A Common Question

What’s the difference between a doula and a midwife?

As a woman certified as both of these awesome professions, I often field this question. I thought I’d try to reach a bunch of you at once. Let me know if you have any questions. This image kinda wraps up the distinction. The midwife is at the woman’s feet, catching the baby and the doulas support her body from up top.

A doula (Greek for “woman’s servant”) is a person who offers support to Mamas and couples during their pregnancy, birth, and postpartum by offering information, touch, and advocacy.  During the pregnancy, a doula gets gets to know a couple and helps them find confidence in their bodies and their process by providing information to help them make some decisions about what they want for their birth. Once they are in labor, she comes to their home and helps them labor there. The doula is very flexible and, besides giving the laboring Mama massage, she can make sure everyone is eating and resting and relaxing and laughing in appropriate amounts. If the couple has decided to birth at the hospital, the doula will help them make their decision about when to go and she will facilitate the transition from home to hospital.

A doula will stay through the complete birth process, performing simple tasks just as she did during labor. In general, the doula helps the birth team stay calm and focused, constantly reassuring everyone that the fluids and noises flowing out of the Mama are totally normal.  After the birth, during which she could have been holding legs or taking photos or both, the doula helps get the baby on the breast and does some immediate processing with the family.

In a nutshell, the doula is there to support whatever the Mama and her chosen partner or team need. Whether this is by answering questions or laying loving hands on the body in labor, the doula offers encouragement and reassurance.

The midwife (meaning “with woman”), in addition to performing all that a doula does to support women, also acts as the primary care provider. This means that a woman would hire a midwife instead of hiring an obstetrician. Midwives are experts in normal birth whereas OB docs are experts in pathology and surgery. When a couple hires a midwife for their prenatal, birth, and postpartum care, they get the support of a doula figure with the expertise of a trained health care professional. That being said, midwives often work in conjunction with OBs if the pregnancy or birth strays outside the boundaries of what’s considered a normal range of safety.

A midwife cares for Motherbaby and her family’s health and wellbeing, checking her blood pressure, monitoring her blood count, measuring the growth of her fetus, and safeguarding the healthy process of pregnancy and birth. Many midwives were doulas before becoming midwives and caring for women’s natural process is high on their list. Though midwives are trained healthcare professionals, equipped to recognize abnormalities in the physiologic process and prepared to handle obstetrical emergencies, they will primarily treat the pregnancy as a healthy life function and support the whole woman in the context of her life, emotions, family, and community. Some midwives (like myself) attend homebirths, but most midwives in this country work in the hospital setting. Because a midwife is more likely to give you the time you deserve to ask questions and process this incredible time in your life and to look at your pregnancy and birth as a healthy and safe part of that life, we encourage you to find yourself a midwife, even when your choice is to birth in the hospital.

Because they give such incredible and complete care, I think every pregnant woman deserves to be attended by a doula and a midwife.

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