Doula vs. Midwife: What's the Difference?

5 Min Read Published January 4, 2024
Doula vs. Midwife: What's the Difference?

What is the difference between a doula and a midwife? This article will demystify the differences between these pregnancy professionals. Read on to learn more about doula vs midwife responsibilities and the pros and cons of entering each profession.

What is the Difference Between a Doula vs a Midwife?

The most notable difference between a midwife and a doula is that a midwife is a medical professional. They directly provide medical care to a woman during labor and the postpartum period. Conversely, a doula is a layperson who provides more emotional support to the patient and family. They are not qualified to practice medicine.

The different types of midwives have varying qualifications. A certified nurse midwife (CNM) is an advanced practice registered nurse (APRN). They have an advanced midwifery education that specifically prepares them to care for women throughout pregnancy and childbirth.

What is a Doula?

A doula is a layperson who helps women throughout their pregnancy, delivery, and postpartum process. They prioritize doing things that help make the birth experience and transition to motherhood easier. A doula's responsibilities range from physical and emotional support during labor and birth to minor housework.

What Does a Doula Do?

A doula's services include providing pregnant women and their families emotional, physical, and educational support. Doulas may be present throughout pregnancy, delivery, and the postpartum phase. Additionally, doulas can help develop birth plans and help to carry them out during the labor and delivery.

Types of Doulas

Antepartum Doula

Antepartum doulas work with pregnant women on bed rest or those experiencing high-risk pregnancies. They provide informational, emotional, and physical support specific to these clients.

Postpartum Doula 

A postpartum doula supports women and their families during the first few weeks after birth. They may provide education on newborn and postpartum care or do housework like cooking and cleaning.

Birth Doula

A birth doula helps women and their families during the birthing process. They can aid in emotional support or be a support person if the pregnant individual is alone. 

Doula Certifications

Postpartum Doula Certification

DONA International issues the Postpartum Doula Certification. To earn this credential, you must attend a 3-5 day training course, pay the required fee, and pass the final examination.

Birth Doula Certification

DONA International's Birth Doula Certification doesn't just teach students how to be effective doulas. They also focus on why the profession is essential. The workshops you'll take to earn this certification include:

  • Benefits of doula support
  • The history of birth
  • The significance of doula support to families
  • Practical hands-on techniques
  • Steps to starting a birth doula career

International Childbirth Education Association (ICEA) Certifications

The ICEA is a leader in perinatal education and has over 60 years of experience educating doulas. Furthermore, it offers two of the few doula certifications accepted by Tricare and Medicare.

ICEA Birth Doula Certification (ICBD)

The ICEA Birth Doula Certification is one of the top doula credentials in the country. The course is roughly $750 with online access and an additional $390 examination fee. Seven sections comprise the program, focusing on the labor process, family integration, and business prospects.

ICEA Certified Postpartum Doulas (ICPD)

The ICPD certification verifies a postpartum doula’s skills to support mothers of newborns and their families. Postpartum doulas who complete this course learn the value of being a member of a postpartum support team. The curriculum focuses on parental support, growth and development, and building a doula career.

What is a Midwife?

The most common type of midwife is a certified nurse midwife (CNM). They are skilled APRNs who provide pre and postnatal care and labor and delivery support. CNMs can also provide reproductive health and gynecological services.

Other midwives also provide medical services during pregnancy but are not nurses. The type of midwifery certification they pursue will impact their scope of practice and work settings.

What Does a Midwife Do?

Midwives offer a range of pregnancy services depending on their certifications. Nurse midwives have the broadest scope of practice, and their responsibilities include the following:

  • Prenatal care
  • Labor and delivery support
  • Postpartum care
  • Gynecological services
  • Reproductive health visits
  • Health education
  • Family planning
  • Basic nutrition counseling
  • STD testing

To learn more about midwife duties, read our guide that explores the question, what does a midwife do?

Types of Midwives

Certified Nurse Midwife (CNM)

Nurse midwives are APRNs with at least a Master of Science in Nursing (MSN) degree in midwifery. CNM programs prepare nurse midwives to provide medical services like labor and delivery support or gynecological check-ups.

Certified Midwife (CM)

A CM is a non-nurse who has completed a midwifery program and attained AMCB certification. They provide comprehensive care to women throughout childbirth, including prenatal, intrapartum, and postpartum care.

Certified Professional Midwife (CPM)

Certified professional midwives attend Midwifery Education Accreditation Council (MEAC) accredited apprenticeships or educational programs. They primarily focus on out-of-hospital births like those at homes or birthing centers.

Lay Midwife

Lay midwives are typically self-taught or informally trained individuals who practice midwifery without official education or certification. They often provide care in home birth settings, primarily for uncomplicated pregnancies and births.

Midwife Certifications

American Midwifery Board Certification

The American Midwifery Board Certification (AMBC) offers three certifications depending on education and experience:

  • Certified Nurse Midwife (CNM)
  • Certified Midwife (CM)
  • Certified Professional Midwife (CPM)

Doula vs Midwife: Which is Right for Me?

Deciding between becoming a doula or a midwife can be challenging. While registered nurses can become doulas, they won't use their degrees in that career.

If you already hold a Bachelor of Science in Nursing (BSN) degree, the optimal path is becoming a CNM. As a CNM, you'll be able to guide and educate women throughout their pregnancy while providing medical care.

Becoming a doula is also a fine choice if you don't have a BSN. You can weigh doula and CNM responsibilities, pros, and cons with your career goals to decide which suits you best. Remember, doulas strictly provide support, guidance, and advice. They do not offer medical advice or interventions.

Midwife vs Doula Pros & Cons

Understanding the highs and lows of these careers can help you choose your path. Here’s a side-by-side comparison of the benefits and drawbacks of entering either field:

Pros

Doula

Midwife

Highly flexible hours

No two days are the same

Growing demand

High demand & earning potential

Highly autonomous

More autonomy than RNs

Guide women and families during the happiest time of their lives

Meaningful work during a vital time in an individual’s life

Helping women start families

Many work environment opportunities

Cons

Doula

Midwife

Low starting salary and variable earning potential

Long, unpredictable hours and on-call requirements

It can be difficult to maintain professional detachment while providing this personal service

Medical limitations (e.g., cannot perform specific procedures or handle high-risk cases)

Long, demanding hours

High-stress work environment

Some medical professionals dislike doulas/don’t take them seriously

Exposure to pathogens

Physically and emotionally exhausting

High burnout and turnover

FAQs

  • Is it better to have a doula or a midwife?

    • Choosing between a doula and a midwife depends on the support you need. A nurse midwife can treat you during your pregnancy and help you deliver a baby. On the other hand, a doula will offer more emotional guidance and support. Of course, you can always choose to have both!
  • What is the relationship between a doula and a midwife?

    • Both doulas and midwives support women and their families during pregnancy, delivery, and postpartum. While midwives offer medical care, doulas provide more emotional support.
  • How much does a doula cost?

    • Doula costs vary depending on the services you require. According to the Pittsburgh Doula Network, doulas charge roughly $30-$40 per hour. Other organizations mention that a doula costs $500-$2,500 for the entire birthing process.
Kathleen Gaines
MSN, RN, BA, CBC
Kathleen Gaines
News and Education Editor

Kathleen Gaines (nee Colduvell) is a nationally published writer turned Pediatric ICU nurse from Philadelphia with over 13 years of ICU experience. She has an extensive ICU background having formerly worked in the CICU and NICU at several major hospitals in the Philadelphia region. After earning her MSN in Education from Loyola University of New Orleans, she currently also teaches for several prominent Universities making sure the next generation is ready for the bedside. As a certified breastfeeding counselor and trauma certified nurse, she is always ready for the next nursing challenge.

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