Midwife vs. Doula: How They Are Different
Aug 12, 2020 Rosanna Turner
Midwives have played an important role in pregnancy and childbirth for hundreds of years.
Today, certified nurse midwives are highly trained medical professionals who not only deliver babies, but also provide care to women during pre-conception, pregnancy, childbirth and postpartum.
"As a nurse midwife, our specialty is women's health—taking care of women from puberty through menopause, with an emphasis on labor, delivery and the postpartum period."
We talked to Rachel Franco, a certified nurse midwife in the Obstetrics & Gynecology Department at Cedars-Sinai, about the differences between a midwife and a doula, the decision to have an OB-GYN or a midwife deliver a baby, and what pregnant women and couples should discuss with their healthcare providers before going into labor.
What is a certified nurse midwife?
Certified nurse midwives are advanced practice registered nurses who specialize in women's reproductive health and childbirth.
"As a nurse midwife, our specialty is women's health—taking care of women from puberty through menopause, with an emphasis on labor, delivery and the postpartum period," Rachel says.
Midwife vs. doula
Rachel says that people often ask about the difference between a midwife and a doula, which are not the same thing.
A doula is a person trained to provide physical, emotional and educational support during pregnancy, labor and postpartum.
During labor, doulas may offer comfort through pain-relief techniques such as breathing exercises, massage and laboring positions. After birth, doulas may help new moms start breastfeeding and support them in other ways postpartum.
Rachel says that women who hire doulas often spend a lot of time with them prior to labor, which can create a strong bond between the mother and the doula. However, women should still seek out professional medical advice from a certified nurse midwife or an OB-GYN.
"With their doulas, women should have feelings of comfort and ease," Rachel says. "However, doulas shouldn't be offering any type of medical opinion about their care."
Having an OB-GYN or a midwife deliver your baby
For expecting mothers, having your baby delivered by a certified nurse midwife or an OB-GYN can depend on many factors.
"In general, midwives are good at managing low-risk women, those who are healthy and expected to have a normal labor," Rachel says.
Women who are deemed at high risk for complications during labor are best served by an OB-GYN, Rachel says.
Differences in philosophy of care
One of the main distinctions between the training a certified nurse midwife and an OB-GYN receives is their philosophy of care.
"We're coming from the perspective that birth is normal until proven otherwise," Rachel says. "The culture of midwifery is to be more judicious in terms of intervening during a woman's labor."
In general, OB-GYNs tend to utilize a more proactive approach to labor management, Rachel says.
Much of an OB-GYN's training is focused on identifying pathology and promptly managing potential labor complications.
Preparing for labor and delivery during prenatal visits
During prenatal visits, Rachel encourages women and couples to discuss their expectations for labor and delivery with their healthcare providers.
Cedars-Sinai offers multiple resources for pregnant women, couples and families, including a Choices in Childbirth pamphlet (PDF) with a birth preferences worksheet that they can fill out and bring with them to the hospital prior to labor and delivery.
Cedars-Sinai also offers childbirth education and parenting classes taught by registered nurses, childbirth educators and obstetric anesthesiologists. Learn more at Cedars-Sinai Obstetrics & Gynecology program's.