Doula vs. Midwife: What’s the Difference?

Curious about the difference between doula vs. midwife roles? Both play a part in the journey of pregnancy and childbirth, but they bring different skills to the table. A doula provides non-clinical support to expectant mothers before, during, and after childbirth, while a midwife is a healthcare professional who provides medical assistance during labor, delivery, and the postpartum period.

This article unlocks the distinct worlds of midwife vs. doula. We’ll explore the difference between doula and midwife career requirements and job duties while highlighting the unique aspects of each role and how they complement each other in the childbirth process.

Doula vs. Midwife: Understanding the Roles

Nurse midwives and doulas may share some responsibilities, such as offering emotional support and childbirth education, yet they each bring their own specialized duties to the table.

The key difference between midwife and doula roles lies in their education and scope of practice. Midwives complete clinical training and, therefore, can provide medical care to their patients. Doulas, on the other hand, complete a short training program and offer non-medical support to their clients.

Doula Job Responsibilities

A doula is a non-medical professional who provides emotional, physical, and informational support to women and their partners during pregnancy, childbirth, and the postpartum period. Doulas do not perform clinical tasks or provide medical care; instead, they offer comfort measures, assist with relaxation techniques, and provide encouragement and reassurance during labor. Their duties may include:

• Providing emotional support to the birthing patient and their partner during childbirth.
• Offering physical comfort measures like massage, positioning advice, and relaxation techniques.
• Advocating for the birthing patient person’s preferences during labor and delivery.
• Providing information about the birthing process.
• Facilitating communication between the birthing patient, their partner, and medical staff.
• Creating a calm and supportive birthing environment.

Nurse Midwife Job Responsibilities

A midwife is a trained specialist qualified to deliver babies, provide prenatal and postnatal care, conduct physical exams, order laboratory tests, and diagnose and manage common health problems related to pregnancy and childbirth. Midwives vary in their training and qualifications. For example, a certified nurse midwife (CNM) is an advanced practice nurse (APRN) who undergoes additional schooling, certification, and licensing. Their duties may include:

• Offering prenatal care, conducting exams, monitoring fetal development, and ordering tests.
• Assisting during labor, managing pain, and providing necessary medical interventions.
• Delivering babies and addressing any complications that arise.
• Providing postpartum care for both the mother and newborn, including health assessments and breastfeeding support.
• Offering family planning services, including contraception counseling.
• Collaborating with other healthcare providers, such as obstetricians or pediatricians, as needed.

Doula vs. Midwife: Education

Doula vs. midwife training paths offer distinct approaches to support birthing individuals and their families throughout the childbirth journey. Let’s explore the key steps to entering these meaningful roles.

3 Steps to Become a Doula

1. Complete a training program: Enroll in an accredited doula program such as DONA International, CAPPA, or ICEA. Training typically involves attending workshops, completing reading assignments, and gaining hands-on experience by participating in births.
2. Obtain certification: After finishing the program, you can take the exam. While certification isn’t mandatory in the U.S., many doulas seek certification to demonstrate their expertise. Each certifying organization has its own requirements and fees.
3. Gain experience: Begin attending births to build your skills. Consider volunteering or shadowing experienced doulas to gain practical knowledge.

6 Steps to Become a Nurse Midwife

1. Obtain a nursing degree: Complete a bachelor of science in nursing (BSN) program, as this is often a requirement to enter a CNM program. Alternatively, you could start your nursing path with an associate degree in nursing (ADN) program, then continue your education through bridge programs such as RN to BSN.
2. Get licensed: Pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) and apply for RN licensure in your state.
3. Gain experience: Begin developing your skill set in a relevant work setting, such as labor and delivery, OB-GYN nursing, or another related specialty. Many nurse midwife programs strongly recommend 1 to 2 years of nursing experience.
4. Enroll in a nurse midwife program: Complete a master of science in nursing (MSN) or doctor of nursing practice (DNP) nurse midwife program, which typically takes 2 to 4 years, depending on your chosen educational path.
5. Get certified: To practice as a CNM, you’ll need both certification and a license. To get certified, you’ll need to pass the national exam from the American Midwifery Certification Board (AMCB), which evaluates your midwifery knowledge and skills.
6. Apply for APRN license: After passing your certification exam, apply for your nurse midwifery license through your state’s board of nursing. Once licensed and certified, you can start looking for nurse midwife jobs.

How Long Does It Take to Become a Doula vs. Midwife?

The required training is another big difference between a doula and a midwife. Becoming a doula typically takes a few months to a year to complete training and certification. On the other hand, becoming a midwife involves obtaining a bachelor’s degree in nursing, followed by additional education and certification, totaling around six to eight years.

Midwife vs. Doula: Which Is Right for You?

Key Advantages of Being a Doula

• Less formal education: Doula training requires less formal education compared to becoming a midwife, making it a more easily accessible career.
• Reduced liability: Doulas have lower liability and malpractice risks compared to midwives since they don’t provide medical care or make clinical decisions during childbirth.
• Competitive salary: Doulas can earn a good income while providing valuable support during childbirth, despite not having an extensive educational background.

Key Advantages of Being a Midwife

• Autonomous practice: In some states, nurse midwives are authorized to practice independently and provide comprehensive care to their patients. In states with reduced or restricted practice, a midwife could practice under the supervision of a physician.
• Higher salary potential: Nurse midwives generally earn higher salaries compared to doulas due to their advanced education and broader scope of practice.
• Diverse work settings: Nurse midwives have the flexibility to work in a variety of settings, including hospitals, birth centers, clinics, and private practices.

Doula vs. Midwife Salary

The difference between doula and midwife pay range is substantial. The average doula salary in the U.S. is $75,760 per year, while the average nurse midwife salary is much higher at $131,570. Your exact income hinges on factors like certifications, experience, and the location of your practice. Some of the top-paying states for nurse midwives include:

• California
• Massachusetts
• Maine
• Oregon

Frequently Asked Questions: Doula vs. Midwife

Doula vs. midwife vs. doctor — what is the difference?

Doulas undergo short training to offer emotional and physical assistance during childbirth, while midwives complete extensive clinical education to provide comprehensive prenatal, labor, and postpartum care. Doctors, or obstetricians, complete medical school and residency programs and can manage complex pregnancies and administer medical interventions during high-risk childbirth.

Can a doula deliver a baby?

While doulas can provide support to birthing patients and their families during labor and childbirth, they do not have the medical training or authority to perform deliveries.

What are the challenges of working as a doula?

Challenges of working as a doula may include irregular hours, managing client expectations, and the limitation of not having medical training to manage obstetric emergencies.

What are the challenges of working as a midwife?

One of the challenges of working as a nurse midwife is dealing with high-risk pregnancies. These professionals are required to make critical decisions to ensure the safety of both the mother and baby. Additionally, dealing with challenging cases, especially those involving loss and difficult ethical choices, can take an emotional toll.

What are the types of midwives?

There are many types of midwives that provide different levels of care:

• Certified nurse midwives (CNMs) are highly trained APRNs with the authority to provide comprehensive prenatal, labor, and postpartum care, as well as gynecological services.
• Certified midwives (CMs) are certified professionals who have completed a midwifery education program accredited by the Accreditation Commission for Midwifery Education (ACME) but are not necessarily registered nurses.
• Certified professional midwives (CPMs) are non-nurse midwives who have met the requirements set by the North American Registry of Midwives (NARM).
• Direct-entry midwives (DEM) are non-nationally certified midwives who are educated through direct-entry midwifery programs or apprenticeships. Qualifications vary by state.
• Lay midwives are individuals who have learned midwifery through self-study, apprenticeships, or informal training rather than formal education programs.
• Traditional midwives are non-licensed and non-certified individuals whose practice is based on cultural or traditional knowledge and practices passed down through generations.

What are the types of doulas?

There are many different types of doulas, each specializing in unique areas of care. Some of the types include:

• Birth doulas provide continuous support to individuals during labor and childbirth.
• Postpartum doulas offer support during the postpartum period, such as breastfeeding education, emotional support, and help with household tasks.
• Abortion doulas impart physical, mental, and emotional support before, during, and after an abortion
• Fertility doulas give support to individuals or couples who are trying to conceive or undergoing fertility treatments.

What are doula certification requirements?

Doula certification requirements in the U.S. vary depending on the certifying organization. Generally, they involve completing a training program, attending births, and passing a certification exam.

What are nurse midwife certification requirements?

You’ll need to have an MSN or DNP degree and an unencumbered RN license to be eligible to take the certification exam through AMCB. Once you pass the exam, you’ll become a CNM.

Are doulas covered by insurance or Medicaid?

Doula services are typically not covered by insurance or Medicaid, but some states or private insurance plans may offer coverage or partial reimbursement for doula services under certain circumstances.

Where do I find employment as a doula?

You can find work as a doula in birthing centers and doula agencies, or even by starting your own business. Online platforms and community centers are also great places to look for opportunities.

Doula vs. Midwife: What’s Your Next Job?

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