Doula vs Midwife: Understanding Their Distinct Roles in Maternal Health

A Whole Health Story

July 31, 2024

Pregnancy and childbirth differ for every woman, presenting unique experiences that can be both rewarding and challenging. Families are increasingly choosing to add the services of a doula to help navigate their maternal healthcare journey, regardless of whether they have chosen a midwife or a doctor for the delivery.

Doula vs Midwife

Both a doula and a midwife are known to be allies during pregnancy, childbirth, and postpartum — yet their roles, training, and scopes of practice differ significantly. With education and training that resembles that of a nurse practitioner, a midwife is a medical professional licensed to independently deliver a baby and administer medications. A doula receives specialized training in supporting pregnancy but is not a medical professional.

What is a Doula?

A doula:

is a non-medical professional trained to help families before, during, and after pregnancy.
provides coaching, emotional support, and comfort measures during labor.
uses knowledge to help pregnant women communicate with their medical team and advocate for their chosen birth plan.
helps with relaxation techniques, provides reassurance, and supports emotional well-being.
can work independently or be affiliated with a hospital or birthing center.
has completed training that includes coursework and supervised practical experience, after which certification can be pursued.

“Many pregnant women feel like they’re not being listened to,” said Dr. Tiffany Inglis, Carelon national medical director for Women's and Children's Health. “But when they form bonds with a doula, they feel heard and supported. That personal and trusting connection can ease their anxieties and help them have a better overall experience.”

What is a Midwife?

A midwife:

is a medical practitioner in the field of maternity health who can deliver a baby and administer necessary medications.
provides personalized care to pregnant women throughout their pregnancy, during labor, and in the postpartum period.
conducts prenatal examinations, delivers babies vaginally, and provides postpartum care.
can integrate into a clinical team to work with doctors when a pregnancy has complications or high-risk needs.
is a highly trained healthcare professional with specialized training in obstetrics but is not a doctor.
holds licenses or registrations from health regulatory bodies.

Recent Research on Doulas and Maternal Health Outcomes

Elevance Health’s 2024 Public Policy Institute (PPI) study, Doula Access Through Medicaid Managed Care Improves Maternal Health, shows doulas can improve maternal health outcomes. The study showed women receiving doula care had a lower percent of Cesarean sections (C-sections) and a higher percent attended a postpartum visit, as compared to those without doula services.

Doula support earlier in the pregnancy can also be beneficial for women. For example, the PPI study found that women who initiated doula care in their first trimester experienced lower postpartum anxiety and depression, compared to women without doula care.

Source: Elevance Health Public Policy Institute 2024 study, Doula Access Through Medicaid Managed Care Improves Maternal Health

Are Doulas Covered by Insurance?

As of February 2024, 13 states (including Washington, D.C.) cover doula support through their Medicaid managed care plans. Another 30 states are in various stages of creating a doula network and providing coverage for doula support through their Medicaid managed care plans.

“Maternal health is about more than physically delivering a baby,” Inglis said. “It requires looking at the broader picture and understanding an individual’s health-related social needs. A diverse healthcare team, including midwives and doulas, integrates vital physical healthcare with essential social support.”