Doulas and Midwives: What’s the Difference, and Do You Need Both?
When preparing for birth, many families find themselves asking: Do I need a doula or a midwife? What’s the difference?
The confusion makes sense — both roles support people through pregnancy and birth, yet their scopes, responsibilities, and ways of working are fundamentally different.
Understanding these differences can help families choose care that truly meets their needs.
What Is a Midwife?
Midwives are regulated healthcare providers. Their role is clinical and medical in scope, focused on monitoring the health of the pregnant person and baby throughout pregnancy, birth, and postpartum.
Midwives:
Provide medical care, assessments, and clinical decision-making
Order tests, labs, and ultrasounds
Attend births as the primary medical provider
Can prescribe medications within their scope
Provide postpartum medical follow-up
Midwifery care is continuity-based and relationship-centered, often with longer prenatal visits and a strong emphasis on informed choice and physiologic birth.
What Is a Doula?
A doula is a non-medical support professional. Doulas do not provide clinical care, diagnose, or make medical decisions. Instead, their role is to support the emotional, physical, and informational experience of pregnancy, birth, and postpartum.
Doulas:
Offer emotional reassurance and grounding presence
Provide physical comfort measures during labor
Support informed decision-making without directing choices
Help partners feel confident and involved
Offer practical and emotional support in postpartum
A doula works for the family, not the healthcare system, and remains focused on the lived experience of birth rather than medical outcomes alone.
The Key Differences at a Glance
Midwife
Medical provider
Responsible for clinical care and safety
Monitors health and manages risk
Leads the birth medically
Doula
Non-medical support
Focuses on emotional, physical, and informational care
Supports the nervous system and coping
Holds space before, during, and after birth
Both roles are essential — but they serve different purposes.
How They Work Together
Rather than choosing one instead of the other, many families find the most supportive experience comes from having both.
A midwife ensures medical safety and clinical expertise.
A doula ensures continuous presence, emotional support, and advocacy.
Midwives may move between rooms, attend multiple clients, or focus on clinical assessments during labor. Doulas remain continuously present, helping families stay grounded, informed, and supported through the intensity of labor.
When both roles are present, care becomes layered rather than duplicated.
Postpartum Support: Another Important Distinction
Midwifery postpartum care focuses on physical recovery, infant health, and medical follow-up. This care is vital — but often time-limited.
Doula postpartum support often extends further into daily life:
Emotional processing of the birth
Infant feeding and adjustment support
Practical help in the home
Holding space during a vulnerable transition
This kind of support fills the gap many families feel once medical visits taper off.
Choosing What’s Right for You
Every family’s needs are different. Some feel fully supported by midwifery care alone. Others find that having a doula offers an added layer of continuity, reassurance, and emotional safety.
The question is not which role is better, but rather:
What kind of support helps you feel safe?
What kind of presence helps you cope?
What kind of care helps you integrate the experience afterward?
