and doulas have similar beliefs about pregnancy and birth. They believe that birth is a natural body process rather than a medical condition. They believe that the body was designed perfectly to give birth and that the body can instinctually do amazing things when given the opportunity.
Midwives and doulas believe in providing holistic care, meaning they care for a person as a whole: physically, emotionally, mentally, and spiritually. While they have some similarities in how they view pregnancy and birth, they still play completely different roles.
What is a Doula?
A doula is a non-medical birth worker. They are trained to provide continuous emotional physical and informational support to mothers and families throughout their prenatal, birth, and postpartum journey. Doulas can help families create their birth plans as they approach the end of their pregnancy, advocate for the mother’s decisions, provide pain management support through massage or breath coaching during labor, and support families during the postpartum period.
When a mother receives continuous support from a doula throughout labor and delivery, data shows that there is a decrease in the use of pain medication during labor, a decreased chance of needing a C-section, a decrease in the length of labor, and a decrease in negative childbirth experiences. (Source)
Doulas do not offer medical advice or assistance. While doulas can help educate you and provide necessary resources, doulas can not provide any medical care to you or your baby.
Types of Doulas
Birth Doula
A birth doula, which is also sometimes referred to as the labor doula, is an individual who supports the pregnant woman during the actual child birthing process. Their responsibilities include being present and providing physical and emotional support. Some ways that a doula can offer physical support is through massage or providing counterpressure on the woman’s back. She can also help with position changes and encouraging breathing exercises such as hypnobirthing. In terms of emotional support, a doula can offer words of encouragement and help to calm a person’s fears and anxieties.
Some doulas also double as birth photographers. If you would like professional photography of your birth, you can look for a doula who is also a birth photographer. They will be able to support you during your birth while also capturing the intimate, precious moments of when your baby came into the world!
Postpartum Doula
A postpartum doula helps the birthing person after they have given birth. She assists with their emotional and physical needs as well, but in different ways. She can assist with breastfeeding, light housekeeping and cooking meals in order to reduce the burden on the new family. It alleviates some of the responsibilities that come with having a newborn, during a time of transition.
Training & Education
Doula training and certification is not regulated by a specific licensing body or state. To become a doula, a person must attend childbirth education, breastfeeding, and birth doula courses, and observe a specified number of births. Postpartum doulas take additional courses on the principles of home visitation and how to care for newborns and mothers.
- What is a Midwife?
A midwife is trained to provide medical care for mothers and babies during pregnancy, birth, and the immediate postpartum period. Midwives are licensed providers who want to help mothers achieve their ideal birth. They will offer emotional support, physical support, and informational support during pregnancy and birth but their main priority will be the health and safety of you and your baby.
Midwife vs Doula
Midwives can provide holistic prenatal care, monitor you and your baby throughout labor, receive your baby, and provide postpartum care. Midwives can care for families giving birth at home, a birthing center or in hospitals.
Types of Midwives
Much like there are different kinds of doulas, there are also different types of midwives, each with their own level of training and scope of knowledge. In the United States, there are two predominant types of midwives: Certified Nurse Midwives (CNMs) and Certified Professional Midwives.
Certified Nurse-Midwives (CNMs)
Certified Nurse-Midwives are rigorously trained. To be certified, they must first study to become registered nurses, and then complete a master’s degree in Nurse-Midwifery. They are then certified by the American College of Nurse Midwives (or ACNM). Their scope of care ranges from the onset of puberty through the reproductive life span. They can order bloodwork and sonograms and prescribe medications.
Certified Nurse-Midwives provide comprehensive gynecological and obstetrical care, utilizing the Midwifery Model of Care. This means an emphasis on informed consent, shared decision making and individualizing a plan of care. CNMs can practice in hospitals, health clinics, birth centers, and at the patient’s home.
According to the New York State Association of Midwives, to obtain a license to practice midwifery, “a midwife must hold at least a Master’s degree, and pass the American Midwifery Certification Board licensing exam.” Holistic Midwifery New York is comprised of a team of Licensed Midwives. They each hold various degrees and licenses: Doctor of Nursing Practice (DNP), Certified Nurse-Midwife (CNM), Master of Science in Nursing (MSN), Lamaze Certified Childbirth Educator (LCCE), and Registered Nurse (RN). All of these credentials mean that they have extensive training and are completely capable of caring for you and your new baby!
Direct-Entry Midwives
Direct-Entry Midwives have different titles, depending on the state in which they are certified. Their program of study can also vary. Usually, however, Direct-Entry Midwives will obtain either an associate or a bachelor’s degree along with completing an apprenticeship. Their scope of practice is more narrow and they cannot prescribe medications. They are also limited in where they can work. CPMs can only attend community births, at the patient’s home or in freestanding birth centers.
Prenatal Care
A midwife provides comprehensive prenatal care. Your midwife will likely see you monthly during your first and second trimesters, then twice a month from 28 weeks to 35 weeks, and weekly visits from week 36 until birth. A midwife can also order tests and ultrasounds, take measurements, perform clinical procedures and internal examinations, and overall monitor the health and wellness of mother and baby.
Labor and Delivery
Midwives usually arrive to the client’s home when they are in active labor. They closely monitor mother and baby, following guidelines for low risk women. Women instinctively know how to birth their babies. Your midwife will observe you closely and offer assistance as needed. Once the baby is born, your midwife will stay for a few hours to monitor. She delivers placenta, checks for any bleeding and lacerations and completes a full newborn assessment.
Postpartum Care
Midwives typically visit the home about 24-48 hours after birth to check in on the mother, do assessments and screenings of the newborn, and offer lactation support. They also provide support by phone for the first 4-6 weeks until the final postpartum visit.
Differences Between a Doula and a Midwife
Although there are some similarities between a midwife and a doula, they do have completely different functions. If you are planning a home birth, you should be under the care of a licensed provider. Investing in a doula is more optional and depends on the unique needs of each family. Some women choose not to hire a doula because they already have a great support system in place. Others choose to add a doula to add an additional layer of care and support.
FAQs
No, a doula is not a midwife. A doula is a care provider who provides emotional and physical support to a person during pregnancy, labor, and birth. A midwife, on the other hand, is a licensed healthcare provider who is equipped to provide medical care during pregnancy, childbirth, and postpartum. While doulas and midwives both support people during birth, midwives have a more extensive range of medical skills and training.
Doulas are not licensed by most states. The doula profession is largely unregulated, which means that there is no standardized training or certification process for doulas.
However, there are several organizations that offer doula training and certification, such as DONA International, the International Childbirth Education Association (ICEA), and the National Association of Doulas (NAD). These organizations have established standards for doula training and practice, and some hospitals and birthing centers may require doulas to be certified by one of these organizations.
Despite the lack of government licensing, doulas are highly regarded for their ability to provide emotional and physical support to individuals during pregnancy, birth, and the postpartum period.
Doulas provide emotional and physical support to individuals during pregnancy, labor, and birth, but they do not perform any medical procedures or interventions.
The role of a doula is to assist and support the person giving birth, not to take over medical responsibilities. Doulas can provide comfort measures, such as massage and relaxation techniques, and offer encouragement and reassurance during labor and delivery.
The doula can also advocate for the individual’s wishes and help to create a positive birth experience, but the actual delivery of the baby is typically performed by a midwife or doctor.
Resources:
Bell House Doulas: https://bellhousedoulas.com/blog/whats-difference-doula-midwife/
Healthline: https://www.healthline.com/health/pregnancy/doula-vs-midwife
WebMD: https://www.webmd.com/baby/guide/doctor-doula-midwife
What To Expect: https://www.whattoexpect.com/pregnancy/labor-and-delivery/midwives-vs-doulas
Chochrane.org: https://www.cochrane.org/CD003766/PREG_continuous-support-women-during-childbirth
New York & Long Island Homebirth Midwifery
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