Ob-gyn vs. doula vs. midwife: What are the differences?

Have you ever wondered what, exactly, the distinctions are between ob-gyns, doulas and midwives? And how do you know which type of healthcare professional will best support you and your partner on your pregnancy journey? Here we share the training each role requires, what they can offer and the support they can provide throughout your pregnancy.

Preconception and prenatal care, no matter who you see, is important

If you’re thinking about trying to conceive, a preconception appointment is a great start to help ensure a healthy pregnancy. If you’ve had a pregnancy test and it’s positive, it’s important to call a healthcare professional to set up a prenatal appointment. Typically, this will be an ob-gyn, but if you don’t have one, don’t worry! Contact your primary care provider to guide you through your next steps as they know your personal history and will be able to help you identify the appropriate level of care needed throughout your pregnancy.

The term “ob-gyn” stands for “obstetrician-gynecologist.” These healthcare professionals have had a substantial amount of education and can assist in many types of obstetric and gynecological care. But maybe you’ve heard about midwives and doulas, too. Depending on their education, level of training and qualifications, midwives can provide prenatal, pregnancy and postpartum care. Doulas, while they don’t have the same level of medical training as ob-gyns and midwives, are well-versed on the emotional, informational and physical components of the individual while also offering prenatal, pregnancy and postpartum support to ob-gyns and midwives. Let’s take a closer look.

What is an ob-gyn?

According to the American Board of Obstetrics and Gynecology (ABOG), ob-gyns are healthcare professionals who, “by virtue of satisfactory completion of an accredited program of graduate medical education, possess special knowledge, skills and professional capability in the medical and surgical care of women related to pregnancy and disorders of the female reproductive system.”¹ An ob-gyn must:

• Obtain a bachelor’s degree 
• Take and pass the Medical College Admissions Test (MCAT) 
• Attend a residency program to gain experience 
• Pass an exam in order to get a license²

What does an ob-gyn do?

An ob-gyn assesses many aspects of your physical and mental health.³ You may already have an ob-gyn you’ve been seeing annually. Many ob-gyns provide holistic care, focusing on the organs in your pelvic area and your reproductive system, as well as how your family and personal history, environment, and lifestyle affect your overall health.³ Ob-gyns also can talk to you about sexual health, birth control, fertility, prenatal care, and perimenopause and menopause.³ Sometimes an ob-gyn may recommend a breast exam, pelvic exam and/or Pap test.³ And, of course, ob-gyns can deliver babies!

What are the benefits of an ob-gyn during pregnancy?

Both ob-gyns and midwives offer prenatal and pregnancy care, but ob-gyns are trained and certified to address any complications that may occur.² Ob-gyns can:

• Perform prenatal screenings, blood tests, urine tests, physical exams and ultrasounds 
• Manage health conditions that may impact fertility, pregnancy or postpartum care 
• Induce labor if needed 
• Prescribe medication 
• Manage an emergency if necessary 
• Perform planned or unexpected surgeries, such as a cesarean section 
• Determine the need for an episiotomy during birth 
• Help the birth along with the use of a vacuum or forceps if warranted²

What is a midwife?

Midwives are healthcare professionals who, depending on their education, certification and license, can provide different degrees of prenatal, pregnancy and postpartum care, as well as some gynecological care.⁴ If you are considering using a midwife, ask about their certifications. These can include Certified Nurse Midwives (CNMs), Certified Midwives (CMs), International Confederation of Midwives (ICMs), Certified Professional Midwives (CPMs) or lay midwives. Depending on their designation, they may or may not be able to work in a hospital, prescribe medicine, order lab tests, provide diagnoses or work in every state.^4,5

What does a midwife do?

Contingent upon their certification, midwives may be able to: 

• Counsel you on fertility and pregnancy care, and help with breastfeeding after birth 
• Prescribe birth control and necessary medication (depending on their designation) 
• Order lab tests and/or ultrasounds (depending on their designation)
• Perform breast exams and Pap tests 
• Assist throughout the birth and after it⁴

What are the benefits of a midwife during pregnancy?

According to March of Dimes, “Midwifery care offers a chance to address health disparities and help improve birth outcomes, especially among women of color. Some studies suggest that midwifery care can lower interventions (like needing a c-section or pain medicine), can lower health care costs, increase patient satisfaction (happiness) and improve care.”⁵ Midwives are a great option if you have a low-risk pregnancy.⁴ If you choose to have a midwife, you can sometimes have more control over different facets of the pregnancy and birth, and you have more options for where you give birth.⁴

What is a doula?

According to DONA International, a doula is “a trained professional who provides continuous physical, emotional and information support to their client before, during and shortly after childbirth to help them achieve the healthiest, most satisfying experience possible.”⁶ Often people hire a doula to work with a midwife or ob-gyn.

What does a doula do?

Doulas offer support in many different ways. Doulas can: 

• Offer emotional and mental support through all stages 
• Act as an advocate 
• Give guidance on ways to breathe and position yourself throughout the birth in order to provide comfort 
• Provide breastfeeding or bottle-feeding tips and techniques 
• Share information on how to soothe a newborn 
• Serve as an extra hand by helping out with laundry or meals⁷

What are the benefits of a doula during pregnancy?

Think of a doula as someone who intimately understands your wants and needs and will serve as an advocate, guide and calming presence throughout the pregnancy journey. They also can help support and guide your loved ones, including those who might be present with you in the birthing room and those who will be visiting or assisting you after the baby is born.

OK, I know who I want, but how expensive will this be? 

If you don’t already have an ob-gyn, before you start scheduling appointments, make sure they — and the hospital where they’ll deliver your baby — are covered by your insurance. Many certified midwives are covered by insurance, but coverage and specific benefits vary.⁸ Not all insurance companies cover doulas. Some hospitals, though, provide doula services for you! Many people hire doulas using their own money.⁸

When choosing an ob-gyn, midwife and/or doula, ask for recommendations from family members and friends, especially those who have had pregnancy and birth experiences you’d like to mimic. But also remember that this is a highly personal decision — it’s important to find someone with whom you can form a good connection. And, for some people, plans change. If you had your heart set on a home birth with a midwife but need a C-section, it’s OK to feel how you feel. Just remember there are lots of scenarios available (for example, including a midwife or doula in your hospital delivery). And perhaps most importantly, know that there are a lot of people in this world dedicated to caring for you and your baby, and they will do what they can to ensure a healthy, happy pregnancy and delivery.

 

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