Doula vs. Midwife: Which One Do You Need?

If you are pregnant, the thought of delivery can be a bit overwhelming. If it is your first baby, it can be the fear of the unknown. Second time moms often are trying to improve on their first birth experience which may have been disappointing or unsatisfactory.

Do I need a labor doula or a midwife?

The role of both the doula and the midwife is to support the laboring woman and her partner through the labor and delivery but their roles are a little different.

What’s the difference between a doula and a midwife? Doulas provide on-going support from active labor, through delivery, and even postpartum support. Midwives are involved in prenatal care and the medical aspect of birth.

Here is more information about each one…

What does a doula do?

Doulas provide continuous support from the start of active labor through delivery and until the mom is in her recovery room. She is a non-medical support person.

Her role is to lessen stress by providing emotional support and encouragement, explaining what is happening and how best to manage the contractions. She is trained in the process of labor and some physical ways to support it.

Studies show that her presence in the labor room lessens the possibility of a Cesarean section, shortens the length of labor and reduces the need for medications and interference in the process with drugs such as Pitocin.

What does a midwife do?

A midwife is involved in the medical aspect of birth. They often work in conjunction with an obstetrician and provide prenatal care. She may provide some labor support and she may also deliver the baby in a hospital or home setting.

Midwives do not do surgery so if the need for a Caesarean section arises the Obstetrician will be called to deliver the baby.

They often stay with the laboring woman through much of her labor. When during the labor she arrives may vary depending on the practice and if she has other women she is supporting.

What about training and certification?

Midwives undergo rigorous training to become certified. Nurse midwives must acquire a Certified Nurse Midwife (CNM) certification through the American Midwifery Certification Board (AMCB) after completing a graduate degree from an accredited school of nursing. Certified midwives (CM), while not nurses, also achieve certification through the AMCB following a graduate degree. 

In contrast, doulas do not require state licensing, and certification, though not mandatory, is pursued by many to enhance career prospects. Certification for doulas can be obtained from organizations like DONA International and the International Childbirth Education Association (ICEA).

The educational paths for midwives and doulas significantly differ. Midwives are often Advanced Practice Registered Nurses (APRNs) and must complete a graduate degree. Doulas, however, may enter the field without a postsecondary degree and typically undergo a few weeks to a year of training depending on whether they seek certification. 

Specific to doulas, training includes childbirth education, breastfeeding, and observing a number of births to meet certification criteria. Additionally, some doulas enhance their qualifications with specialized training such as massage therapy to become Certified Massage Doulas.

Is it better to have a midwife or a doula? Do I need both?

Ask your Obstetric practice if you have access to a midwife. If you do, how extensive is her support during labor?

Here are some questions to ask your midwife:

  • Will she be there continually?
  • Will she have other patients?
  • Will she provide hands-on suggestions and encouragement for you during the entire length of labor?

She may provide all of your emotional and physical support but she may not. You can ask her if she thinks it would be good for you to have a doula as well. A midwife may be all that you need.

Doulas stay with you throughout labor

A doula can be especially helpful if you do not have a midwife and you are working with an Obstetrician. The doctor will not stay with you during your labor. He/she will literally arrive when you are ready to deliver.

From start to finish, labor can take 24 hrs. During that time you will labor alone with your partner with the nurses checking on your progress. The beauty of a labor support doula is she stays with you the entire time. She doesn’t change shifts as the nurses are likely to.

She is a calming presence who will help you to trust your body and work with what is happening. She may be all that you need.

During birth, do labor doulas replace partners?

A labor support doula will support both you and your partner. She will meet your needs and help him to be involved as much as he would like to be. Some partners want to be hands-on so they just need encouragement and suggestions on how to support you.

Other partners may go “numb” in a hospital setting and feel overwhelmed by the whole process of giving birth. The doula will pick up where ever he would like her to. Having a doula also allows him to take a break, get a bite to eat and a cup of coffee – remember delivering a baby takes time!

Some additional benefits of having a labor doula:

  • She will help you have the birth you want. Do you want medication or do you want a non-medicated birth? Doulas will assist you throughout the process.
  • She knows the hospital setting. Everyone’s goal is to have a healthy baby. How you achieve that can sometimes be different from the way the protocol of a hospital outlines. If there is a non-medical reason they want to speed up your delivery, the doula can help you ask the right questions so you may have some additional time to labor before interference.
  • She doesn’t change shifts. You may love one of your nurses but chances are she will not be working the whole length of your labor. Your doula stays with you until you deliver and beyond.
  • She will help your breastfeeding get off to a good start. Problems with breastfeeding often start right at delivery when things aren’t initiated with the baby as needed. She will help you avoid some nursing issues.
  • She stays with you after delivery until you are comfortable in your recovery room. This allows the dad to follow the baby to where they will do the testing, and you will not be left alone.
  • She comes back to your home for a postpartum visit where she will go over the labor with you and help everyone feel good about the birth. We live with our birth memories for the rest of our lives.

Midwife vs Doula – What’s the Bottom Line?

Through the exploration of the unique roles, responsibilities, and benefits that doulas and midwives bring to the birthing experience, it’s clear that both professionals play critical and distinct roles in supporting expectant parents. 

Doulas, with their focus on emotional support and advocacy, complement the medical care and expertise provided by midwives. This distinction underscores the importance of expectant parents making an informed decision based on their specific needs, whether for emotional support, medical care, or a combination of both.

Labor Support in CT

MothersCare offers labor and postpartum support in New Haven, Fairfield, Hartford, Middlesex, New London & Windham, CT.

About Susan Shepard

I am the owner/partner of MothersCare Doula Services in CT. I am a Postpartum doula and my business partner, Sheila Marley is a Labor doula. MothersCare places both Labor and Postpartum doulas with CT Families. I am the mom of five beautiful children, one set of twins. The best quote for me as a young mother and the catalyst for MothersCare is “It’s not weakness to know you need help, it’s wisdom.”

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