How to Choose: Doctor, Doula, or Midwife?

Doctor Doula Midwife

First of all, the good news is that you don’t have to pick just one! But it can be confusing to sort out the different types of care providers that might support you in giving birth. What follows is an overview of the roles each of these people play and how they can help you welcome your baby or babies into the world.

Doctors

The majority of people who have babies in the United States do so under the supervision of a physician, which is someone with a Doctor of Medicine or MD degree [1]. Many parents choose a doctor that specializes in obstetrics and gynecology, also known as an OB/Gyn, but in some regions family physicians also deliver babies. Doctors usually work in hospitals, can assist with vaginal births, and also have training to perform Cesarean deliveries.

If you already see a doctor for yearly visits and she or he delivers babies, you might want to continue to see him or her throughout your pregnancy. Parents-to-be sometimes choose a doctor that delivers babies at the hospital where they would like their child to be born or one that specializes in births that might be more complicated or risky due to the health of the mother or baby.

Midwives

Midwife is a word that comes from Old English words meaning “with woman.” Midwives care for women during the childbearing year a bit differently than doctors, with a focus on not intervening in pregnancy and birth [2]. Today, there are several different types of midwives that support birthing women [3].

The most common type of midwife is a Certified Nurse Midwive or CNM. CNMs are nurses who have a specialized degree in midwifery, which covers well-woman care, prenatal care, birth, and postpartum care of mother and baby. CNMs attend births in hospitals, out-of-hospital birth centers, and in homes. CNMs can refer you to an obstetrician if needed, and some CNMs work in the same practices as physicians to offer a wide spectrum of care for all types of pregnancies and births. Certified Professional Midwives or CPMs and Certified Midwives or CMs are not nurses, but often have clinical training in childbirth and have passed a national exam. CMs and CPMs most often attend home births, and the laws governing their practice vary from state to state.

You might choose to receive your prenatal care from a midwife if you are healthy and would prefer a birth with few interventions, or if out-of-hospital birth is something that appeals to you and makes sense give your medical history. Midwives are trained to assist birth, and also to recognize when a pregnancy or birth requires more support and then refer the parents-to-be to a physician.

Doulas

Birth Doulas are attendants that do not deliver babies or provide medical care, but instead support parents-to-be emotionally and physically leading up to, during, and after childbirth [4]. Doulas have various levels of training and expertise, and can receive certification from several national organizations. You might choose to have a doula at your birth if you want support for you and your partner from someone who is not a family member or a friend and who may have knowledge of comfort measures or birth in general. Usually, if you’d like to have a doula, you must find and hire one yourself, but some hospitals now have doulas available—either as volunteers or on staff—and you just need to ask for one. Learn more about what a doula does here.

Find care providers you feel comfortable with

Regardless of whom you choose as your provider—doctor or midwife—and whether you want a doula present when you give birth, your comfort level with them and their practice is important. It is okay to speak to several providers before you determine what is best for you and your baby and to involve your partner and family in the decision-making process, so that you can have confidence in the care that you receive and feel comfortable asking questions.

Sources:

  1. Childbirth Connection, Types of Care Providers
  2. American College of Nurse Midwives, Our Philosophy of Care
  3. WebMD, What is a midwife?
  4. Mayo Clinic, What are the benefits of having a doula?
Abby Olena
Dr. Abby Olena has a PhD in Biological Sciences from Vanderbilt University. She lives with her husband and daughter in North Carolina, where she writes about science and parenting, produces a conversational podcast, and teaches prenatal yoga.

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