Doula vs. Midwife - What’s The Difference?

This post was written by Kim Van Galen, a passionate doula (founder of Sankalpa Doula), placenta specialist, pregnancy masseuse, and mother of two.

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In the journey of pregnancy and childbirth, the roles of a doula and a midwife often intertwine, yet they serve distinct purposes. Understanding the disparity between these two essential figures in maternal care is crucial for expectant parents navigating their options.

In this article, we embark on a journey to unravel the nuanced disparities between doulas and midwives, dissecting their roles, qualifications, and contributions to the birthing experience. We delve into common inquiries surrounding their practices, empowering expectant families to make informed decisions tailored to their unique childbirth preferences and needs.

What is a Midwife?

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A midwife is a healthcare provider specializing in pregnancies, childbirth, and postnatal care. Midwives possess medical training and licensure, capable of providing clinical assessments, prenatal care, delivering babies, and addressing maternal health concerns while prioritizing a holistic and woman-centered approach to childbirth.

In earlier times all women birthed at home. The midwife would attend the birth as long as needed, accompanied by other women to assist the laboring mother. Midwives were mainly unmarried women for the rest of their lives, having a critical role in the community and serving as primary caregivers. 

They would care for the mother in an emotional, medical, mental, and spiritual way. Embodying the original meaning of the word "midwife" as someone who is "with a woman" during childbirth. Traditionally, aspiring midwives learned their craft from experienced elders, passing down generations of knowledge.

At some point, male physicians took an interest in childbirth. They attended many births while having little training in obstetrics. This transition marked a shift from the ceremonial approach to childbirth towards a more medicalized setting. By the mid-1960s, the medicalization of clinical births took a rise. More and more babies were induced and born through cesarean section. This is not per se ‘right or wrong’. 

Birth has never been more safe than today, and this is due to the medicalization of birth. But what also happened during that time is that a lot of knowledge disappeared. Midwives had to attend more births at the same time, having less time with each mother. Important information such as Spinning babies® techniques, baby positioning, and other varieties of coping tools during labor were forgotten. 

Around a decade ago, some midwives courageously ventured beyond the confines of conventional medical practices, enduring hurtful labels like "charlatan" or "quack." Yet, in doing so, they've ignited a transformative spark within the birthing scene. Nowadays, the emotional and mental aspects of labor are making a comeback. 

There’s a lot more information available about birth due to social media and the many birth preparation courses. More mothers would like to give birth at home and aim for an unmedicated birth. Also, doulas are asked more frequently to assist the birth.

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What is a Doula?

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So what is a doula, and what’s her role within the birth scene? Originating from the Greek word "doulē," meaning "a woman who serves," a doula in modern times is a professional birth companion, standing steadfastly by the mother's side, assisting her and her partner mentally, practically, and emotionally. She provides information, advocates, and suggests different tools and techniques to cope with the intensity of birth. 

There are some misconceptions surrounding doulas, such as the belief that they exclusively attend home births, are overly ritualistic or spiritual, or are against pain medication. 

Generally speaking, these assumptions are not true. A doula remains unbiased and is available to provide support regardless of whether you choose to give birth in a hospital, birth pool, or at home in your own bed. A doula is often a true chameleon. She seamlessly blends into the background when not actively engaged, adeptly managing the interplay between medical professionals, family members, and the emotional needs of expectant parents.

Doulas are not medically trained birth workers, nor carry medical responsibilities. This is why a midwife and a doula can become such a great birth team for the expecting parents. 

While the midwife prioritizes the medical welfare of both the baby and the mother, the doula's emphasis is on offering warmth, comfort, and unwavering support throughout the birthing journey. 

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Key distinctions between a midwife and a doula

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Midwife: Usually works for a midwifery practice or hospital, adhering to their protocols

Doula: Works independently and exclusively for you, with no other obligations

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Midwife: A midwife offers a full scope of prenatal and labor care

Doula: Does not provide medical care or deliver the baby

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Midwife: May have multiple birthing mothers at once and works in shifts

Doula: Offers continuous support throughout labor

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Midwife: Covered by health insurance

Doula: Not covered by health insurance and requires separate payment

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Midwife: Can offer pain medication

Doula: Only offers pain management (like massage, counterpressure, TENS machine, etc.)

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Especially in and around Amsterdam, the birth scene is changing. Midwifery practices are more patient during birth, protocols are becoming less rigid, and birth professionals are attending courses like pregnancy massage, Spinning Babies®, and trauma-informed care. 

By exchanging fresh insights and diverse birth stories and by maintaining an open-minded perspective on childbirth, we can indeed make a change. Because ultimately, everyone deserves to embark on their birthing journey with the support and positivity they deserve.

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Doula vs. Midwife - Frequently Asked Questions

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If you’re looking for more information about Doulas and Midwives, below are the answers to some of the most common questions.

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Doula vs. Midwife - which one do I need more?

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Doula support is complementary to essential midwifery care, so the question is not about choosing between them. The choice is whether you want a doula present or not.

Determining whether you need a doula largely depends on your individual needs, preferences, and the circumstances surrounding your pregnancy and childbirth journey. If you seek emotional support, continuous guidance, and personalized advocacy throughout labor and birth, a doula may be the ideal companion for you.

On the other hand, if you mainly desire comprehensive prenatal care, clinical assessments, and medical expertise during childbirth, a midwife might better align with your needs.

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What is the cost of Doula vs. Midwife?

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The cost of hiring a doula versus a midwife can vary significantly depending on factors such as location, experience level, and the scope of services provided. Generally, doula fees range from €1,000 to €2,500 or more. Essential midwifery care is covered in the health insurance. For case-load midwives (1-1 care), there’s often an extra fee charged of €1000 to €1500 to fully cover the midwifery services. Doula services are often fully paid out-of-pocket, although some supplementary health insurances may cover some of the doula expenses. Ultimately, researching local providers and discussing payment options and insurance coverage can help expectant parents plan for the financial aspect of their childbirth experience.

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