Midwife, doula, OB/GYN – What is the difference?

Susan Cheek-Williams, CNM

Obstetrics and Gynecology

When it comes to prenatal care, woman have several options available to them. But how do you choose between a midwife, doula and OB/GYN? Is one better than the others? Susan Cheek-Williams, CNM, explained how they’re different so you can choose the right provider for you.

What is a midwife?

A certified nurse midwife is a woman’s primary healthcare provider during pregnancy, responsible for the physical assessments of both mother and baby. Midwives are advanced practice registered nurses with at least a master’s degree in midwifery. They specialize in caring for pregnant women with low-risk pregnancies during pregnancy, birth and postpartum.

Midwives can provide nonsurgical gynecologic care, but they do not provide any surgical services such as cesarean sections (c-sections). The midwifery model of care focuses on education and shared decision making with the patient. Assessment for abnormal findings is only a small part of a prenatal visit with a midwife. The majority of a visit is spent discussing how to maintain a healthy pregnancy, providing anticipatory guidance and preparing for the birth process.

What is an OB/GYN?

An OB/GYN, or obstetrician-gynecologist, is a doctor specializing in female reproductive health, pregnancy and childbirth. OB/GYNs can work with patients of all ages. They provide preventive care as well as treat and manage diseases. During pregnancy, OB/GYNs often focus on pathology and may not be as comfortable with less medical intervention.

What is a doula?

Doulas are professionally trained in the physical and emotional support of families during labor and postpartum periods, but they are not healthcare professionals. Many pregnant women choose doulas for extra support during their pregnancy and birthing journey. Doulas can assist women while they labor at home and accompany them to the hospital or birth center for delivery. Doulas do not make medical decisions for the families, but they can encourage education and advocate for shared decision making while in a healthcare setting. 

What are some benefits to using a midwife?

Most women seek out midwifery care because they want a low intervention or unmedicated birth. Midwives support healthy women in managing childbirth and advocate for birth plans which often include less restrictive fetal monitoring and freedom from IV lines to allow for better mobility during labor. Many pregnant women also choose hydrotherapy or waterbirth when using a midwife.

When a pregnant woman is in labor, midwives often provide hands-on physical labor support and have an increased presence for emotional support. Certified nurse midwives practicing in a hospital setting can order pain medication or epidural anesthesia if desired by their patient. Laboring in a hospital also provides these patients with immediate access to OB/GYN physician care if circumstances should arise that require urgent medical attention.

How do you choose the right provider for you?

The right provider is different for everyone and differs for every pregnancy, based on the health of both mom and baby. Women with preexisting conditions, such as diabetes or high blood pressure, or those carrying multiples may be best suited for an OB/GYN provider. Women who strongly desire an unmedicated birth or who desire to have a low intervention delivery may benefit from the midwifery model of care.

The goal of all providers is to make sure your childbirth experience is as safe and smooth as possible.