What is the difference between an OB or midwife and a doula?

The most important thing you can do when thinking about your pregnancy and birth is to pick the appropriate team of people to support you.  

There is a lot of confusion over who your team entails. Here’s a breakdown of the important differences between an OB or midwife, and a doula.

So what is the difference between an OB, midwife and a doula?

The biggest difference between OBs or midwives and doulas is that an OB or midwife is your medical care provider; This is the person who is responsible to take care of your and your baby's medical needs. This person has the authority to diagnose, prescribe treatment for medical conditions, perform clinical procedures, and may make decisions regarding your care; they are the person entrusted to take care of you and your baby in the event of an issue or emergency.

There are important differences between an OB and a midwife. An OB (obstetrician) is a doctor who specializes in pregnancy, childbirth, and a woman's reproductive system and has graduated from medical school.

There are two main categories of midwives, nurse-midwives and professional midwives. The difference between the two is how they obtained their education, and where they primarily practice.

Nurse-midwives are registered nurses who have graduated from an accredited nurse-midwifery education program and have passed a national exam. You will find most nurse-midwives practicing in hospitals and birth centers.

Professional midwives are non-nurse practitioners who have training and clinical experience in childbirth, including childbirth outside of the hospital, and have passed a national exam and may practice in a birth center, and may also attend homebirths.

A doula is a non-medical companion who sees to the laboring persons informational, emotional and physical comfort and support throughout their birthing journey.

As a doula, I help birthing people maintain a sense of control, comfort, and confidence in ways such as soothing with touch through a variety of techniques of physical support from massage to tying a rebozo. I can apply counter-pressure, perform hip squeezes, and suggest and help the birthing person into different positions between contractions to ease the discomfort and make for more efficient labor. I can help to create a calm physical space and environment, and assist with water therapy such as helping the birthing person in and out of the tub, helping to run water over the belly or back and help to keep the birthing person nourished and hydrated with snacks, water, and ice.

One of my primary goals as your doula is to care for the emotional health of my clients and enhance their ability to have positive birth memories. I offer emotional support to help you feel cared for and feel a sense of pride and empowerment before, during, and after birth with my continuous presence throughout the journey, offering reassurance, encouragement, and praise.

I provide informational support to keep you and your partner informed about what’s going on with the course of labor, as well as provides them with access to evidence-based information about birthing options. I can help you find evidence-based information about different options in pregnancy and childbirth, helping explain medical procedures before or as they occur, suggesting techniques in labor, such as breathing, relaxation techniques, movement, and positioning (positioning is important both with and without epidurals).

What I consider to the be foundation of my work is advocacy. I advocate for my clients by supporting you in your right to make decisions about your own body and baby by encouraging you or your partner to ask questions and verbalize your preferences, creating space and time for you to ask your care providers questions, gather evidence-based information, and make decisions without feeling pressured.

Another important distinction is who is working for whom. As your doula, I am working for you, and not the clinic, hospital, OB or midwife, but you! I arrive when you call, and I leave only after you and baby are comfortably settled in. I will also visit you once or twice more during the postpartum period, or more if you opt for postpartum doula care.

While OBs and midwives are there to take care of your medical needs, they are also taking care of other patients needs as well. Nurses provide physical and emotional support when they can, but research has shown that labor and delivery nurses can only spend a limited amount of time in each client’s room, between 12% and 31% of each person's labor. Nurses may also go off shift, at which point their support ends, and a new provider is introduced. As your doula, my primary responsibility is to you - the birthing person— not to a hospital administrator, nurse, midwife, or doctor.

If I have an OB or a midwife, do I really need a doula?

While you typically cannot have both an OB and a midwife attend your birth, you can have an OB and a doula, OR a midwife and a doula.

One way to understand what a doula's role is to compare the work we do to that of a personal trainer. So for example, a medical expert has the authority to tell you to exercise and what foods to eat in order to achieve your health and wellness goals, but it is the personal trainer that teaches you how to exercise, sets your workout schedule and your routine, suggests meal plans, and motivates you as you make progress. A doula works in a similar scope and capacity. I am here to help you achieve your goals and have positive experiences regarding your pregnancy, childbirth, and the postpartum period in an informed, personalized way.

But what about my partner?

Let it be clear that hiring a doula does not and cannot replace or replicate the unique support that your partner can give you, but we can work together to support the birthing person to the fullest. Instead of replacing your partner in the laboring room, I provide support to both of you. It’s important to remember that partners are undergoing their own transformation during the birth. I bring with me my years of accumulated knowledge and experience of labor and childbirth to serve you both and can provide support for your partner as well by helping to explain things that are happening, coaching your partner in ways to offer you support, and remaining in the room with you while they use the restroom, get a bite to eat, or call home to update or check on the rest of the family.

Can I afford a doula?

I firmly believe that everyone who wants a doula should have a doula. This is why I work with people and meet folks where they are at in terms of payment by offering an all-inclusive doula care package and flexible payment options, and a willingness to barter to ensure a stress-free experience.

Ready to assemble your birth team? Book a free, no-obligation consultation where we can meet up and discuss what is it you're looking for and see if we're a good fit and work out a payment plan that serves us both!