The differences between a midwife & a doula

by Chrissie Smith-Schuler, doula
Baby Yum Yum - The differences between a midwife & a doula
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As a doula (birth coach), I often get asked if I am a midwife. When I say I’m a doula and not a midwife, I’m asked what the difference is between a midwife and doula. This is not a bad question as a midwife and doula play two very different roles in your pregnancy and birth, but both are very needed and important.

What is the role of a midwife?

In a nutshell, a midwife is a medically trained person who offers you clinical care and support during your pregnancy. A midwife will deliver your baby. Midwives deal with low-risk pregnancies and will only intervene medically if necessary. They are also there to try and support your birth choices. You would meet early on in your pregnancy and they will do all the checks on you and baby throughout your pregnancy. Some couples opt to have an independent midwife (midwives who have their own practices) who they see throughout their pregnancy and with who they form a relationship. This same independent midwife then delivers their child when the mother goes into labour. Midwives will assess you regularly during your labour to make sure that all is going smoothly and they can also administer pain medication if the mother requires. Independent midwives in South Africa work at natural birth units and some hospitals. They also do home births. Once you’ve taken your baby home, your midwife will also usually make house calls to check on you and baby.  In these appointments, she will weigh your baby, and check your and baby’s health. This can be a great help in the early postpartum weeks. Other couples may choose to birth at a unit where there is a staff of midwives and they see whoever is on duty for their appointments and birth. All maternity units are usually staff with midwives as well.

What is the role of a doula?

A doula is a non-medically trained person; however, they do have a good knowledge of the birth process. They give couples evidence-based research about pregnancy, labour and postpartum. A doula is also not trained to deliver your baby, but rather to guide and help the couple. You would meet with your doula a few times during your pregnancy to discuss your birth preference and help you draw up a birth plan, as well as advise you on other aspects of your labour such as what to pack, how to time contractions, etc. Your doula is also your go-to person for any “silly questions” that you may not want to bother your midwife with (no question is too silly!). A doula’s primary role is to be there for you, your baby and your partner emotionally during your pregnancy and labour journey. What is the role of a midwife They will also be with you from early labour until baby is born and for a while after. They know your wishes and will help you to try and achieve them through with emotional support and natural pain-relief techniques. They are there to encourage you and your partner, and make you feel safe and secure. Your partner is definitely not left out in this process. Your doula will support your partner and also give him tips and ideas on how to support you. The doula-partner relationship is a team effort to help you. During your labour, your doula will be your liaison between your midwife, hospital staff and yourself. After your baby is born, a doula will help with breastfeeding if the mother has chosen to breastfeed. They will also help the mother to shower and get comfortable – and anything else you may need. A doula will see you again once you are home to help with any number of things like breastfeeding or showing you how to bath the baby.

Do you need both a midwife and doula at your birth?

For first-time couples, the labour process can be overwhelming and scary.  Your midwife will be with you, but has tasks to do during your labour that will mean they will not be able to stay with you during each contraction. They would also not usually be with you in the early stages of labour. Your partner may not know how best to support you, so it is definitely useful to have a doula at your birth as she is simply there to support you and your partner continuously. A doula would come to your house if you prefer in early labour and report back on your progress to your midwife. You would all then decide when would be the best time to go into hospital if you are having a hospital birth. It is therefore a great idea to have both who will support you in very different but beneficial ways in your pregnancy, labour and postpartum.

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