Midwife vs. Doula: What’s the difference, and why might I choose either or both for my pregnancy and birth?
Finding out you’re pregnant can come with more choices than you might initially think, and one of those is choosing your care team. If you’re newly pregnant, you might be wondering: what’s a midwife vs. a doula? If you are, you’re a step ahead of where I was with my first pregnancy! When I found out I was pregnant with my now 3.5-year-old daughter, Maggie, I just assumed I’d keep seeing my regular OB-GYN for care, and that working with that practice would largely dictate what my birth experience would look like.
About a third of the way into my pregnancy, though, I started listening to a podcast called The Birth Hour which started shifting everything birth related for me. I began to learn that I had so many more options than I’d ever considered. I realized I wanted to attempt an unmedicated birth, and to accomplish that goal I needed a strong team around me. Enter a midwife and a doula.
So let’s get back to the question at hand…what exactly is the difference between a midwife vs. a doula?
That’s a question I’ve been asked by lots of mamas-to-be since my pregnancy, and so I wanted to dig into each and what makes them different:
Midwife
A certified nurse midwife (CNM) is someone who can replace a traditional OB-GYN as your main care provider during pregnancy, birth, and postpartum. (In fact, you can see most midwives for general gynecological care that has nothing to do with pregnancy.) They hold an undergraduate degree in nursing as well as their RN license, and have the ability to prescribe medicine. As far as cost goes, most insurance policies will cover midwifery care just like they would OB-GYN care throughout your pregnancy. Midwives aren’t able to perform C-sections, but you can absolutely use an epidural and other pain medication during birth with a midwife.
Midwives tend to be more hands-on than OB-GYNs, starting with prenatal visits and extending into birth. Typically when an OB-GYN is delivering your baby, they will be in and out of the room often, leaving you to labor without them for long periods. A midwife, though, is in the room with you for the majority of your labor. They are also a great choice if you plan to go with a birth plan that includes a birth tub, birth center birth, or home birth. (Note: Midwives always partner with OB-GYNs so that if your birth calls for unexpected intervention like a C-section, there will be someone there to make that happen.)
Doula
A doula is a great complement to either an OB-GYN or a midwife during labor and delivery. Their focus is all on you (versus the OB or midwife, who is very focused on the baby and the way the birth is progressing medically). Doulas work to keep you supported, calm, and focused during birth, and if you have a partner in the room with you they’ll help them know how best to support you as well. They don’t perform any medical procedures or assist with the birth. They can act as support prior to birth (we took a great 12-week birth class with our doula group) and postpartum, too. It’s important to note that there are many kinds of doulas, including postpartum doulas, adoption doulas, and bereavement doulas. We worked with a birth doula.
As far as certification goes, it’s looser than being a midwife. However, my recommendation would be to use DONA International to find a certified doula to work with. You can search their database here. From a cost standpoint, check with your insurance company to see if they’ll cover a portion of doula support. For most, working with a doula will be an out-of-pocket expense that can range in price from $800 to $2,500, according to What To Expect.
For us, working with both a midwife and a doula was absolutely the right choice – each does very different things – and now that I’m pregnant again we’ll be using the same midwife and doula groups to help us navigate another pregnancy and birth experience.
Read more on how to stay connect with your village while pregnant here.
