What is the difference between a Midwife and a Doula?
Midwife vs Doula
What’s the difference? Do I need Both?
One very common question that newly expecting parents have is what’s the difference between a midwife and a doula. This guide is adapted from Amanda Smith, a great option for doula care in Colorado Springs.
A quick overview…
Doulas and midwives are both priceless assets to your birth team. As your healthcare provider, your midwife will handle the clinical responsibilities during pregnancy, labor and delivery, and postpartum, while your doula provides information, as well as physical and emotional support. Midwives and doulas have differing but complementary roles. Both will support and encourage the healthiest birth practices, ensuring a more satisfying childbirth experience for your family.
let’s dive deeper: Midwives
Throughout all of human history, midwives have helped women through pregnancy and birthing. A midwife typically cares for healthy, low-risk mothers and babies from conception until 6 weeks postpartum. In the midwifery model of care, pregnant women will usually experience longer prenatal appointments to allow plenty of time for answering questions and building relationships, they’ll be supported and assessed throughout all of labor and birth, and they’ll have around 10 postpartum visits within the first 6 weeks after delivery.
Midwives are experts in normal, natural birth and have received extensive training in handling complications. Families who choose midwifery care will be seen by a midwife instead of an obstetrician. If a pregnancy or labor and delivery become too complicated, midwives will transfer care of the client to a physician.
Today, 5 types of midwives provide varying levels of care to women and newborn babies:
Certified Nurse-Midwife (CNM) - a Registered Nurse who has a graduate degree in Midwifery
Certified Midwife (CM) - a Midwife that has met her state’s requirements for certification
Certified Professional Midwife (CPM) - a midwife that has met the didactic and clinical requirements from the North American Registry of Midwives (NARM) and passed their comprehensive exam
Direct-Entry Midwife - a midwife that does not have a background in nursing
Lay Midwife - an uncertified or unlicensed midwife who often has an informal education
Midwives are the key to increasing access to effective maternity care and improving birth outcomes for mothers and babies.
The American Public Health Assoc. & the World Health Organization recommends midwives as the primary maternity care providers for the majority of women
The Millbank Report: Evidence-Based Maternity Care recognizes the CPM as the benchmark for low intervention & good outcomes
Nations with the lowest infant mortality employ midwives as the primary maternity care providers for the majority of women
Mounting evidence supports the value & cost-savings potential of midwifery care, according to a report issued by the Washington Department of Health in 2010
Birth centers & planned home births have been shown to be safe for low-risk women, with demonstrated potential to significantly reduce costs to the system
CPMs are currently legally recognized in 28 states & own approximately half of the birth centers in the U.S. (narm.org)
Photos above highlight Kim Woodard Osterholzer, an excellent home birth midwife in Colorado Springs.
let’s dive deeper: doulas
A doula is defined by Doulas of North America (DONA) as a woman who is trained and experienced in childbirth and provides continuous physical, emotional, & informational support to a woman during labor, birth, & the immediate postpartum period. The word doula originates from the Greek word for “slave” and was made popular in the 1970s by Dana Raphael to describe an experienced woman who, after birth, assisted the mother with breastfeeding her baby (Klaus, M., Kennell, Berkowitz, & Klaus, P., 1992).
According to DONA, a doula's role can be summarized in 7 objectives:
To recognize birth as a key experience that the mother will remember all of her life;
To understand the physiology of birth & the emotional needs of a woman in labor;
To assist the woman & her partner in preparing for & carrying out their plan for the birth;
To stay by the side of the laboring woman throughout the entire labor;
To provide emotional support, physical comfort measures, an objective viewpoint, & assistance to the woman in getting the information she needs to make good decisions;
To facilitate communication between the laboring woman, her partner, & care providers;
To perceive the doula's role as one who nurtures and protects the woman's memory of her birth experience.
Photos above show Colorado Springs doula Madison Lopez of My Blessed Birth supporting a family in labor while midwives Amy Burgess and Jennifer at Beginnings Birth Center (the only free standing birth center in Colorado Springs) hook up straps to assist different laboring positions.
Evidence Based Birth:
“Of all the ways birth outcomes could be improved, continuous labor support seems like one of the most important and basic needs for birthing people. Providing labor support to birthing people is both risk-free & highly effective. Evidence shows that continuous support can significantly decrease the risk of Cesareans, NICU admissions, Pitocin, & medications for pain relief. Labor support also increases satisfaction & the chance of a spontaneous vaginal birth. Although continuous support can also be offered by birth partners, midwives, nurses, or even some physicians, research has shown that with some outcomes, doulas have a stronger effect than other types of support persons. As such, doulas should be viewed by both parents & providers as a valuable, evidence-based member of the birth care team.”