Midwives vs Doulas: What is the difference and do I need both?

Midwives vs Doulas: What is the difference and do I need both?

Dulce Birth Amanda Wolka Killeen Texas
Image by Amanda at Amanda Faith Photography amanda-faith-photography.com

The world of birth terminology can be incredibly overwhelming when everything is being thrown at you all at once. There are new people in different roles, tests and interventions you have never heard of, and gear to equip you to have the best experience possible. But what does it all mean and who does what? We’re going to dive into the very commonly asked question, “What is the difference between a midwife and doula, and do I need both?”


A midwife has training and professional experience providing medical or physical care for pregnancy, labor, and postpartum. Depending upon the laws in the state the midwife practices, a midwife may perform gynecological examinations (for example, Pap smears, pelvic exams, and breast exams), write prescriptions, care for a woman during labor and delivery, perform fetal monitoring, and provide information about contraception. A midwife usually seeks to eliminate or minimize unnecessary technological interventions, believing that pregnancy and birth are normal life processes. However, a midwife is also skilled at identifying and referring women who need the services of an obstetrician during their birth. A midwife is medically trained and qualified to deliver babies.


A doula is a non-medical support person or companion who aims to help mothers through the birthing process with her physical and emotional needs. They are trained to provide continuous one-on-one care, as well as information, physical support, and emotional support to women and their partners. Doulas focus on the needs of the mother, offering non-medical mental, physical, and emotional support. They can also be essential in serving women not only during labor, but in the postpartum period as well.


Both a midwife and a doula are meant to be an integral part of your birth team. Midwives and doulas work together to give you a well-supported, safe, and empowered birth. They are both individuals you can hand-pick and hire to attend your birth and will focus on your emotional well being at greater depths than your standard OB. Both a midwife and a doula may provide additional information to educate you on natural birth or offer classes and courses on natural pregnancy, nutrition, physiological birth, postpartum and newborn care.


A midwife and a doula are two very different and distinct roles in your birth space. A midwife will of course be aware and concerned with your emotional and physical comfort, however in your birth space a midwife’s first concern is the physical health and well being of you and your baby. The midwife will be listening to fetal heart tones, monitoring your temps and heart rate, as well as ensuring that the baby is in an optimal position to descend and be born without complications. Your hired doula will primarily be focused solely on how the mother is coping physically and mentally. The doula may spend much of labor holding a mothers hand, applying counter-pressure for pain relief, reminding the mother to drink water, or asking if you would like to change position. You will typically not find a doula interacting in the midwives space, checking temps, charting, or prepping a birth space. And likewise you will not often find a midwife applying counter-pressure or filling up the mothers water bottle unless the mother hasn’t hired someone to attend and is really needing the extra support. There are many midwives who do occasionally provide more support in labor due to the close bond that has formed between them and the client, but much or the physical and emotional help comes from a doula who is present solely to fulfill that role.


Because a midwife and a doula are two very different and distinct roles in your birth space, neither can replace the other. A doula cannot replace the presence of a medically trained midwife. Likewise, a midwife cannot guarantee uninterrupted emotional and physical support the way a doula would, her primary responsibility in the space is to ensure the well-being of the mother and baby. While many women choose to give birth and go through postpartum without the additional support of doula, the phrase “it takes a village” holds incredible truth. Having experienced support on your birth team can be invaluable, so while a doula is not necessary in the birth space in the way a midwife is, they offer a world of benefit to mothers and families.

Our hope is that our families and mothers feel like they have the tools and understanding to make informed choices for their birth space for it to be everything they need it to be. 

At Dulce Birth and Wellness Center, our families will commonly hear us referring to our community doulas as “support specialists”.

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