midwife or doula

Midwife or Doula? What’s the Difference?

Midwives and doulas. Both midwives and doulas support birthing people in labour and birth – but the way they support birthing people differs. If you’re not in the know, you may not even realize that there is a difference. Read on to find out how midwives and doulas differ and how they complement each other. 

When I first started telling people that I was going to become a doula, so many people assumed that I was going to be catching babies. 

Yeah, no.

Catching babies is most definitely not part of a doula’s role. 

Sometimes the assumption is that pregnant people can choose between a doula and a midwife. Sometimes they think that if they choose a midwife that they do not need a doula. But both doulas and midwives support birth differently and have separate and complementary roles.

Doulas and midwives support birth differently and have separate and complementary roles.

So, what IS the difference between a midwife and a doula?
A midwife is a medical professional.

In Canada, midwives are licensed medical providers that have taken part in a midwifery training program out of a university. A pregnant person is able to choose between a midwife or a doctor/OB for their prenatal care. Though admittedly, in Alberta our access to midwifery care is limited due to funding. Just like a doctor, midwives are responsible for the health of you and your baby during pregnancy, birth, and immediately postpartum.

In uncomplicated pregnancies, midwives are responsible for all prenatal care. They advise on health concerns, run prenatal tests, prescribe maternal medications/supplements, and perform physical examinations. If something complicated comes up that is outside the scope of midwifery care, they consult with an OB. In pregnancies that become high risk, they transfer care to an OB for the health and safety of the baby and pregnant person.

Midwives monitor and perform physical examinations on both baby and birthing person during labour, birth, and immediately postpartum. From checking your blood pressure to listening to baby’s heartbeat to checking for baby’s position before and in labour. They do it all. They also provide postnatal care for 6 weeks for both birthing person and baby. Midwives try their best to make sure you have a comfortable birth, but ultimately, their focus needs to be on the clinical tasks.

Evidence shows that doulas do help you achieve a more positive birth outcome.

Doulas are not medical professionals. 

Doulas do not take part in any medical tasks or medical decisions. 

Birth doulas provide emotional, physical, and informational support during pregnancy and birth. A birth doula will meet with you prenatally and develop a relationship with you and your partner (if there is one). They help you develop a birth plan that feels right to you and direct you to any needed resources in your community. Birth doulas know how to help you feel calm and supported in labour – from comfort measures to help you manage contractions to knowledge of different labouring/birthing positions depending on your baby’s position and stage of labour. By providing you with informational support, a doula can also help you feel confident when you communicate your needs with your health care provider.

Postpartum care is also part of doula support. A doula provides emotional support in the immediate postpartum period and can help to initiate breastfeeding. Many doulas are also educated in breastfeeding support and can help if issues arise later on. Both birth doulas and postpartum doulas can provide varying levels of postpartum support.

Again, doulas are not medical providers. They do not take part in any of the decisions or procedures that take place during a pregnancy or birth. If you have a medical question, they will direct you to your healthcare provider. And though they may not be involved in the medical aspect of pregnancy and birth, evidence shows that they do help you achieve a more positive birth outcome. When a birthing person has continuous labour support, like the kind a doula provides, both birthing people and their babies are statistically more likely to have better outcomes.

Do I need both a midwife and a doula?

As a person who has had midwifery care, I can’t sing its praises enough. I love what midwifery care looks like and I wish it was available for more Albertans. As an Edmonton doula, my goal is to complement that excellent care that midwives give. In doing so, the pregnant people who have both doulas and midwives are supported in all the best ways possible.  

Most importantly, a doula does not replace a health care provider. Instead, doulas and health care providers work together to ensure the best possible outcome for clients. Our work complements each other. One particularly wise woman once told me, “ultimately, a midwife cares for the body, a doula cares for the soul.” Both body and soul are important, and a midwife will absolutely do their best to care for the soul as well. But, ultimately, their focus is the health and safety of you and your baby. A doula can fill in that gap so that your soul can be best supported as you make this incredible transition into parenthood.

So yes, I will absolutely suggest that pregnant people under midwifery care also have a doula. Having both a midwife and a doula ensures that you get the best support in all ways – and you absolutely deserve the best support.

Love Sarah