What is a Doula? Why have one? and how to choose the right one...

There has been so much publicity lately about midwives, the NHS and doulas, not all positive and not all negative so I really wanted to take a closer look at the roles and relationships between doula, midwife and client and why there's a sudden increase in the use of Doulas, why you may seek to hire one and how you find the right one.

I know myself it can be overwhelming when information is coming from all angles.

Bringing a new life into the world is a miraculous and profound experience, and many expectant parents are either bombarded with information, fears or lost in other peoples stories and opinions. Many first time parents I have met expect the medical system to support them in all aspects of pregnancy and birth and are dissapointed when their needs are not met or voices not heard. However a growing number of women now seek private support outside of the system to make this journey smoother and more positive.

Support can come in many forms as we all have different needs, however the two most common types of birth support are doulas and midwives. While both play important roles during pregnancy and childbirth, their responsibilities, training, and approaches differ significantly. Understanding these differences can help you decide what you want your support to look like.

What Does a Midwife Do?

Midwives are trained healthcare professionals who provide medical care to pregnant people throughout pregnancy, labour, delivery, and the first few days of postpartum. Their focus is on the health and safety of both the birthing person and the baby. Unless you hire an independant midwife however, you may not see the same midwife throughout your pregnancy or for your birth as the NHS currently does not hold this capacity or framework.

• Medical Training and Certification

Midwives complete formal education and certification, often including nursing or specialised midwifery programs. They are licensed to perform prenatal exams, monitor fetal development, order tests, and manage labour and delivery.

• Scope of Care

Midwives can deliver babies in hospitals, birthing centers, or at home, depending on the circumstances. They handle routine births and can identify complications that require referral to obstetricians or hospitals.

• Medical Interventions

Midwives can provide certain medical interventions such as administering medications, managing pain relief options, and performing emergency procedures if necessary.

What Does a Doula Do?

Doulas offer continuity of emotional, physical, and informational support before, during, and after childbirth. Unlike midwives, doulas do not provide medical care or deliver babies. They offer support, encouragment, advocacy and continuity as well as individual skills such as massage, yoga, nutrional support and many others. Some midwives actually become doulas as they feel the model of care is what they are attracted to and feel they can offer more this way and I have known doulas to become midwives because they feel they can bring their holistic knowledge into the work, which lets face it, is greatly needed right now.

• Continuous Support

A doula stays with the birthing person throughout labour and after birth until first feed is established offering comfort measures like breathing techniques, massage, positioning suggestions, and encouragement.

• Emotional and Informational Support

Doulas help educate parents about birth, understand their options, communicate with medical staff, help with informed birth preferences and feel empowered in decision-making. They provide reassurance and help reduce anxiety during birth. Every doula will have unique skills. For example I offer birth re-imprinting therapy to help with birth trauma as well as teaching birth biomechanics.

• Postpartum Assistance

Many doulas also offer postpartum support, helping with breastfeeding, newborn care, and emotional adjustment after birth as well as help for the whole family. Again the help offered is unique to the doula as some will clean and cook and sleep over night.

Key Differences Between Doulas and Midwives

Aspect	Midwife	Doula
Medical Training	Yes, licensed healthcare professional	No medical training but most are trained by a registered body and mentored to keep standards high.
Role	Provide medical care and deliver babies	Provide continual emotional and physical support
Medical Interventions	Can perform and manage interventions	Do not perform medical tasks but help navigate informed choice
Presence	May not be continuous during pregnancy and labour	Continuous presence before, during and after birth
Focus	Health and safety of mother and baby	Comfort, advocacy, and emotional health of the pregnant person or both parents

How to Choose the Right Doula for You

Choosing a doula is a personal decision that depends on your preferences, values, needs and birth plan. Here are some steps to help you find the right fit:

1. Identify Your Needs and Preferences

Think about what kind of support you want during your pregnancy and labour. Do you want someone who focuses on emotional encouragement, physical comfort techniques, or both? Consider whether you want postpartum support as well.

2. Research Credentials and Experience

While doulas are not medical professionals, many complete training programs and certifications through organisations such as Doula Uk. Many parents assume doulas with the most experience will be the best and for some complicated pregnancies this may be true but mostly the importance of connection is key. You need to feel/think whether you trust and feel held and safe with the person you are choosing. Just like we all have different friendship groups and partners because of the connection we make, its the same. So how do you feel with that person?

3. Meet Potential Doulas in Person

Schedule interviews to get a sense of their personality, communication style, and approach. A doula should make you feel comfortable, respected, and supported. Share your hopes and fears and see how you feel with the way they respond. It is very much a personal choice and sometimes you may not know what it is but you know that person is right for you. My doula friend, says "Theres a doula for everyone" and this is so true which is the beauty of it.

4. Ask About Their Philosophy and Services

Discuss their views on birth, pain management, and involvement with medical staff. Clarify what services they offer, including prenatal visits, labour support, and postpartum care.

5. Check References and Reviews

Ask for references from previous clients or read online reviews to learn about others’ experiences with the doula.

6. Consider Logistics and Cost

Make sure the doula’s availability matches your due date and that their fees fit your budget. Some doulas offer sliding scales or payment plans. Even if it doesn't say this on their website, it's worth asking as I know some doulas do this but don't advertise the fact. At first glance, cost may seem a lot but when you add up insurance, travel, training, all the on call days and the length of time spent at the birth and how much this effects a doulas own life, broken down it is similar to an average wage.

Why Having Both a Midwife and a Doula Can Be Beneficial

The midwife handles medical care and ensures safety, while the doula provides continuous emotional and physical support. This combination can lead to a more positive birth experience, lower rates of interventions, and greater satisfaction. When everyone in a birthing persons birth team is working together, it is a beautiful thing. However it can be tricky as not all midwives like having doulas in the room, simply because they don't often understand the doula or know the experience they hold and view them as medically naive. I was recently at a birth in which the midwife of 30 years did not appreciate my input as she was jumping ahead with fear around a lowered heart beat (I completely respect this as I have attended a fatal birth at no fault of anyones and it is very traumatic for everyone involved) but I could also see my client needed to try changing position first in case the umbilical cord was being pressed on, this was not something either midwife suggested and my knowledge of birth biomechanics was more useful than the fear they carried. They agreed to give me 10 minutes as it was safe to do so in this time and after a few lunges and in to a forward lean, the heart beat resolved to be normal again, completely avoiding intervention.

This is why midwife and doula make such a great team because both bring different knowledge and qualities. Some midwives love having doulas as it helps them greatly and they know births will often be more succesful and quicker because of the sense of support and safety helping to release all those juicy hormones. It's great when the midwives and doulas already have a good working relationship.

Final Thoughts on Choosing Birth Support

Understanding the distinct roles of doulas and midwives helps you make informed decisions about your birth team. Midwives provide essential medical care, while doulas offer continuous comfort and advocacy. When selecting a doula, focus on finding someone whose style and values align with yours. This support can make a meaningful difference in your birth journey, helping you feel confident and cared for every step of the way.

If you are expecting, start your search early to ensure you find the right doula available for your due date, who will support your unique needs and birth preferences. Your birth experience deserves thoughtful preparation and compassionate care. We invest in weddings, cars, houses, careers so why not invest in the most life changing exerience you will ever have. I often remind people that investing in our bodies and minds is the only true investment we will ever make as we these are the only real home we carry for the whole of our life and we can't replace or get a new mind or body. Giving birth is a threshold and to feel really witnessed in that moment as well as supported and loved is something you can't really put a price on.

For more info on support packages please see Doula Support Options