What’s the difference between a doula and a midwife?

This question comes up all the time. Like, allll the time.

Wanna see a throwback video we made about this 13 years ago??? Yes, this is how long we have been answering this question over and over and over again.

Someone announces they are training as a doula or working as a labor doula, and the response is almost automatic:

“Oh, so like a midwife?”

If you are rushing to catch a train, you might say yes and keep moving. But the real answer matters, especially if you are pregnant, hiring support, or exploring an online doula training yourself.

A doula and a midwife are very different roles. They work really beautifully alongside each other, but they are not interchangeable terms. And understanding that difference helps families build safer, more supportive and magically supportive care teams.

So let’s get into it.

What does a doula do?

A birth doula is a trained, non medical support professional (so, your clients need to be working with a doctor or midwife!). In your doula training, the focus is on emotional, informational, and physical support across pregnancy, labor, birth, and the early postpartum period.

As a birth doula you get to be in a great role on the care team because a doula does not perform medical exams, diagnose conditions, prescribe treatments, or make clinical decisions. That is not their role and should never be.

Instead, a doula supports the experience of pregnancy and birth. You know, the heart-centred part. The care around how a person feels during a major life and body event. 

That can include helping clients understand their options, talking through test results in plain language, offering comfort measures during labor, supporting communication with care providers, and providing steady emotional reassurance for the person having the baby and their loved ones in the room.

One of the defining features of doula care is continuity. A doula is often the only person who stays consistently connected with you across pregnancy, labor, and birth. They are on call, they know your preferences, and they know your story.

A note on continuity? Some people are not as jazzed as they should be when they hear this because they have watched TV shows and movies with birth and in them the room is full of nurses and a doctor or two… real life, the room is empty a lot of the time and the person in labor and their birth mates are alone. Like alone, alone. Yes, they can page a nurse if needed, but that is an unfamiliar and scary environment in the hospital and having a doula there is such a stress reliever. 

Many families describe a doula as a knowledgeable, warm, grounded support person who helps them feel less alone and more confident during an intense and vulnerable time.

What does a midwife do?

A midwife is a medical professional. Midwives are trained to provide clinical care for pregnancy, birth, and postpartum, including monitoring health, ordering tests, performing exams, prescribing medications, and managing uncomplicated births.

Midwives are responsible for the medical wellbeing of the birthing person and the baby. They chart, assess risk, respond to complications, and collaborate with physicians when higher level care is needed.

In most settings, midwives join the birth during active labor and remain through delivery and immediate postpartum care. Their role is clinical, regulated, and medically accountable.

Midwives are incredible providers. And their scope is fundamentally different from a doula’s.

Doula versus midwife: it is not a competition

One of the biggest misconceptions is that you choose either a doula or a midwife.

In reality, they work best together.

A doula does not replace a midwife. A midwife does not replace a doula. They serve different functions within the same care ecosystem.

During labor, a midwife may move in and out of the room as they monitor progress, chart, respond to pages, and coordinate care. A doula stays with the laboring person, offering continuous support, comfort, and reassurance.

While the midwife focuses on clinical safety, the doula focuses on emotional safety, physical comfort, and communication.

This is why many families say that having both creates a more balanced and humane birth experience.

What support looks like in real time

Here is a simple way to think about it.

The midwife is responsible for what is happening medically.
The doula is responsible for how it feels to go through it.

For example, if a provider recommends an intervention, the midwife explains the medical rationale. The doula helps the client process the information, ask questions, and feel supported while making a decision. The doula will take into account the person in labor’s goals, fears, risk assessment, comfortability and more.

If labor becomes intense, the midwife monitors safety and progress. The doula supports breathing, positioning, grounding, and emotional regulation.

If the partner needs a break, the doula stays present so the birthing person is never alone.

This division of roles is intentional and protective.

Why your doula training matters

Because doulas are non medical, the quality of doula training matters enormously.

Good doula training teaches scope of practice clearly. It prepares doulas to support without overstepping, to inform without directing, and to advocate without interfering.

Online doula training that rushes through content or blurs medical boundaries can leave new doulas unsure of their role, which helps no one.

Strong doula certification programs emphasize ethics, collaboration, and respect for medical providers alongside deep skill building in support.

This clarity is what allows doulas and midwives to work together effectively.

We are speaking up loudly about the antiquated weekend doula training model and you can read more about that here.

Home births, hospital births, and team care

A doula and a midwife make a beautiful team in both home and hospital births.

If clients want a homebirth, they must have a midwife because in most countries a doctor doesn’t not attend them. At home births, midwives manage the clinical aspects of care while doulas focus on continuous comfort and emotional support. There is also a lot of prep and clean up in a home birth and a doula will help the family with all of that which is such a lifesaver to the family. 

In hospital settings, doulas help families navigate systems, understand policies, and feel less overwhelmed by the clinical environment, while midwives or physicians provide medical care.

The setting may change, but the roles do not.

So what is the difference, really?

A midwife provides medical care.
A doula provides non medical support.

A midwife is responsible for clinical outcomes.
A doula is responsible for continuous presence and support and protecting the emotional well being of the client.

A midwife may care for multiple clients at once.
A doula is dedicated to one family at a time.

Both are valuable, necessary, and they are not interchangeable.

Considering hiring a doula or taking a birth doula training?

If you are pregnant and building your care team, understanding the difference between a doula and a midwife helps you choose support intentionally.

If you are exploring an online doula training, this distinction is foundational to ethical practice.

Doula versus midwife is not about hierarchy. It is about collaboration. When each role is respected and clearly understood, families receive better, safer, and more compassionate care.

That is the goal.

Reach out if you want to chat about becoming a doula [email protected] – we love to talk to folks!!