If you're preparing for birth, you may come across two different sources of support: midwives and doulas.
Both can play valuable roles during pregnancy and birth, but those roles are fundamentally different.
A midwife is a regulated healthcare professional responsible for clinical maternity care.
A doula provides non-medical practical and emotional support before, during or after birth.
Understanding that distinction can help you decide what support you'd like around you during pregnancy, labour and the early weeks with your baby.
What Does a Midwife Do?
In the UK, midwife is a protected professional title, and midwives must be registered with the Nursing and Midwifery Council (NMC) to practise. The NMC regulates midwives and sets the professional standards they must meet.
For most people receiving NHS maternity care, a midwife will be the main healthcare professional providing care during a straightforward pregnancy.
Midwives provide clinical care throughout pregnancy, labour and after birth. Depending on your individual circumstances, they may work alongside obstetricians and other healthcare professionals.
During pregnancy, your midwife may:
- discuss your health, wellbeing and medical history
- check your blood pressure and urine
- arrange or discuss screening tests
- monitor your baby's growth and movements
- discuss your birth choices and preferences
- provide information about labour and birth
- discuss your mental health and wellbeing
- identify when additional medical assessment or specialist care may be needed
NHS antenatal care is largely organised around these midwife appointments, with doctors becoming involved when additional medical care is required.
What Does a Midwife Do During Labour?
During labour, a midwife provides both clinical care and support.
They monitor you and your baby, assess how labour is progressing, provide information and support, and can help you access pain relief.
Importantly, a midwife is trained to recognise when you or your baby may need additional medical attention and arrange this when necessary.
That clinical responsibility is one of the fundamental differences between a midwife and a doula.
Will I Have the Same Midwife Throughout Pregnancy and Birth?
Not necessarily.
This is something I would correct from the original P+G article.
You may meet different midwives during pregnancy, and the midwife caring for you during labour may not be somebody you've previously met.
The exact model of maternity care varies between NHS trusts and maternity services.
What Is a Doula?
A doula provides non-medical support.
Unlike a midwife, “doula” is not a regulated healthcare profession in the UK in the same way as midwifery.
A doula doesn't replace your midwife or doctor and isn't responsible for monitoring the clinical health of you or your baby.
Instead, their role may include emotional, informational and practical support.
Some doulas work primarily around pregnancy and birth, while others provide postnatal support after the baby has arrived.
What Does a Birth Doula Do?
A birth doula may get to know you during pregnancy and discuss your preferences, concerns and hopes for birth.
During labour, they may offer:
- reassurance and encouragement
- practical comfort measures
- help with relaxation
- massage if wanted
- suggestions for comfortable positions
- support for your birth partner
- a familiar presence throughout labour
- help in communicating your preferences and asking questions
The important distinction is that these are supportive rather than clinical responsibilities.
A doula doesn't perform clinical examinations, diagnose complications, prescribe medication or make medical decisions on your behalf.
Does a Doula Advocate for Me?
A good doula can help you feel informed and confident about expressing your preferences. They can remind you of questions you wanted to ask and support you while you communicate with your maternity team.
But you remain the decision-maker about your care, and your doula doesn't take over discussions with healthcare professionals or make decisions for you.
That's an important boundary.
Midwife vs Doula: The Main Difference
The simplest distinction is:
| Midwife | Doula | |
|---|---|---|
| Healthcare professional | Yes | No |
| Profession regulated by NMC | Yes | No |
| Provides clinical maternity care | Yes | No |
| Monitors mother and baby | Yes | No |
| Recognises and responds to clinical concerns | Yes | No |
| Provides emotional support | Yes | Yes |
| Provides practical comfort during labour | Yes | Yes |
| Can provide continuity as a familiar support person | Sometimes | Often |
| Replaces the other? | No | No |
A UK doula is therefore additional support, rather than an alternative to a midwife.
The legal distinction is significant too: midwifery is a protected function in the UK, and attending someone in childbirth in a professional clinical capacity is restricted to appropriately registered professionals, apart from specific legal exceptions.
Do I Need a Doula If You Have a Midwife?
No. You don't need a doula in order to have a supported birth.
Your NHS maternity team provides your clinical maternity care, and you can usually choose to have a partner, relative, friend or another appropriate birth partner with you too, subject to the arrangements at your chosen place of birth.
But some people decide they would value additional continuity and dedicated emotional support from somebody experienced in supporting births.
That's where a doula may appeal.
Can I Have Both a Midwife and a Doula?
Yes. And it isn't really a question of midwife or doula, because they aren't interchangeable.
If you choose a doula, they work alongside rather than instead of your maternity professionals.
A simple way of thinking about it is:
Your midwife is responsible for your clinical maternity care.
Your doula is there to provide additional non-medical support.
The two roles can therefore complement one another.
What About Your Partner?
Choosing a doula doesn't mean your partner becomes redundant. Quite the opposite.
A doula can sometimes support the birth partner as well as the person giving birth — particularly during a long labour when partners may also need reassurance, information, food or simply a short break.
If you're preparing for birth together, our Pregnancy for Partners: How to Support Her Through the 9 Months looks at the partner's role throughout pregnancy and preparation for birth.
What Is a Postnatal Doula?
Some doulas specialise in the period after birth.
A postnatal doula's role varies, but may include practical and emotional support while a family adjusts to life with a new baby.
Again, this is not clinical postnatal care.
Your midwife and other NHS healthcare professionals remain responsible for your medical care and your baby's clinical care.
But practical support after birth can be enormously valuable — whether it comes from a doula, partner, relative, friend or wider support network.
Our Partner's Guide to Postpartum Care looks at what helpful support can actually involve once mother and baby are home.
How Do I Choose a Doula?
If you're considering employing a doula, take some time to talk before making a decision.
You might want to ask about:
- their training and experience
- the type of support they provide
- their approach to birth
- their boundaries and what they don't provide
- availability around your due date
- whether they provide postnatal support
- what happens if they're unavailable when labour begins
- fees and cancellation arrangements
- references or testimonials
Perhaps most importantly, ask yourself whether you feel comfortable with them.
Birth is an intensely personal experience. Qualifications and experience matter, but so does feeling that somebody will listen to you and respect your choices.
Building Your Birth Support Team
There isn't one perfect combination of people for every birth.
You may feel completely comfortable with your NHS maternity team and your chosen birth partner.
You may decide you'd value the additional continuity of a doula.
Your pregnancy may require additional care from obstetricians or other specialists.
What matters is understanding who is responsible for what.
Your midwife provides regulated clinical maternity care.
A doula, if you choose one, provides additional non-medical support.
Your partner or other chosen birth companion provides the personal connection that comes from knowing you.
Together, those roles can form a support team built around your individual circumstances and preferences.
Preparing for What Comes Next
As birth approaches, you may also find these guides useful:
Third Trimester of Pregnancy: What to Expect in Weeks 28–40+
What to Pack in Your Hospital Bag
And remember that your support needs don't end when your baby is born, in many respects, they are just beginning:
Fourth Trimester: The Complete Guide
Further Reading
Pregnancy for Partners: How to Support Her Through the 9 Months
Third Trimester of Pregnancy: What to Expect in Weeks 28–40+
Partner's Guide to Postpartum Care
Fourth Trimester: The Complete Guide
Written by Primrose + Ginger