Doula vs Midwife: What’s the Difference?

Bringing a baby into the world is an exciting journey, and you deserve to have the right support every step of the way! Whether you’re planning your birth experience or just beginning to explore your options, understanding the roles of doulas and midwives can help you feel confident and empowered. Both professionals offer incredible support, but in different ways. By learning about their unique qualifications, you can choose the best team for your pregnancy, birth, and postpartum experience.

What is a Doula?

A doula is a trained professional who provides emotional, physical, and informational support to pregnant women before, during, and after birth. Unlike medical providers, doulas do not offer medical advice or perform clinical tasks. Instead, they focus on comfort measures, advocacy, and continuous practical support throughout the birthing process and postpartum.

There are three main types of doulas:

• Birth doulas: Facilitate birth planning, and provide emotional support during labor and delivery.
• Postpartum doulas: Provide care to both newborn infants and their mothers during the postpartum recovery period, including during the day or overnight shifts (sometimes informally referred to as “night nannies”). 
• Full-spectrum doulas: Are trained to serve as both birth and postpartum doulas, providing the “full-spectrum” of pregnancy and postnatal care.

It’s important to carefully vet candidates when hiring a doula. “Doula” is not a protected title, meaning a state license is generally not required to practice as a doula. To use the title of Certified Doula (CD), however, requires completion of a doula certification program, which includes a set number of hours of live instruction, a written exam, references from both families and supervisors, and regular recertification. 

Doula training varies, but most programs emphasize hands-on techniques, emotional support strategies, and birth plan guidance. Although certification is not required, many doulas choose to complete training programs to enhance their expertise.

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What is a Midwife?

A midwife is a trained healthcare professional specializing in pregnancy, birth, and postpartum care. Midwives offer medical care and are qualified to provide prenatal care, monitor fetal development, and manage labor and delivery for low-risk pregnancies. Midwives often collaborate with OB-GYNs for comprehensive maternity care.

Unlike doulas, the use of the title “midwife” requires certification, including attending an accredited midwifery program and passing a national certifying exam administered by the American Midwifery Certification Board (AMCB). There are two primary types of midwives: 

• Certified Nurse Midwives (CNMs):  Certified Nurse Midwives have a bachelor’s degree in nursing from a nurse-midwifery program and have passed a certification exam. In the US, CNMs are licensed in all 50 states and can prescribe medication, either independently or in conjunction with a supervising physician. CNMs must be recertified every 5 years, and you can verify the status of CNM’s license on your state board before starting care.  
• Certified Professional Midwives (CPMs): Certified Professional Midwives, also known as Certified Midwives, have completed an accredited midwifery program and passed a certification exam; however, they are not nurses. Legal recognition and licensure of CPMs varies by state. They may or may not be able to practice independently and prescribe medication.   

It’s important to consider what level of care you are looking for from your midwife and understand your state’s regulations before selecting a provider.

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Doula vs Midwife: Key differences

Understanding the distinctions between a doula and a midwife can help expecting families determine which professional best meets their needs. While both doulas and midwives support pregnant individuals, their roles differ significantly. 

Midwives provide medical care, including prenatal checkups, labor management, and postpartum medical support, whereas doulas focus on emotional and physical support without medical intervention. Both professionals assist with birth planning, but a midwife can also provide clinical guidance and medical interventions when necessary. 

Doulas offer continuous emotional support during labor, while midwives split their focus between medical care and emotional well-being. In the postpartum period, doulas continue offering non-medical support, such as newborn care and parenting education, while midwives handle medical checkups for both the birthing person and the baby. 

Additionally, midwives are essential for those seeking home birth or birth center options, as they are trained to manage labor in these settings safely. If a birthing person requires medical intervention beyond a midwife’s scope, they may collaborate with an OB-GYN to ensure proper care.

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When to hire a Doula vs Midwife

Choosing between a doula and a midwife depends on the level of support and medical care needed.

• Hire a doula if: You want continuous emotional and physical support during labor, guidance with your birth plan, and help navigating the postpartum period, including newborn care.
  
  • When to hire a doula: Many people choose to hire a birth doula early in the second trimester, around 20 weeks, to begin building a relationship and discussing birth preferences. Postpartum doulas can be hired at any time, including after baby arrives, but booking early ensures availability.
• Hire a midwife if: You have a low-risk pregnancy and prefer a provider who can offer prenatal care, manage labor, and provide medical support during birth.
  
  • When to hire a midwife: Midwives provide medical care throughout pregnancy, so it’s best to hire one as early as possible—ideally in the first trimester—to ensure comprehensive prenatal care and to establish a birth plan.
• Hire both if: You want the best of both worlds—a midwife for medical care and a doula for continuous, non-medical support. Be sure to check with your hospital or birthing center before hiring both–some have limits on the number of “guests” a birthing person can bring with them. 
  
  • When to hire both: If you want both medical and emotional support, hiring a midwife early in pregnancy and a doula by the second trimester can create a well-rounded care team for birth and beyond.

Both doulas and midwives play essential roles in maternal care. Understanding their unique contributions can help pregnant women and birthing persons create the birth experience that best aligns with their needs and preferences.

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