Midwives and Doulas

What’s the difference?

You’re expecting – congratulations! Now you have some important and very personal decisions to make about your pregnancy and, eventually, your birthing process. Do you want to have all your pregnancy check-ups in a medical office, and give birth in a hospital? Do you want your pregnancy to be monitored by a midwife? Do you want to give birth at home? Do you want pain medication during labor? Do you want professional support through the entire process, from prenatal to postpartum?

These questions will help you figure out the best plan for your pregnancy and birthing process. If you decide that you want care outside of what is offered by a hospital during pregnancy, the birth, or both, some of the best resources available are midwives and doulas.

Under the guidance of a midwife or doula, you can find emotional support and the answers to any questions regarding the pregnancy, childbirth and postnatal care, says Susan Terwilliger, a midwife who practices as Alaska Birthing. If you’re wondering about whether you should choose a doula or a midwife (or both), here’s what you need to know.

“The paths to becoming a doula or a midwife differ in educational requirements, training, licensing, and level of responsibility. The midwife is the primary care giver at a birth,” says Susan. “The doula is a support person that offers education, non-medical solutions to common complaints, familiarity, continuity, and guidance in a variety of scenarios, but she does not carry the primary responsibility for overseeing the birth.

Midwives have a broader scope of practice. They provide prenatal care (including the physical monitoring and lab work necessary for a healthy pregnancy), delivery of the baby, and postpartum care (including the required newborn tests and filing for a birth certificate). Midwives offer this service to women who choose to give birth outside the hospital, either at home or at a birth center. There are some midwives that can also provide a level of primary care for births in the hospital.”

Shanna Switzer of Alaska Birth Services, who has been a certified doula for 10 years, says doulas “offer prenatal education and birth preparation, informational support and evidence-based resources, and physical and emotional support during the labor and birth process. We are the feet and back rubbers, the cheerleaders, the water bottle holders and a continuous, positive source of encouragement during the labor and birth process…. We step in as an advocate and protector of the birth space for laboring women, upholding and reminding everyone involved of her desires and wishes as much as possible. We support laboring women in all birth locations.”

In the simplest terms, midwives are there for medical care and ensuring a healthy birth, and a doula is there for education, support and advice. Since these two professions do different things, but are both extremely useful, can you have both?

“Having both a midwife as care provider and doula for birth support is an amazing way to experience pregnancy and birth,” says Shanna. “Doulas and midwives are like the dream team – low risk, holistic, personalized care (from a midwife), with continuous support from a doula that the expecting mom and partner have connected with, and feel safe and fully supported by.” says Shanna.

If you want to give birth in a hospital, with quick access to emergency services, you can still have a midwife and a doula there to assist with your birth. If you want to have a home birth, you need to have a midwife there as a medical provider to ensure the health and safety of you and your baby. A doula would be in addition to a midwife for a home birth, and would be there to coach you, make sure you are fed and hydrated, and help position you for labor and birth while helping to keep you comfortable and positive.

There are many options for your pregnancy, birth, and postpartum care. To decide which are right for you, be sure to do your research and decide what is most important to you, Susan says. “Educating yourself about the choices available in your community is second only to getting educated about the nature of birth itself. Whether that is done by reading, watching videos, talking with friends and family, or consulting with a variety of providers, the gathering of information brings to light the decisions that you will make along the way.”