Midwives and doulas, as well as OB-GYNs (obstetrician-gynecologists), play a role in caring for pregnant people, just in different ways.
Understanding the roles of midwives and doulas is helpful for expecting parents seeking personalized care during pregnancy, childbirth and beyond. Additionally, midwives offer gynecologic health and family planning services, including routine exams and preconception care.
What is a Midwife?
Midwives are healthcare professionals specializing in reproductive health across a woman’s lifespan, from adolescence through menopause. They can help treat women in different phases of life and educate them about sexuality, pregnancy, childbearing and menopause.
Midwives deliver a unique style of care that not only emphasizes a patient’s physical health, but focuses on their emotional, spiritual and social needs as well. They are trained to offer personalized and holistic care for patients that can include:
- Prenatal care: Monitoring maternal health and fetal development during low to medium-risk pregnancies (while OB-GYNs manage high-risk patients and surgeries).
- Labor and delivery: Assisting with natural childbirth, pain management techniques and supporting informed choices during labor; providing options for women during normal labor progression, including the ability to customize their birth setting, labor and give birth in any position, and choose vaginal birth after cesarean (VBAC) and vaginal twin birth.
- Postpartum care: Providing guidance on recovery, breastfeeding and newborn care during the first several weeks of life.
- Gynecological services: Conducting routine annual exams like pap smears and breast exams, offering family planning advice and managing women’s health concerns, such as the use of birth control/contraceptives or STI testing.
Midwives can practice in various settings, such as hospitals, birthing centers and homes. They can work independently or collaborate closely with obstetricians when medical interventions are necessary.
For general women’s health care, midwives practice within medical offices, just like OB/GYNs. If a patient develops a medical condition that requires a higher level of treatment, including during pregnancy or birth (such as a C-section), a midwife refers her to an OB/GYN, maternal/fetal medicine specialist or other specialists as needed.
What Are Midwifery Services?
Certified Midwives (also known as Licensed Midwives) are health professionals who have completed the educational requirements specified by the Accreditation Commission for Midwifery Education (ACME).
Their educational requirements include a Master’s degree and competencies for board certification in midwifery practice by the American Midwifery Certification Board (AMCB).
What is a Doula?
Doulas are non-medical professionals who are trained to provide physical, emotional and informational support to pregnant people before, during and after childbirth. They can also provide additional support during the postpartum period, which is sometimes referred to as the “fourth trimester.”
Certified nurse midwives (CNMs) provide medical care; doulas do not.
Doulas do not perform medical tasks or make clinical decisions, but focus on enhancing the birthing experience and ensuring a patient’s wishes are respected. Their role is centered on advocacy and empowering the birthing process through:
- Emotional support: Offering reassurance, encouragement and comfort measures prior to birth and during labor and delivery. For example, they can help patients create birth plans, prepare the nursery, pack for the hospital or birth center, and emotionally and mentally prepare patients for labor and life with a newborn.
- Physical support: Providing massage, positioning suggestions, and helping with relaxation techniques, breathing and natural pain management.
- Information and education: Educating about childbirth options, procedures, and newborn care to manage expectations, answer common questions and reduce uncertainty.
Key Differences Between Midwives and Doulas
To summarize the difference between the two, midwives focus on clinical care and medical management throughout pregnancy and childbirth, while doulas provide emotional support, comfort and advocacy during labor and delivery.
Here’s more about how midwives and doulas compare:
Training and Scope
- Midwives: Trained healthcare providers with certifications and licenses. They offer medical services, including prenatal care, childbirth assistance and postpartum care.
- Doulas: Non-medical professionals without formal medical training or licensing who help assist in the birthing process and recovery.
Role During Birth
- Midwives: Directly involved in medical care, monitoring patients’ health and managing complications.
- Doulas: Offer continuous support, focusing on comfort and empowerment. They can also help advocate for birthing preferences and assist in informed decision-making.
Settings and Services
- Midwives: Work in hospitals, birth centers and homes, providing comprehensive maternity care.
- Doulas: Typically support births in any setting the birthing person chooses, from hospitals to homes.
While midwives and doulas differ in their roles and training, it’s common for them to collaborate to provide patients with the best possible pregnancy and birthing experiences. For example, midwives can focus on the medical aspects of birth, while doulas can help with breathing and comfort.
For more information on maternity care options at Stony Brook University Hospital, including midwifery services, visit Stony Brook Women’s Center. The Division of Midwifery at Stony Brook University Hospital has been serving women and families since 1996. From a staff of one, we now have 17 midwives on our team. At Stony Brook, all midwives are faculty members in the Department of OB/GYN. Our philosophy is to place the needs and desires of women first while maintaining a safe and supportive environment.
