The Big Difference Between Midwives and Doulas

What is a midwife?  How is that different from a doctor?  And what is a doula?  Aren't a midwife and a doula just the same thing?

I love midwives.  Actually, I love anyone who takes the stance that birth is normal until there is evidence that it is not.  Midwives have worked hard to gain recognition of their job and to educate the community on their roles in birth.  In this regard, midwives and doulas are alike, as we both work hard to help define our roles and responsibility to our clients and garner recognition and respect within the medical community. As the hashtag is constantly reminding us #thestruggleiseal

After we look at the fact that most midwives and doulas are women, and we both specialize in care of the pregnant and laboring woman, the roles a midwife and a doula play in your labor and delivery are very different, and shouldn't be thought of as an either/or choice.


A midwife in the Commonwealth of Virginia can be licensed one of two ways.  The first is a Certified Nurse Midwife (CNM).  She will most likely work out of an Obstetrician's office or a birth center.  She is a Registered Nurse with extensive advanced schooling who will help you deliver your baby in a hospital, birth center and even homebirths, and be responsible for your and your baby's medical care, and for any emergencies that may arise.  Health insurances often see no difference between an obstetrician and a CNM, which can make billing insurance easy.  The are trained in minor surgery (i.e. a few stitches after your birth), and can write prescriptions, but work closely with an obstetrician if your medical needs require major surgery (i.e. cesarean birth).  In Fredericksburg and the surrounding areas, we currently have six amazing Certified Nurse Midwives to help you with your medical center birthing experience.


If a homebirth is what you seek, then you are looking for a Certified Professional Midwife (CPM), who has done extensive training on normal physiologic birth outside of a hospital.  She is both certified and licensed by the state.  She will attend to all of your prenatal care, focus on your diet and overall physical and mental health before the birth. She has done a lot of schooling and undergone a rigorous licensing process for this privilege. In Fredericksburg, there are currently three CPM practices who will help you give birth at home (or in some birth centers as well).

 Doula caring for mom through a difficult contraction

Doula caring for mom through a difficult contraction

Professional Labor Doulas are certified and trained birth-workers who specialize in helping a family transition into and through that first year of parenthood.  We offer unbiased and unwavering support of your choices for yourself and your family. We have no say in the well-being of your body (we think that's really up to you!) and our standards of practice only permit us to focus on a healthy mind for you and a healthy bond with the baby. We're there purely for comfort and support.  Essentially, we help with birth from the waist up

During your pregnancy a doula will prepare you with the language with which you can speak to your provider to make your wishes clear.  We will check in on how you are feeling during your pregnancy, and remind you that what you are feeling is normal and good and real.  During labor, while your OB or midwife is listening to the baby's heartbeat, your doula there to wipe your face with a cloth, make sure you're drinking enough fluids, tell you that you are beautiful, then trade spots with your partner when they need a rest while we massage your back.  After your care provider leaves, we will stay with you to get your family situated for bonding, and we will come to your home a week after your new arrival to make sure you are transitioning smoothly to your new normal.

A great doula will work hand-in-hand with the medical care provider (OB, CNM or CPM) on your team to help you feel strong, empowered and cared for before, during and after your birth.  A Professional Doula will not take the place of or try to bypass doctors; we are not discount midwives who "know most of what they know".  Its not even close to the same job. And now you know. 

Victoria McCollum

Victoria McCollum is a birth and postpartum doula and owner of Doulas of Fredericksburg, in Fredericksburg, Virgina. She resides there with her husband and three precocious sons.