Doula, Midwife, or Both? Your Birth Team, Decoded

Doula, Midwife, or Both? Your Birth Team, Decoded

After finding out you’re pregnant, one of the many important decisions you’ll need to make is who will help you bring your new baby into the world. The first person that comes to mind is probably your OB/GYN, but you may also want to consider adding a midwife or doula to your birth team. 

“Midwives and doulas care for you, the individual,” says Rachel Nicks, a doula, lactation counselor, and founder of Birth Queen. “We ask you what your dream pregnancy and birth are, and we do our best to support you and your desires and bring it to fruition. You’ll get one-to-one, personalized, holistic, wraparound care—medical, emotional, physical, and beyond.”

When you’re building your birth team, it’s important to understand the difference between a midwife and a doula—and the unique benefits they each offer. Here’s what you need to know.

What does a midwife do?

Certified nurse midwives (CNMs) are trained healthcare professionals who are qualified to provide medical care throughout pregnancy, labor, and delivery. 

In a low-risk pregnancy, a midwife can provide many of the same services you’d typically get from your OB/GYN. Certified nurse midwives can perform gynecological exams, confirm a pregnancy, monitor the fetus, recognize complications, prescribe medication, induce labor, order an epidural, perform an episiotomy, “catch” a vaginal delivery, and provide postpartum support. 

CNMs can help with delivery at a hospital, birth center, or home birth. However, only an OB/GYN is surgically trained. If your pregnancy is high-risk or a cesarean delivery is needed, your midwife will coordinate with an OB/GYN who can provide the necessary care. 

Some key benefits of having a midwife on your birth team include:

  • Medical care. “Essentially, a midwife is a clinical provider that manages the entire birth including prenatal, delivery, and postpartum care,” says Dr. Caitlin O’Connor, ND, a naturopathic doctor and midwife.
  • Pregnancy support. Because midwives are trained to provide prenatal care, they can support you throughout your entire pregnancy—not just during labor and delivery.
  • Holistic approach. Midwives provide compassionate care that addresses your physical and mental wellbeing.1 “Many folks like the whole-person approach—the personalized care, acknowledgment of the emotional and spiritual components of birth, longer prenatal appointments, and more postpartum follow-up,” Dr. O’Connor says. 
  • Advocacy. Your midwife will work with you to create a birth plan that’s tailored to your preferences. During labor and delivery, a midwife can act as an advocate to ensure your birth experience aligns with your goals as much as possible. 
  • Less intervention. Midwives generally view childbirth as a natural process rather than a condition, so they may be less apt to recommend induction, pain medication, or cesarean delivery.2 A midwife may recommend techniques such as massage, music therapy or alternative laboring positions to help with pain management during labor and delivery.3
  • Postpartum support. After your baby arrives, your midwife may continue to support your transition to parenthood by providing breastfeeding tips, postpartum checkups and emotional support.

What does a doula do?

Doulas build a relationship with their patients throughout a pregnancy—ultimately becoming their advocate and affirming a laboring mother’s experience, preferences, and needs. They help reassure, empower, and reduce anxiety for their patients. Studies show that this type of support can be particularly beneficial in communities experiencing healthcare gaps and dangerous disparities in maternal healthcare.4  

The main role of a doula is to help you stay calm and comfortable during labor and delivery. Along with verbal encouragement, doulas may offer comfort measures such as breathing techniques, massage and optimal laboring positions.5 

Research suggests having a doula reduces anxiety and stress during childbirth. Doula support is also associated with shorter labors, lower incidence of C-section deliveries, and increased rates of feeding.6

Doulas do not, however, provide medical care. “A doula provides emotional support to the birthing person and their partner, but is not a clinical provider,” Dr. O’Connor says.

Here are a few of the key ways a doula can improve your birth experience:

  • One-to-one support. While an OB/GYN or CNM may have multiple patients to attend to in a day, your doula will typically care for you exclusively throughout your labor and delivery, Nicks says. 
  • Pain relief techniques. A doula can help you manage labor pain via a variety of comfort measures. This can be especially beneficial if you’re hoping to have an unmedicated birth.
  • Education and empowerment. “A doula provides education and support for the birthing person and the partner,” Nicks says. Their goal is to empower you to make informed decisions, develop your birth plan and feel confident advocating for yourself during labor and delivery.7
  • Encouragement. A doula will stay by your side to provide emotional support and reassurance throughout your labor and delivery.
  • Postpartum support. After your baby arrives, a doula may continue to offer breastfeeding guidance, newborn care and emotional support as you navigate the transition into parenthood. 

The Benefits of Having Both a Midwife and a Doula on Your Birth Team

So, which should you add to your birth team—a midwife or a doula?

The short answer is: You don’t have to pick just one! A midwife and a doula serve two different roles, and they can complement each other as part of your birth team. “One does not replace the other,” Dr. O’Connor says. “Especially in a hospital setting, a doula can augment the personalized clinical care of a midwife with individual coaching and support.”

A review of studies found that women who received care from a midwife had lower rates of emergency C-section and certain birth complications.8 And research suggests that women who have a doula on their birth team report more autonomy and confidence during labor, and greater satisfaction with their overall birth experience.9 No matter who you choose, rest assured that you’re helping to facilitate the best possible birth experience for you and your baby. 

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  1. Samantha Salome Krausé et al; The characteristics of compassionate care during childbirth according to midwives: a qualitative descriptive inquiry; May 2020
  2. Cleveland Clinic: Midwife

  3. Patrycja Guzewicz et al; The Role of Midwives in the Course of Natural Childbirth—Analysis of Sociodemographic and Psychosocial Factors—A Cross-Sectional Study; Dec 2022

  4. Bridging Health Disparities and Improving Reproductive Outcomes With Health Center–Affiliated Doula Programs  

  5. American Pregnancy Association: Having a Doula – What are the Benefits?

  6. Alexandria Sobczak et al; The Effect of Doulas on Maternal and Birth Outcomes: A Scoping Review; May 2023

  7. International Doula Institute: Are Birth Doulas Advocates And Activists?

  8. Rekiku Fikre et al; Effectiveness of midwifery-led care on pregnancy outcomes in low- and middle-income countries: a systematic review and meta-analysis; May 2023

  9. Alexandria Sobczak et al; The Effect of Doulas on Maternal and Birth Outcomes: A Scoping Review; May 2023