Kate Fields, CNM, with Vancouver Clinic.
Many expecting moms wonder what the difference is between a midwife and a doula — and which one they need. As a certified nurse midwife and former doula, I love discussing the type of support each individual can offer a woman during her pregnancy and labor.
The biggest difference between a midwife and a doula is their medical training. At Vancouver Clinic, all of our midwives are certified nurse midwives. This means that in addition to being registered nurses we hold a master of science in nurse midwifery and have passed a national certification exam. We are trained to care for women during pregnancy, childbirth, and the postpartum period. We also provide basic gynecology care for women, teenagers, and postmenopausal women.
We are able to take care of all of a woman’s needs during pregnancy and childbirth. We are also fortunate to work with an incredible group of OBGYNs who see patients if they have complications or if a pregnancy becomes high-risk. Nurse midwives are not surgeons and do not perform cesarean section deliveries, although many of us are trained to be surgical assistants and stay with our patients during an unplanned C-section.
Doulas have special training in childbirth and pregnancy and support the non-medical aspects of labor and childbirth. The word “doula” comes from the Greek word that means “a female caregiver.” Doulas provide physical, emotional, and educational support during pregnancy, labor, and the postpartum period. They form close relationships with a woman and her family; relieve stress; share information based on their experiences with childbirth, pregnancy, and parenting; and advocate for a woman during labor.
However, doulas do not replace midwives. Doulas can’t provide clinical care, write prescriptions, or perform cervical exams or other medical tasks. They complement a birth team, which often includes a woman’s partner, a registered nurse, and a midwife.
Research shows that having a doula present during birth can decrease medical interventions, including epidurals and cesareans. Some studies suggest that having a doula may help decrease the length of labor. Vancouver Clinic midwives frequently work alongside doulas. Some women choose to have a doula to ensure one-on-one continuous support in labor, since it’s possible that a midwife may be providing care to more than one woman at a time.
Hiring a doula is a personal decision. There are programs that offer low-cost doula services, or even volunteer doula services with a doula in training. A doula is not required in order for a woman to have the birth experience she desires.
Nurse midwives are experts at helping women have the birth they want to have, whether that includes an epidural, a water birth tub, nitrous oxide, or other options. Midwives review a woman’s birth plan, provide expert feedback and recommendations based on the latest research and safety data, and help a woman in labor make decisions based on how her body is responding to birth. We value giving women judgement-free birthing options—including involving a doula.
Kate Fields is a certified nurse midwife at Vancouver Clinic. She helps guide and support women and families through pregnancy, childbirth, and the postpartum period. Her goal is to empower women to make choices that are right for them.
