What’s the Difference Between a Midwife and a Doula?
What is a Midwife?
Midwives are medical professionals. Which means their job is to look after the health of mom and baby.
A midwife does this by meeting with women during their pregnancy and doing all the health checks that any other care provider would do. These include, but are not limited to: Requesting ultrasounds
Measuring fundal height
Listening for baby’s heartbeat
Requesting diabetes screening.
During labor a midwife is trained and equipped to assess and respond to medical emergencies. A midwife might assess how things are going by listening to baby’s heart rate, doing cervical checks, or checking moms blood pressure.
Midwives are trained to deal with typical emergencies that occur during labor and delivery whether they happen at home, at a birth center or at the hospital. Some of these complications include:
- Hemorrhage
- Tearing
- Shoulder Dystocia
- Breech presentation*
- Nuchal cord (umbilical cord around baby’s neck)
However a midwife will typically partner with an OB or transfer care to an OB if the patient becomes high risk since high risk pregnancies are out of a midwife’s scope of training.
In addition to attending home births and having access to a birth center, midwives also have permission to practice at a designated hospital.
What is a Doula?
Doulas on the other hand are not medical professionals.
They focus instead on your comfort. This can range from physical to emotional comfort.
A doula will also give you the tools and knowledge so that you can make informed choices during your birth experience.
Doulas relieve contraction pain by suggesting position changes, applying counterpressure, doing massage, etc.
A doula might do this herself or demonstrate them and suggest the support partner to continue doing them.
Many doulas have a bag full of helpful tools to relieve contraction pain. Some of these contraction relieving devices include a TENS machine, massage roller, a comb (using the “gate control theory”), rebozo, essential oils, twinkle lights, etc.
Doulas greatly value informed choice and do not try to sway your decisions.
To be able to make informed decisions, you need to know your options. It is best to start learning about your options during pregnancy instead of during labor when/if complications arise.
During prenatal visits, a doula will go over the benefits and risks of routine and common interventions.
Your doula will also tell you the statistics that go along with each intervention.
Doulas love the acronym B.R.A.I.N. which stands for:
Benefits – what are the benefits of doing the intervention? what are the benefits of not doing it?
Risks – what are the risks associated with the intervention? what are the risks if you decide not to do it?
Alternatives – what other options are there?
Intuition – what is your intuition telling you to do?
Now or Never – when do you need to decide? is it urgent?
During labor a doula will create opportunities for you to say “no” to the things you indicated on your birth plan, but the decision always rests with you and you can change your mind whenever you want about anything.
A doula will focus on you having a positive birth experience regardless of any complications that may arise.
They do this by helping relieve contraction pain, ensure you are making informed choices, helping you feel in charge and in control, and debriefing in the early postpartum period.
Unlike midwives, a doula can support you in any location, whether it is a home birth, birth center, or any hospital in your area.
A doula can also support both high and low risk clients because their job does not include directly managing those complications.
However a doula is a great asset for high risk clients and those with unexpected complications. A doula can also be a good, non-biased, non-related sounding board.
Check out some testimonials here to see how hiring a doula could make your birth experience better.
*Not all midwives are trained in breech birth but many have at least a rudimentary understanding
Happy Birthing!
