Midwife...or Doula? What's the Difference?
It doesn’t happen as much now as it used to, but often doulas are asked, “What is the difference between you and a midwife?”
The answer is pretty easy really. Doulas don’t do any clinical tasks or make medical assessments. I often joke we take care you from the waist up and a midwife takes cares you from the waist down - but really that’s not the full truth because midwives are also excellent at so much more than cervical checks and while doulas never give medical advice, they know a whole lot about how to help you have a good “waist down’ experience as well.
Doulas and Midwives
The role of doula and midwife complement each other and both doulas and midwives bring their heart and their skills to each and every birth they attend. Both midwives and doulas spend lots of time listening to the families they work with. Appointments are not quick in and outs, they are a time to talk, ask all the questions and create relationship and they both focus on non-judgemental support.
However, their roles are also very different even if they do share a few things in common.
A midwife is incredibly skilled at keeping women and babies low risk and safe during pregnancy, labor and postpartum. The midwife will monitor both the laboring woman and her baby using the clinical skills most people associate only with doctors - for example fetal monitoring, blood pressure checks and more. The midwife will use those same skills to help navigate the twists and turns of labor and provide encouragement at every step of the way. Depending on the labor, a midwife may have time to provide relational and physical labor support, but her primary focus is on guarding the health of the laboring person and the baby.
A doula is solely focused on providing that relational and physical support to the family, starting prenatally. During prenatal meetings, the expecting family shares their life, their plans, their hopes and also their fears. During this time, a doula becomes familiar with the families she works with and the doula already has carries a great deal of knowledge of birth. By knowing both, she helps families consider options and makes suggestions based on their goals, hopes and desires. It is very personal! The doula’s presence also allows everyone to be who they need to be during the birth of their child.
A doula is not going to touch anyone’s cervix (or even your newborn in most cases) but she may rub your lower back and give you hip squeezes for hours or fend off a nosy mother in law with ease…and she can because unlike the midwife, she has no responsibility for monitoring baby and making medical assessments. The doula is going to be a constant presence from early labor in the home, to the transition to your place of birth and until the baby has arrived and everyone is snuggled together.
All the Oxytocin
As a doula, providing support within a solid relationship is my favorite part of the job. When it is happening, the expecting family feels supported and cared for even if labor ends up happening in a way that was not planned. Relational support is the reason why research shows that people that have doulas at their birth have a higher level of satisfaction with their birth experience no matter how the birth occurs.
Birthing with midwives does not change the doula’s role. As you consider your birth team, you may want to re-frame the thought, “Do I want a doula or midwife”, to thinking of working with BOTH. You will find midwives and doulas working together create all kinds of the good stuff - oxytocin, and every birth needs more of that! Surrounding a birthing family with a supportive birth team impacts the experience in so many positive ways and the more your team feels that love, the more good stuff is brought to the birthing room.
