What’s the difference between a midwife and an OB-GYN? What about the difference between a doula and a midwife—are there any differences between the three?
It may seem like doulas, midwives, and obstetrician-gynecologists (OB-GYNs) are just different ways of saying the same thing. After all, these three professions revolve around the care of pregnant women throughout the birthing process.
These roles are very distinct, however, and figuring out which one you want to become—or which one you may want to assist with your own pregnancy—begins with understanding what distinguishes each of them.
What is a doula?
Doulas provide non-medical professional support to pregnant women, particularly during labor and delivery. Their objective is to address and advocate for the mother’s physical and emotional needs. Doulas cannot actually deliver babies because they are not medically trained to do so. Instead, they provide general support to a mother as she gives birth.
What does a doula do?
Doulas usually meet with clients a few times before the birth to help them make a birth plan and provide information about what to expect during childbirth. They may help ease labor pains with non-medical interventions such as breathing, massage, or moving the mother into different positions.
A doula gives a mother encouragement during childbirth and emotionally supports her and her partner. When they work with mothers after birth, they provide guidance on breastfeeding, caring for an infant, and caring for themselves during the postpartum period.
Barbara Timson worked as a midwife in her home country of Switzerland before eventually moving to Seattle where she has been a birth doula for over 20 years. She said that she enjoys being a doula so that she can give women the emotional support that is often lacking in the modern healthcare system.
“I just love the intensity of birth and the connection one has with a [pregnant] woman,” Timson said. “It’s so raw, you get so close. There’s no status. It’s just the most beautiful human connection for a short time of total trust.”
Doula requirements
Doulas do not need a license to practice since they are not medical professionals. However, most choose to obtain a certificate to boost their credibility. They can receive training from various organizations such as Doulas of North America (DONA) International or the International Childbirth Education Association (ICEA). A doula’s education comes more from experience than formal education.
Since they do not have a medical education, most doulas work in private practices, birthing centers, or home health.
Midwife definition
Unlike doulas, a midwife IS a trained health professional that provides care for women across their lifespan with a focus on the processes of pregnancy and childbirth. Many midwives are also Registered Nurses (RNs).
Midwife job duties
“As a midwife, I was more responsible for making all the decisions, it becomes more medical,” Timson said. Indeed, a midwife’s duties are not restricted to caring for pregnant women—they also provide obstetric and gynecological care to women at all stages of life.
Like doulas, midwives aim to provide physical and emotional support to mothers and may act as a liaison between the patient and her healthcare team. Midwifery education programs encourage minimizing unnecessary medical interventions, which is similar to the philosophies of many doulas.
“Our focus as midwives is more typically on normal birth and really having the time to stay with patients during normal labor and birth, whereas physicians [and OB-GYNs] are by necessity constantly pulled into the more complicated patients,” said Dr. Eileen Thrower, Chair of the Department of Midwifery and Women’s Health at Frontier Nursing University.
Unlike doulas, most midwives work in hospitals. In fact, 95 percent of births attended by Certified Nurse Midwives (CNMs) and Certified Midwives (CMs) occurred in hospitals in 2017. Midwives can also work at birthing centers and in-home health, but it’s less common.
“I’ve worked at a birth center, I’ve worked at a large tertiary care, huge public hospitals, I’ve worked at community-based hospitals, and midwifery can look really different in all of those places,” Thrower said.
Midwifery requirements
Although there are several types of midwives that have differing levels of education and credentials, the majority of midwives in the United States are either Certified Nurse-Midwives (CNMs) or Certified Midwives (CMs).
Both have at least a master’s degree in midwifery and have passed a certification exam administered by the American Midwifery Certification Board. CNMs are also Registered Nurses (RNs).
Their extensive education separates them from doulas and gives them the authority to…
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