What Does a Midwife Do?
This article is written by Paula Grady LM, CPM - a California licensed midwife serving Napa, Sonoma, Solano, Contra Costa and Marin counties for over 25 years. If you are are looking for natural pregnancy care in the North Bay area, you can learn more about Paula and her practice here.
What does a midwife do? How is she different from an OB / GYN or a doula? In this section we answer questions like these, with the goal of helping you choose the ideal care team for your natural birth.
Many new moms considering a natural childbirth have questions such as:
- What is a midwife?
- What is a doula?
- What is a certified nurse midwife?
- How do these roles differ from that of an of OB / GYN?
This post will address these questions. It will help you answer questions like: "Who can I count on for support in a natural childbirth?" and "How do I choose my care team?"
Let’s start by describing the differences between a Licensed Midwife, an OB/GYN, a Certified Nurse Midwife, and a Doula.
What Does a Midwife Do: Differences Between the Roles
A Licensed Midwife (LM), such as myself, is a healthcare provider usually licensed (at least in the United States) by their state medical board and / or the American Midwifery Certification Board. Licensed and certified midwives specialize in providing 'natural' prenatal care, childbirth support and postpartum care in home birth settings or birth centers to women who prefer a natural birth plan. Their licenses orient them toward women with low-risk pregnancies, not requiring medications or surgical intervention.
An OB / GYN (obstetrician-gynecologist) is a medical doctor who specializes in women’s reproductive health. He or she is trained to provide medical, surgical and all other forms of gynecological care for women throughout their reproductive lives. This includes the administration of birth control and the diagnosis and treatment of reproductive medical conditions, including high-risk pregnancies and complex childbirths.
A Certified Nurse-Midwife (CNM) is a registered nurse who has obtained additional specialized training in midwifery care, has passed a national certification exam and is supported by the American College of Nurse-Midwives. Certified nurse midwives provide a range of primary care services, including prenatal, labor and delivery and postpartum care. They are licensed to provide medical interventions such as epidurals and other pain medications and can work in a hospital setting.
A Doula is a trained professional who provides physical, emotional, and informational support during pregnancy, childbirth, and the postpartum period. Doulas do not provide medical patient care or perform clinical tasks. Instead, they focus on providing comfort measures such as relaxation techniques, breathing exercises, massage, and positioning suggestions during labor. They also offer emotional support by being a reassuring presence, providing encouragement, and helping navigate the childbirth process.
In addition, there are professionals in related fields who are trained to provide specific health services to pregnant women. These individuals offer services such as prenatal massage, prenatal chiropractic and birth hypnosis.
In my practice we have aligned with professionals in each of these areas, to provide a well-rounded set of pregnancy care resources. We often find them to be a great addition to mom's natural birth support team.
How to Choose Your Team
The choice of which health care provider(s) to include on your support team depends on the type of care you prefer. There are several kinds of teams:
Natural Birth Team
If you are leaning toward a natural birth experience, with minimal medical intervention you might choose a licensed and certified midwife to lead your support team. You might also choose to work with a doula, although most licensed midwives provide the same type of support as part of their overall service.
Hospital Birth Team
Hospital Birth Team: If you are leaning more toward having your birth experience directed by a medical doctor, with more direct access to pain medication and emergency care if needed, you might prefer to have an OB / GYN as one of the health care professionals on your support team.
Hybrid Birth Team
If you are thinking about a blended approach, in which your prenatal and postpartum care are more self-directed, but labor and deliver itself take place in a hospital, with an effort to approach the conditions of natural childbirth as closely as possible – a doula and / or CNM might be good healthcare professionals to include on your team.
Any of these choices must be influenced by your personal health profile and other conditions of your pregnancy that may pose risks best managed by a medical doctor. These scenarios might include twins, breach, VBAC and health risks such as pre-eclampsia or gestational diabetes.
Moving Forward...
Our main questions in this article were "What does a midwife do? How does a midwife compare to a doula compare to an OB / GYN? Who should I have on my natural birth support team?"
I hope that we have answered these important questions for you. At this point you may want to know how your care team works with you to manage the pain of childbirth. Find out here! And if you are curious about the cost of a natural birth, have a peak at How Much is A Midwife.
About the Author
Paula Grady, LM is a Licensed Midwife and Co-Founder of The Midwives Childbirth Services, serving families across Sonoma, Napa, Marin, and the North Bay. Paula has supported hundreds of women through pregnancy, natural birth, and postpartum recovery, with a calm, evidence-based, woman-centered approach grounded in more than two decades of experience. Read Paula’s full profile here.
Additional Resources
North American Registry of Midwives - credentialing organization for Certified Professional Midwives
American College of Nurse-Midwives - professional association representing midwives
Medical Board of California - governs licensure of medical care providers including licensed midwives