Doula vs midwife

  1. What's the difference?
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  2. 13 Comments

  3. by   Crocuta
    Quote from stillpressingon
    What's the difference?
    A midwife performs actual medical care and delivery. A doula is there to support the mother and meet her needs.

    We had both a midwife and a doula attending the homebirth of our daughter. We appreciated how they both performed their own roles to make the birth a special and relaxing time.

    http://www.dona.org/
    Last edit by Crocuta on Jan 26, '07
  4. by   *Bethany*
    Exactly what the previous poster said. A doula does not perform any medical care whatsoever. She is there for emotional support, education, and offering comfort measures.

    I've once heard that when comparing midwife and doula you can think of it this way. The doula works with the mom from the waist up and the midwife works with the mom from the waist down. I know this isn't very technical because what if the doula gives the mom a foot massage or something....

    hope that helps.
  5. by   SmilingBluEyes
    it would depend.

    In the UK, a midwife is more like the RN in the USA....

    Correct me if I am wrong....
  6. by   SmilingBluEyes
    To further muddy the waters, remember, there are varying degrees/types of midwifery

    You have Lay Midwifery, Certified Midwifery and Certified Nurse Midwifery, all practiced in varying places in the USA.
  7. by   Kelky
    Midwives in the UK are a combination of the OB RN here and midwives here. There are no OB RN's as you cannot work as an RN in maternity in the UK, you have to have a midwifery qualification to provide care. I don't think doulas necessarily have any medical training do they?

    There are no lay midwives in the UK either, illegal, but aren't they illegal in parts of the US? sorry getting sidetracked here but it got me thinking
    Last edit by Kelky on Jan 26, '07
  8. by   KellNY
    No, doulas have no medical training, although some are trained to perform cervical exams. They are not medical professionals.

    You can also visit alace.org for some more info.

    A doula helps mom with position changes, "therapeutic touch" (not a massage per se, since not a LMT), encouragement, relaxation, aromatherapy, foot rubs, counter pressure, getting and fixing snacks and drink for mom and dad, etc.

    In a medical setting (ie hospital) where the midwife may be attending several births, as well as charting, seeing pts on the ante partum floor and the clinic, a doula can be most beneficial because she is there the whole time-with ONLY that woman.

    They are also very helpful at homebirths, as an above poster mentioned. Many home birth doulas arrive to help the mother well before the midwife needs to be there.

    Big difference in the pay as well. As a doula, I make between $0-$700 per birth (though only made that $700 once, and worked my butt off for it too!). I also volunteer a lot, which explains the zero.

    But we're both on call, and both there for the same reason--to help mom and baby have the safest, happiest, easiest delivery possible.
  9. by   Belinda-wales
    Quote from SmilingBluEyes

    In the UK, a midwife is more like the RN in the USA....

    Correct me if I am wrong....
    A UK midwife does more than just deliver babies. Because she is present at every birth, whether at home or in hospital.
    The midwife is usually the first and main contact and often the lead health care professional for the expectant mother during her pregnancy, and throughout labour and postnatal period. She helps mothers to make informed choices about the services and options available to them by providing as much information as possible.
    The role of the midwife is very diverse. She carries out clinical examinations, provides health and parent education and supports the mother and her family throughout the childbearing process to help them adjust to their parental role.
    The UK midwife also works in partnership with other health and social care services to meet individual mothers' needs.
    Midwives are responsible for their own individual practice and have a statutory responsibility to keep up to date with current knowledge. All midwives have a named Supervisor of Midwives to assist them with updating their knowledge and to ensure their practice is safe. It is the only profession that has statutory supervision to protect the public from incompetent practitioners with in the UK.
    Midwives in the UK work in all health care settings; they work in the maternity unit of a large general hospital, in smaller stand-alone maternity units, in private maternity hospitals, in group practice, at birth centres, with general practitioners and in the community. The majority of midwives practice within the NHS, working with other midwives in a team and other health care professional and support staff. Midwives can also practice independently and there is a small group of midwives who do so.
  10. by   tinyscrafts
    A doula should not be performing vaginal exams or checking heart tones. If she has those skills (and the insurance to cover her butt) she is acting as a "monitrice" and should be using that term. To use "doula" complicates the issue and perceptions by medical staff for the rest of us.
  11. by   KellNY
    Montrice would be a better term, yes. As would "Labor Assistant".

    But some doulas do perform it, not as a diagnostic measure, and not in place of midwifery care.
  12. by   tinyscrafts
    Most (all but one, I think) certifying organizations say it is against the doulas scope of practice to do so though.
  13. by   KellNY
    ALACE trains in it, I know that. As do a lot of smaller certifying agencies (not DONA, obviously). On top of DONA, there are lots of doulas who certified with these smaller agencies/organizations, and many more who are not certified at all. (For example, I'm certified as a doula through Creative Childbirth. I'm sure you never heard of them. I'm not affiliated with DONA in any way, and I'm affiliated with ALACE only as a CCE)

    A lot of doulas are also RNs with experience in L&D.

    I'm not saying it's a good idea or not to give vaginal exams, just that it is done, and it's not incredibly uncommon.
  14. by   tinyscrafts
    Yup, I know, I think it makes things very confusing, that's why I'm a fan of the different terms. But people are just now getting what a doula is...
    I'm an ALACE CCE too
    They now make people sign a form saying that the one VE experience is for learning purposes only and does not qualify them to do it on clients, but leave it open for MW assistants, RN;s etc who get further training to do so if they choose. I think that' s a good thing.
    I've run into people who look at me like I have three heads when I mention I'm trained thru ALACE because of this one issue so it's become a peeve of mine.

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