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What’s the Difference Between a Midwife and Doula?

Difference Between a Midwife and Doula; Pregnant couple with doula at home

Often mistaken for one another, midwives and doulas each have their own role as part of a woman’s labor and delivery team. What doulas and midwives have in common is a commitment to providing support throughout pregnancy and the birthing experience. While both offer physical and emotional support, it’s important to understand the difference between a midwife and doula. 

What Does a Midwife Do?

A midwife is a healthcare provider that can provide care before, during, and after childbirth. Midwives are trained medical practitioners and what they can do varies depending on qualifications and state requirements. All midwives are qualified to deliver babies.

Midwives that are also registered nurses (RNs) are called certified nurse-midwives, or CNMs. Certified nurse-midwives can provide the widest range of healthcare services to women.

The services midwives provide may include gynecological examinations (Pap smears, pelvic exams, breast exams), prescription medication, and fetal monitoring during both pregnancy and childbirth. Midwives also provide care to women who are not pregnant through well-woman care and contraception counseling.

The biggest reason women choose to use midwives is because of the relational aspect. Though they are clinically trained, the relationship between a midwife and expectant mother is often less clinical than that of a doctor and patient. The midwife provides more emotional support than doctors in tandem with their medical training. Many women crave more of this personal attention and comprehensive care during the birthing experience.

Midwives aim to avoid or limit intervention during childbirth. They believe it is best to let it happen as naturally as possible because pregnancy and birth are normal life processes. However, because of their extensive training, midwives can recognize when intervention is in fact necessary and refer them to an obstetrician during birth.

For more information about the benefits of midwifery care, check out our previous post. 

What Does a Doula Do?

A doula is a professional who has expertise in helping birthing parents before, during and after childbirth. They serve as childbirth advisors or counselors. 

This sounds similar to a midwife so far, but there are differences. The doula is focused mainly on the mother during childbirth, while other care team members focus on both the mother and the baby. Doulas do not deliver babies or provide medical prenatal care, as they are not medically trained in a clinical setting. 

Therefore, unlike midwives, doulas cannot conduct gynecological exams, prepare for C-sections, use equipment to monitor mother and baby (like CTG machines), perform ultrasounds, administer medication, give epidurals, or perform any necessary medical care after the birth (i.e. stitching tears if that is necessary).

Doulas function as a reliable source of support for a birthing parent. They are present for the birth and comfort parents emotionally and physically throughout the birth experience. They are there to facilitate the most stress-free and comfortable labor and delivery through several techniques. These practices include:

  • Breathing technique support
  • Relaxation methods
  • Massage
  • Assistance with labor positions
  • Supporting and involving any birth partners (spouses, significant others, family members, friends) in the process.

There are two primary types of doulas:

  • Birth doulas provide the support previously mentioned through childbirth. 
  • Postpartum doulas provide support to new parents and baby after the birth to help them adjust, including explaining normal newborn behavior, techniques for soothing, and support for breast or bottle feeding.

All the information discussed here pertains to professional doulas. You’ll want to choose a doula that is trained and certified by a reputable organization. 

What are the Qualifications for a Midwife?

Midwifery has developed and evolved differently in countries throughout the world. After all, the profession has been around for hundreds of years. Despite these differences, the International Confederation of Midwives’ definition of a midwife is: 

“A person who has successfully completed a midwifery education program that is based on the International Confederation of Midwives (ICM) Essential Competencies for Basic Midwifery Practice and the framework of the ICM Global Standards for Midwifery Education and is recognized in the country where it is located; who has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery and use the title ‘midwife’; and who demonstrates competency in the practice of midwifery.”

There are three different types of midwives in the United States that have different qualifications and certifications. These different types of midwives and their basic qualifications are:

  • Certified Nurse-Midwife (CNM): Has a graduate degree from an accredited program at an ACME (Accreditation Commission for Midwifery Education) accredited institution and an RN license. The RN license may be acquired before the commencement of their midwifery program or within the program. Certified through the American Midwifery Certification Board (AMCB) part of the American College of Nurse-Midwives (ACNM).
  • Certified Midwife (CM): Has a graduate degree and has completed clinical midwifery education through an ACME accredited program. Certified through the AMCB and part of the ACNM.
  • Certified Professional Midwife (CPM): Certification from the North American Registry of Midwives (NARM) does not require an academic degree. Instead, certification is based on demonstrated competency in the specified areas of skill and knowledge. Part of the National Association of Certified Professional Midwives (NACPM).

The American College of Nurse-Midwives has a great document that goes into much greater detail about what the differences between the types of midwives are.

What are the Qualifications for a Doula?

Doulas are not usually required to have official certification, but it varies from state to state. However, there are some states proposing laws that allow Medicaid reimbursement for doulas. If that happens, then certification and regulation will probably increase. Although certification is not always required, most doulas still undergo comprehensive training and education.

Formal training for doulas is available through three organizations:

Which One Do I Need?

Midwives and doulas are two types of professionals that can both be part of your care team. Their qualifications and expertise can complement each other to the benefit of the birthing parent. It depends on how many people you want in the room during the birth and what kind of support you’re looking for.

At City of Oaks Midwifery, our midwives are highly qualified. All of our care providers are certified nurse-midwives and have additional qualifications. We offer full-scope midwifery services and primary care. If you want to make us part of your collaborative care team, schedule an appointment by calling 919-351-8253.

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