Doula Vs. Midwife: What's The Difference, And How Do You Choose?

What’s The Difference Between A Doula And A Midwife? And Do I Need Either (Or Both)?

October 26, 2020 Updated February 18, 2021

Doula showing labor positions to a pregnant woman
Newman Studio/Getty Images

As soon as your pregnancy journey begins, so do the questions. Not only will you be pondering the perfect name for your little peanut, but you’ll also be preparing to make some pretty important pregnancy decisions. One of the first quandaries you may face is who you want on your health care team as you make your way towards labor and delivery. And at some point in your pondering, you’ll probably start asking yourself about a doula vs. midwife and the differences between the two. Do you need one? Do you need both? Will they be delivering your baby? There’s a lot to mull over, so let’s jump right into this discussion.

Until now, you may even have thought that doulas and midwives do the same thing. That’s an understandable mistake to make, as they do both help moms-to-be get through pregnancy and delivery. However, there are a few key differences between the two. To understand them, you’ll first need to compare and contrast what they do.

What is a doula?

Think of a doula as a sort of birth coach. ICYMI, bringing a tiny human into this world can be tough. It’s exhausting in essentially every way. A doula helps get you through that by offering emotional, physical, and mental support. And it isn’t relegated just to labor and delivery. Depending on the doula you choose, they may be along for much of the pregnancy ride in some capacity — particularly the closer you get to your due date. Such doulas offer antepartum (before birth) care. Some doulas similarly offer postpartum care to tend to a new mom’s needs after birth.

During labor, a doula might give you massages, help you in and out of a birthing pool, recommend different labor positions, coach your breathing, and more. One major benefit of a doula is having an experienced birth advocate at your side throughout your side during a time you’re bound to feel overwhelmed. Plus, although a doula’s primary role is being there for mama (in Greek, doula means “woman’s servant”), they also offer ancillary support to partners.

Do doulas deliver babies?

While many doulas seek rigorous certification training on childbirth, they are not considered clinical medical professionals. They aren’t able to offer medical advice or prescribe medications. Their main role in the delivery space is to support Mama and help the midwife or doctor as needed. Many women who choose to have a doula report a more comfortable birthing experience (and have been found to request less pain medication during labor).

What are some disadvantages of doulas?

Having support during your delivery is always a good idea, but we want to help you make the best decisions for you and your family for this incredible moment. And that means weighing the pros and cons. Here are a few notes to mull over before bringing a doula into your delivery.

TBH, there really aren’t any major downsides to having a doula. They’re usually wonderful! Having said that, you may prefer your partner to provide the support and physical assurance your doula is hired to give. Are we saying that your partner and doula offer the same support? No, not at all. But if you want this experience to be an intimate moment between just you and your partner, you may prefer not to have another person in the mix.

What does doula training include?

Like physicians, doulas must take classes and training courses to become certified. Each instruction program is unique, but many require hours of childbirth education and doula training courses. Other subjects include antepartum and postpartum doula training. Students must also attend breastfeeding and birthing classes and complete a doula proficiency exam and a HIPAA or client confidentiality training course. To provide the best support for mothers in labor, it’s important for doulas to become familiar with the pregnant body and the birthing process. 

What is a nurse-midwife?

Much like a doula, midwives serve the laboring mom by acting as an advocate on her behalf. But since a midwife is also a trained medical professional, they can play a more hands-on role in delivery. This includes:

  • Performing gynecological exams
  • Offering prenatal care
  • Prescribing labor-inducing medications
  • Ordering an epidural
  • Administering pain meds
  • Teaching mom to breastfeed
  • Delivering a baby vaginally

To become a nurse-midwife, one must first become a registered nurse. They can then seek higher education that includes a nurse-wife component. Most nurse-midwives hold a Master of Science degree in Nursing (MSN).

Do midwives do ultrasounds?

Per the American College of Nurse-Midwives, more and more midwives are adding ultrasound certification to their resumes.

So, do you need both?

To deliver your baby, you’re going to need either a nurse-midwife or an obstetrician (and definitely the latter in the event of a C-section). As for whether you should also have a doula, well, it can only help! Bringing your baby into the world is a big deal, and you’ll be feeling all the feels. Having another trained pro there to help guide you through it could prove invaluable.

Are doulas covered by insurance?

Thank the stars for health insurance, right? Especially when it comes to paying your OB-GYN. But can it cover your doula? The short answer is sometimes. Doulas, like doctors, require payment, and sometimes your insurance will take care of the cost. However, this is not always the case. Sometimes you can only get part of the expense covered. Just call your health insurance company to see if it includes doulas in your coverage.

If your insurance doesn’t offer doula coverage, no worries! If you want one, you can still get one. Thankfully, some doulas deliver babies because they’re passionate about helping women during childbirth. To make this possible, they offer flexible pricing and help mamas create a budget that works for them financially. You can also look into volunteer doula programs, which are meant for women who can’t afford the costs of a doula.

What’s the difference between an OB-GYN and a midwife?

An OB-GYN and midwife both deliver babies, but there are key differences between both professions. Midwives usually deliver babies in patients’ homes and outside of hospitals. They are trained health professionals but aren’t considered physicians.
Women usually seek them out when they want a home birth. OB-GYNS always deliver babies inside of the hospital. They are doctors who are experts in obstetrics and gynecology.

Women usually visit an OB-GYN throughout their pregnancy. You can talk to them about birth control, pregnancy, menopause, and anything that has to do with your reproductive health. If you have questions about your uterus, they can provide expert advice. They can also screen you for cervical cancer, help treat infections, urinary tract issues, perform surgeries, and more.