As midwives, we occasionally encounter confusion about the role of a midwife compared to the role of a doula. Quite often clients have questions about how our services may overlap and whether or not the presence of a doula would be necessary or helpful when they are also cared for by a midwife.
Midwives and doulas are really quite similar in their shared goals and philosophies.
Both are dedicated to supporting families through their pregnancy, childbirth and new parenting experiences. Both often also have a focus on family-centred care that empowers personal choice. We both also tend to have quite a bit of experience in facilitating a ‘normal‘ or ‘natural’ birth, but also all have experience working with different circumstances that may present themselves which are outside of the realm of a “natural” birthing experience. These shared goals make doulas and midwives natural partners.
However, the way that these philosophies are carried out is where we differ.
Midwives are registered health professionals who provide clinical care to expectant families. The role of a midwife includes clinical tasks like such as:
- ordering tests and ultrasounds
- monitoring the health of the pregnancy
- monitoring the progress of labour
- completing vaginal exams
- monitoring health of mother and fetus (blood pressure, temperature, fetal heart rate)
- ‘catching’ the baby
- suturing any tears
- providing emergency medical treatment (rescucitating a baby and providing medication, IV fluids)
- monitoring health and well being of mother and baby for 6 weeks post-partum
Midwives are trained via a 4 year university degree (or equivalent international program). Midwives are also registered with the College of Midwives and adhere to rigorous guidelines and quality assurance programs.
Doulas are specialists in labour support.
Doulas, on the other hand, are exclusively focused on providing non-clinical care. They are specialists in labour support and unlike midwives, do not have clinical obligations which could detract from their mission to continuous support to the family. Doulas are often present at a birth, quietly coaching a mother with breathing, assisting her with positioning or mobility, providing drinks, nourishment, cold cloths and encouragement throughout the process. Doulas also are often available to be physically present with families during the early labour stage, whereas midwives reserve their care for active labour. As a midwife, there have been many times that I am grateful for the presence of a doula to deliver this kind of support while I am occupied preparing necessary equipment or focusing on hands-on clinical skills necessary for a safe delivery. The type of care that doulas and midwives provide have important differences, but really can be quite complementary when used together.
Stephanie Aghajani is a graduate of the Ontario Midwifery Education Program at Laurentian University and has been a Registered Midwife since 2007. She is a founding member of Midwives of Headwater Hills and has been working in Orangeville since 2009.