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Mother giving birth to baby with midwife and doula help

Midwife or Doula: How to Make Your Choice

why not both?

Pregnant mamas have a lot of decisions to make prior to baby’s arrival. A good chunk of those decisions tend to have to do with how baby will arrive. Will you be at home? In a hospital? Maybe a birthing center? Should you hire a midwife or a doula? What’s the difference between a midwife and a doula anyway?

We spoke to Maria Pokluda, doula and founder of Great Expectations Birth, to answer some of your questions.

What’s the Difference?

First and foremost, when it comes to what a doula and a midwife do, the main difference is that a midwife is a clinician and a doula is not. “The doula is the one that is there for the emotional and physical support of pregnancy, labor and birth,” says Pokluda. “They offer continuous care and have worked to build a relationship with expecting families and the doula transitions seamlessly with the family through pregnancy, labor and postpartum.”

Doulas do not do any medical tasks or assessments; for example, they won’t be touching anyone’s cervix (or even your newborn, Pokluda adds). But they will be the ones to rub your lower back or fend off unwanted visitors. “The doula is going to be a constant presence from early labor in the home, to the transition to your place of birth and until the baby has arrived.”

A midwife and doula do have some overlapping training, but the midwife’s primary job is to guard the health of the baby and keep an eye on the clinical indicators. The midwife will monitor both the woman and baby using skills that Pokluda says most people probably associate with doctors, such as fetal monitoring, blood pressure checks and so on.

“Their focus must be on safety. A doula does not have that responsibility,” Pokluda adds.

And here’s a memorable way to understand the distinctions between a doula and a midwife: Pokluda jokes that a doula helps from the waist up, while the midwife helps from the waist down. “It always gets a laugh, and in the simplest ways it does sum it up—but both doulas and midwives are so much more!”

Who to Choose

Pokluda’s best advice is to always get the most support possible. “The idea that you need to choose a midwife or doula is false—I say have both!”

That’s not always possible though, so Pokluda notes that the choice between a midwife or doula really depends on the goals of the family. “Having a midwife or doula has been shown to reduce the risk of unnecessary interventions, Cesarean birth and NICU admissions, as well as increasing the rates of breastfeeding success—but those benefits are gained in different ways.”

Pokluda also says that a doula and a midwife complement each other in their roles. “Surrounding a birthing family with a supportive birth team impacts the experience in so many positive ways.”

Image courtesy of iStock.