What is the Difference Between an OB/GYN, a Midwife, and a Doula?
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People often ask this question when we dive into conversations about my work as a birth doula. There’s a common misconception that birth doulas and midwives are interchangeable, but the truth is, each has a unique role in supporting folks along the childbearing continuum. Additionally, OB/GYNs have their own distinct roles here. I’m happy to shed some light on the scope-of-practice for each provider of care and identify how various practitioners can contribute to your journey and best support you - from fertility to postpartum. Let’s doula this.
OB/GYNs and Midwives both care for women and individuals from menstruation to menopause, along the reproductive continuum. They are both medical care providers who specialize in women’s health and are able to deliver women of their babies.
OB/GYNs are doctors/physicians and surgeons who are trained to diagnose and treat health conditions and prescribe medications. OB/GYNs are necessary members of one’s health care team in complicated pregnancy and birthing matters and when surgery is anticipated and/or needed. They tend to high-risk pregnant patients and are available for low and no-risk patients as well. Note: there are some really lovely OB’s out there - who also work alongside midwives (and welcome doulas!) to lend provision to wrap-around care for the people they serve. If you need an OB/GYN, find you one like that! You can check the IRTH app to find “prenatal, birthing, postpartum and pediatric reviews of care from other Black and brown women” that might lead you to a great provider.
Midwives are incredible givers of nourishing care who ideally operate within the comprehensive Midwifery Model of Care. They are not doctors and are not trained to lead surgeries (although some Certified Nurse Midwives may assist OBGYNs with their surgical procedures). They tend to and help manage the care of low risk pregnant and birthing women and people. Some midwives are Certified Nurse Midwives (CNM’s) who most often deliver women of their babies in hospitals. CNM’s are advance practice registered nurses. Some CNM’s work out of birthing centers, and rarer but still, some attend home births. Most birthing centers and home births are attended by either Traditional/Lay Midwives, Direct-Entry Midwives (DEM), Certified Midwives (CM), or Certified Professional Midwives (CPM). Trained and skilled Midwives are able to provide medical care in physiologic experiences (in relation to the birthing a baby, this means vaginal birth) and are prepared to respond to emergency situations where breathing and bleeding is concerned and transfer further or out-of-scope medical and surgical care to an emergency response team or OB/GYN whenever necessary. It is important to note that most countries’ birthing populations (including Europe) are predominately attended and serviced by Midwives, not OB/GYNs. And for the record, Black Grand Midwives were the original deliverers of this nation. It must remain in our collective conscious.
Doulas are trained professionals that specialize in providing continuous support to individuals who are navigating major life transitions. Doulas are non-medical care providers who provide emotional, informational, and physical support (when serving in-person (think soothing touch and comfort techniques) and guidance to the clients in their care. There are many kinds of doulas:
Fertility Doulas
Abortion Doulas
Birth Doulas
Postpartum Doulas
Bereavement Doulas
Death Doulas
Full-Spectrum Doulas
Doulas have various paths to their professional service, there is no board of licensure or universal mandate of requirements to adhere or follow (although many doulas operate within the scope of practice set-forth by the communities and educational cohorts by which they are connected). Some have approached their work from the vantage of ancestral tradition and/or bodied experience, some have completed educational certification programs, some have journeyed all of the above.
Birth Doulas journey with women during their pregnancies, labor + birth, and shortly after childbirth. Some birth doulas meet folk at hello (as volunteers at hospitals and elsewhere) and others journey with clients from positive pregnancy test to immediate postpartum. Birth doulas do not deliver women of their babies - they walk alongside them as they become new, and new again mothers. Often, doulas are month after month, week after week, day-in, day-out, middle of the night - I’m here with you mama, whatever you need type care providers. They often visit at least one Primary Care Provider (PCPs like OB/GYNs or Midwives) appointment with their clients, sometimes more. They answer questions for their clients and provide evidence-based information and research to empower their voices and decisions. They often visit clients in their home and spend virtual time, encouraging them holistically - they talk nutritive intake, body movement, relationships and boundaries, easing labor sensations and transitions, prepping for new mama + new baby post birth, building their confidence (and their spouse or partner), etc. Personally, I see myself like a real good sista-girlfriend wrapped all up with professional training and lived experience - crafted to nurture and walk alongside - to be a witness, a holder of holy ground.
Doulas protect, uplift.
Doulas provide grounding and perspective.
Doulas promote an abundant flow of companionship and guidance.
Navigating the journey of childbirth, particularly as a Black woman or person of color, underscores this additional layer of importance: seeking a birth doula with the kin-temperament and lived experience of respectably and properly supporting you. It’s hard enough out here in these streets than to spend your time - let alone this significantly impactful time - translating culturally-nuanced need. And although we know all skinfolk ain’t kinfolk, you've got the increased likelihood of being loved on like you need, when you search within the fam home. Some great places to search online:
Black Doula Directory (I’m here)
Novant BIPOC Doulas (and here) *newly crafted + published in 2024
There are certainly more places - do a little googling for doulas in your area (some also travel, even multi-state, nationwide, globally - I do - and many provide 100% virtual support - I have). Also, some people really enjoy the virtual arrangement throughout their whole partnership with a doula. You don’t have to want your doula in your physical space with you during your birth, you may just want and need the preparation leading up to, the preparation for your intimate partner to serve as your sole support, you may just want to know your doula is an ear-bud away with a soothing tone and voice. Most doulas are flexible and really want to show up just how you need them, with that individually-tailored support.
Ask your friends, co-workers, family. Someone you know who may have recently (or some time ago) given birth, had a doula, and may recommend their services! Most of my work has come by way of referral - there’s a level of comfort that one might have when they know that someone they know has had a good experience with someone. And when it comes to choosing the doula that’s right for you - go on vibe, go on what you need. Do you feel good talking to her, has she navigated to and through the place and space you are hoping to go, can she help you travel that way, and thrive, too?
May this information help lead the way, as you make informed choices along the way, with the kind of providers that you need for a most competent, nourishing way.
