Every woman has the right to have her child in a safe, healthy environment that makes her feel comfortable and empowered. For some, that's in a hospital with a doctor. For others, it's a midwife and doula that make a woman feel like the bad*ss she is during birth. But what's the difference between a midwife and a doula? Do you need both? Turns out, the differences are pretty significant. While many women who go the route of a midwife choose to also have a doula present at their birth, they serve very different functions in the process.
Think of it this way — preparing for childbirth can feel a lot like you're pretending to build your first house. You're nervous about the choices you'll need to make and need guidance to get things to line up correctly. The midwife? She's your foreman. She'll guide you through the job, inspecting the little things, and making sure everything is safe and reliable. Your doula is a co-worker who's been on the job a long time. She has experience and knowledge that you don't yet have, and she remains calm even when you think the walls may come down around your ears. She teaches you the tricks of the trade and provides stability when you most need it.
According to doula Emily Landry's website, a midwife handles the medical side of things. They evaluate the pregnancy, the mother, the baby, and monitor the safety of the baby as well as catching your little one. They provide essentially the same service as an OB-GYN would during the pregnancy and childbirth. The doula, however assists the mom. She provides pregnancy and birth support. She helps you write a birth plan, educates you about your options, and most importantly, she's there when you give birth.
A doula is very experienced in childbirth and educated in the field. She can provide massage, help you find a position that is comfortable for you, and she understands what you're going through. Sure, your partner could do a lot of this, but they likely won't have the knowledge or experience a doula does. Also, I don't know about you, but the last thing I wanted when I was in labor was for my husband to mansplain anything to me about what was happening in my vagina — I would've lost my dang mind.
A midwife is the technical director of your birth. She is there to provide the knowledge and expertise needed to safely usher your child into the world and direct any medical intervention that's necessary, according to the University of Utah. A doula helps the midwife by allowing her to focus on the physical, medical necessities of childbirth while she looks after the emotional and physical needs of the mother.
A study at the University of Minnesota showed that women who have doulas present at their births — whether it's attended by a midwife or an OB-GYN — experience lower rates of C-section, lower rates of epidural, and faster spontaneous vaginal deliveries than women who don't have a doula. This is great news, but a bit dispiriting to hear as most insurances don't reimburse for doula care, in spite of the fact that the study showed that it would actually save them in medical costs over and above the fee most doulas charge. Also, doulas are primarily white, upper class, and well educated. Their clients also tend to be white, upper class, and well educated, again, in spite of the fact that people of lower incomes, who generally end up receiving more medical intervention than their wealthier counterparts, could often benefit more from the use of a doula than upper class whites, according to the study.
While doulas and midwives perform very different functions, they go together like my daughter's bed time and a glass of wine. If you're considering using a doula, make sure they are properly certified through DONA International, and have relationships with midwives or OB-GYNs in your area.