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

So... a doula is like a midwife, right?

We get this question ALL the time!  It's O.K. We get it and honestly, we take it as a great compliment.  Doulas and midwives are like peanut butter and jelly - we make a great pair!  At a glance, there are a lot of similarities between midwives and doulas!

Midwives and Doulas are both:

  • people (usually women) who support you through pregnancy, birth, and after baby is born
  • there to help you get the information you need to make the best choices for you
  • able to work with you in your home or at a hospital
  • passionate about positive and empowered birth experiences

With all of those similarities it can be tricky to spot some of the key differences between midwives and doulas.  So, let's take a closer look!

Peterborough doula Hello Baby

What is a midwife?

A midwife can be your primary health care provider during your pregnancy, birth, and for the first several weeks after your baby is born.  Your midwife takes the place of an OBGYN and is responsible for your health and the health of your baby from pregnancy until about 6 weeks after birth.  Midwives usually work out of clinics which may, or may not, act as birthing centres and you will be connected with a team of midwives which means no matter when your baby is born, someone you know and trust will be there.

What kind of training does a midwife have?

A midwife has completed extensive education through one of seven recognized midwifery education programs by the Canadian Association of Midwives.  This training includes training in a four-year University program and a one-year mentorship with an experienced midwife.  Once her/his training is complete, a midwife practicing in Ontario is licensed by the College of Midwives of Ontario and can begin working with a practice.

Can a midwife do everything an OB(GYN) can do?

During your pregnancy, you will have access to all of the same tests and screenings as you would if you were under the care of an OB including ultrasounds and genetic screening and all standard lab tests.  When the results of the tests come back, it is your midwife who will discuss the results with you and help you make your choices.

During your labour, you have lots of options for pain management but there are certain things your midwife cannot do for you.  Pharmaceutical pain relief (like epidurals and narcotic pain medications) and inductions other than a membrane sweep have to be done in a hospital setting either by or with permission from an OB.   The level of involvement an OB has in these cases depends on the type of "privileges" your midwifery team has at any given hospital. 

Midwives have hospital privileges in Ontario hospitals. This means that they can admit and discharge clients at hospitals and access hospital resources needed by clients, including a consultation from a doctor if there is a concern or complication. Midwives are the only health-care professionals specifically trained in out-of-hospital birth.
— Ontario Midwives

As you would assume, a cesarean surgery would not be done by a midwife, though she can attend the birth with you and your birth partner in most cases.

What is a doula?

A doula is a great addition to your birth team!  Doulas are women (though there are some male doulas who have recently started practicing) who are passionate about helping you have a positive and empowered birth and have the knowledge and the skills to help you make it happen!  A doula is not a medical professional so you will still need either an OB or a midwife as your primary healthcare provider during your pregnancy and birth.  

A doula supporting a labouring woman and her birth partner. www.dona.org

A doula supporting a labouring woman and her birth partner. www.dona.org

What training does my doula have?

Doulas complete a certification program that includes "in-class" training, extensive reading, practical experience, and writing (and passing!) an exam through their chosen training organization.  As part of her training, your doula learns about the physiological process of birth, the various interventions you have to choose from, pain management techniques, newborn care, breastfeeding support, identifying and supporting common mental health issues and more.  Your doula might also be a certified Childbirth Educator, or hold other special certifications; just ask her!

Can a doula do the same things a midwife can?

Doulas and midwives have different but complimentary roles.  Your doula will not be doing any of the medical checks or charting that your midwife does; things like cervical checks and fetal monitoring are not a doula's "thing". What you doula does have is a deep understanding of birth and how to support and guide you through it.  Your doula can: 

  • help you review the benefits and risks of any choices you have to make
  • hold your hand during checks and tests
  • explain what's happening to your birth partner so they feel informed and involved
  • suggest different ways your birth partner touch or speak to you as you labour
  • work alongside or take turns with your birth partner to make you as comfortable as possible
  • reassure you that the sensations and emotions you are feeling are a normal part of birth
  • keep you focused and motivated to continue birthing when you feel like giving up
  • stay with you when the other members of your birth team need rest or food
  • be as "hands-on" or as "hands-off" as you need her to be.

Why do doulas and midwives make such a great team?

Remember how we said doulas and midwives were like peanut butter and jelly?  Here's why. Both midwives and doulas are focused on helping you birth on your own terms.  They both know that a well supported woman (or birthing person) will have a more positive and empowered birth experience so they are able to work together (or around each other... over each other ... and even under each other) with ease.

So... what's the difference between a doula and a midwife?

In a nutshell, your midwife can focus on your health and wellness.  Your doula can focus on your comfort and confidence.  When all of these factors are well managed and supported, birth can happen however you want it to!

Have you booked your doula yet?

If you would like to know more about Hello, Baby!'s team and how we can support you and your birth partner through pregnancy, labour, and the first year with your baby click HERE to contact us.  We can't wait to work with you for your best birth.