There are more options providing support for new and expectant parents than ever before. Because it is a topic that many people don’t think about until becoming pregnant, it can be hard to navigate and even harder to know where to begin. The difference between a doula and a midwife is something that a lot of expectant parents wonder about, and it’s something that we get asked about a lot at Baby Caravan.

Although both are commonly associated with unmedicated births, midwives and doulas provide different services to birthing people. While both provide high levels of support during pregnancy, labor, and postpartum, there are many differences between doulas and midwives. If you are ready to begin your search for the right provider for your birth, start with our guide to learn the differences between a doula and a midwife, and what these valuable practitioners offer.

Doulas

The definition of a doula as outlined by DONA International is:

“A trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible.”

The most significant thing to point out about the definition of a doula is that the support provided is for the birthing person and does not include medical or clinical services.

Note: For the purposes of this post we will be discussing the differences between birth doulas and midwives, but postpartum doulas are also widely available to support families during the postpartum time. Want to learn about postpartum doula care? Check out our blog post on the topic here.

Training

Although many professional doulas receive both intense and in-depth training, it is not required by law in the same way that medical licenses are for medical staff. That being said, many amazing doula training programs exist around the country and many doulas are highly dedicated to receiving ongoing training, education, and certifications throughout their careers.

For instance, doulas certified through the largest program in the United States, DONA, are required to undergo certain intensive workshops, lactation training, childbirth education, and submit two evaluations by medical professionals on the quality of care provided at two births.

The training opportunities in the United States are vast and diverse. Birthing Advocacy Doula Trainings require 12-weeks of course attendance in addition to providing care, homework, and various other requirements.

You can learn about a doula’s training and background in your initial contact with them and explore the topic during your interviews. Download our doula interview questions guide here to help you with your search.

PRENATAL SUPPORT:

Most doulas provide some amount of prenatal support, often in the form of in-person or virtual meetings to discuss the parent’s birth preferences. They do not provide any types of examinations or medical advice but are often rich sources of information about local and relevant resources.

LABOR AND DELIVERY SUPPORT:

The primary role of a birth doula is to provide emotional and physical support for birthing parents during labor and delivery. This takes on various forms depending on what the birthing parent’s needs are. Some of the support includes:

Helping to execute the parent’s birth preferences
Assisting with pain reduction or coping measures
Emotional support for birthing parent and partner
Creating a calm environment

Having continuous support during labor has significant positive outcomes for parents and babies including fewer interventions, a most positive feeling about the birth experience, shorter births, and more successful breastfeeding when desired.

Ready to begin your doula search? Contact us today to get connected with great NYC doulas.

POSTPARTUM SUPPORT:

Most doulas, including ones on the Baby Caravan team, offer one or multiple postpartum visits as part of their birth doula packages. These meetings serve as comforting and often educational check-ins to talk about how new parents are doing with the transition. Many doulas offer lactation support during their postpartum visits as well.

If you want ongoing support Baby Caravan has doulas who offer postpartum coaching for new parents. Learn more here.

Cost/coverage:

Doula costs vary by state and how experienced a doula is. A comprehensive doula package in the tri-state area typically ranges from $900-4,500.

At this time doula services are not covered by most insurance plans, but flex-spending accounts (FSA) and health savings accounts (HSA) can be used. To get all of the details on paying for doula care check out our blog post: Are Doulas Covered by Insurance?

Midwife

DEFINITION OF A MIDWIFE:

Midwives Alliance of North America:

Midwives are the traditional care providers for mothers and infants. Midwives are trained professionals with expertise and skills in supporting women to maintain healthy pregnancies and have optimal births and recoveries during the postpartum period. Midwives provide women and birthing people with individualized care uniquely suited to their physical, mental, emotional, spiritual, and cultural needs.

Training:

The term “midwife” is a blanket term that describes care providers with various types of training, certification, and range of services. The primary types, as outlined by WebMD are:

Certified nurse-midwives (CNMs) are registered nurses who have graduated from an accredited nurse-midwifery education program and have passed a national exam. They can practice in all 50 states and the District of Columbia.

Certified midwives (CMs) are non-nurse midwives who have a bachelor's degree or higher in a health field, have completed an accredited midwifery education program, and have passed a national exam. Only a few states permit CMs to practice.
Certified professional midwives (CPMs) are non-nurse midwives who have training and clinical experience in childbirth, including childbirth outside of the hospital, and have passed a national exam. Not all states permit CPMs to practice.
Lay midwives are not certified or licensed but have apprenticed or received informal training.

PRENATAL SUPPORT:

Most midwives support a pregnant person throughout their pregnancy and provide medical exams during their appointments. While they often partner with physicians, they can and do act as primary providers during pregnancy and labor. Midwives conduct prenatal visits to monitor the health of a pregnant person and baby, order diagnostic tests such as ultrasounds, and some are able to prescribe medications.

LABOR AND DELIVERY SUPPORT:

While a doula provides emotional support to parents during labor, midwives focus on helping to deliver a healthy baby. Because they provide medical support, in a hospital setting many are able to:

administer pain medications
induce labor
provide fetal monitoring
request epidurals
perform episiotomies
deliver a baby vaginally

Not all of these services are available if you use a midwife in a home birth or birth center. Make sure to have in-depth conversations with anyone you interview about what it will look like to have their support in the setting of your choice.

POSTPARTUM SUPPORT:

Midwives provide postpartum checkups for mother and baby. The number and types of visits will vary depending on the types of midwife you work with and the birth setting. Make sure to ask about this as you conduct your search for the right midwife.

Costs/coverage:

The cost of a midwife will also vary depending on the location of your birth. Some accept Medicaid and Insurance, while others are out of network. A hospital birth will typically run upward of $2,000 but is typically covered by insurance.

Because of the licensing requirements for most midwives even in the home birth or birth center setting, insurance may still cover these settings. Check with each individual provider to confirm coverage.

Do I still need an OBGYN?

Most midwives work in partnership with OBGYNs to refer out to if necessary, for instance in the case of a complicated or high-risk pregnancy or birth. They are trained to recognize when a pregnant person needs certain medical interventions. It is always a good idea to have a preferred OBGYN as a pregnant person and parent, but your midwife can likely refer you out to someone they know and trust if they deem it necessary.

What option is best for me?

When deciding who to work with during your pregnancy and during the birth of your baby it is important to remember that the roles of midwife and doula are not interchangeable. Because neither takes the place of the other, it is often a choice of whether to hire both a midwife and a doula or not.

Some factors that you may want to consider when deciding whether or not to hire a doula in addition to a midwife are: