The Difference Between Midwife And Doula Explained

Photo by Nick Van Snellenberg

Are you looking for a midwife or doula in Vancouver?

I’ve had many people ask me what the difference is between a midwife and a doula. Sometimes, the impression is that you need to choose either a midwife or a doula, or that you do not need a doula if you have a midwife. However, a midwife and doula have distinctly separate roles in their support of your birth.

When it comes to choosing a medical care provider for your pregnancy and birth here in Vancouver, you are able to choose between a midwife and doctor/OB. Both medical doctors and midwives are covered by MSP as maternal health care providers.  Doulas fill an additional role, and work as a complement to the care provided by your doctor or registered midwife.

In Canada, midwives are licensed medical professionals. The UBC Midwifery training program is a four year degree within the Faculty of Medicine.  Vancouver Midwives are able to attend both home births and hospital births, and are responsible for the health of you and your child prenatally and during childbirth.

Your Midwife will:

• Run prenatal tests
• Advise you on health during pregnancy, birth and postpartum
• Prescribe maternal health related supplements or medications
• Monitor you and baby during labour and birth
• Perform physical examinations prenatally, during labour and postpartum
• Consult with an obstetrician if a medical complication arises which is out of the midwifery scope of practice
• Do their best to help you have a comfortable birth, but their primary responsibility will be their clinical tasks

For further information on the midwifery model of care / scope of practice in Vancouver, visit the College of Midwives of British Columbia.

Doulas, on the other hand, are not medical professionals. Doulas provide emotional and physical support during pregnancy and birth.

Your Doula will:

• Establish a prenatal relationship with you
• Help you articulate your vision for your birth
• Direct you to resources in the community for pregnant women and families
• Help keep you and your partner feel calm and supported during labour
• Use tools and techniques to help you manage the intense physical sensations of labour and birth
• Make suggestions regarding labouring and birthing postions depending on how your labour is progressing
• Ensure you feel confident communicating your needs to your health care provider
• Provide postpartum emotional support and help with breastfeeding initiation.
• Direct you to your doctor or midwife for any medical questions.

Although doulas do not provide medical care, research shows they do increase your likelihood of avoiding unnecessary medical interventions such as instrumental delivery and cesarean birth.

Read my other article, What do doulas REALLY do? for more details on what a doula does.

Do I need a midwife and a doula?

Doula support is an amazing complement to the care you will receive from your midwife.  There are many amazing midwives here in Vancouver, and they certainly provide great support for your birth. However, their ultimate responsibility is the health and safety of you and baby. They need to be present, alert and at the top of their game during really active birth and pushing.  Your doula will stay with typically join you earlier than your midwife, from as early as you would like her there until after the birth of your baby. We love being part of early labour onward. That continual support makes so much difference!

Also, here in Vancouver, midwives work in teams of 2-4 midwives. You will have a chance to meet all of the midwives on your team during your prenatal visits at least once, but there is no guarantee of which midwife will be on call when you begin your birth process. Most doulas are contracted as individuals, and a back-up is only called in in case of an emergency or overlap of births.

If you are looking for birth professionals who view pregnancy and birth as a normal, natural event, using both a midwife and a doula will give you the full spectrum of support and medical care.

Midwives and doulas work well together and respect each other’s roles in supporting your birth. However, they are different professions and you will need to select your midwife and doula separately.