Every mom-to-be wants a safe birth and a strong maternity care team by her side on the big day. What about the rest of your support system? Some roles are easier to fill than others, like your OB/GYN and spouse, partner, or loved one. But what about midwife versus doula support? How are they different? Who is responsible for what during childbirth? Do you need both?
At a glance, a certified nurse midwife (CNM)—with a hospital birth—is your licensed medical provider and can deliver your baby. A doula is an optional, non-medical support person for comfort and advocacy.
In this article, Chrissy Honig, a CNM at Henry Community Health, breaks down the benefits of midwifery for a healthy pregnancy and safe hospital delivery. She’ll also explain how doulas can provide non-clinical support to enhance comfort during childbirth.
What do midwives and doulas have in common?
Certified nurse midwives and doulas are experts in supporting pregnant women who want unmedicated, natural labor and delivery. They believe birth is a natural, physiological process and offer individualized services throughout pregnancy as well as during the postpartum period.
Both midwives and doulas are known for listening and providing essential information and resources that help families make informed decisions about pregnancy care.
How are midwives different from doulas?
Certified nurse-midwives and doulas fill distinct yet related supportive roles, most notably during childbirth. CNMs are licensed clinicians who can provide medical care and offer pain-relief options during hospital labor and delivery. Their priority is you and your baby’s physical safety. Optional non-medical caregivers, such as doulas, can provide extra support and advocate on your behalf. Their primary focus is on your comfort.
- Labor-related clinical training
- CNM: Has completed graduate-level midwifery education and obtained national board certification
- Doula: None; has finished non-medical labor support studies
- Official hospital-birth responsibilities
- CNM: Is licensed to provide medical care and can also offer emotional support
- Doula: None; available for emotional support
- Delivery decision-making role
- CNM: Is certified to lead clinical decisions, consulting the OB/GYN as needed
- Doula: None, but may help advocate for birth preferences
“My job is to give accurate, evidence-based information so patients can make the best decisions for their family.”—Chrissy Honig, Certified Nurse Midwife
Certified nurse midwives, like Honig, are hospital-credentialed professionals who assess labor, interpret fetal monitoring results, write orders, prescribe medications, and deliver babies. And, if something unexpected happens and you need to make a change to your birth plan, a CNM will coordinate with your OB/GYN.
Doulas, being non-medical professionals, can only provide non-clinical support in a hospital setting. “A doula is trained in non-medical labor support and advocacy,” says Honig. This means they can’t perform exams, make diagnoses, order tests and lab work, direct the medical care plan, or deliver babies. Instead, they act as a steady presence, offering comfort techniques, partner coaching, and communication help.
Midwife training, licensure, and scope of practice
Certified nurse midwives are required to complete graduate midwifery education, pass a national board exam, and maintain certification through ongoing professional development. CNMs practicing at hospitals hold specific privileges that outline what they can assess, order, prescribe, and perform, including managing labor and delivering babies.
“Essentially, certified nurse midwives are advanced practice providers,” says Honig. “We’re credentialed. My patients have the luxury of being able to connect with me and use the midwifery model of care in addition to having the hospital experience with highly-qualified OB/GYN providers available in the background if things become high risk and vaginal delivery isn’t possible.”
Researchers have also found that midwifery care through pregnancy and support during labor with fewer interventions overall and lower cesarean rates for low-risk patients.
Midwife versus doula: How the roles fit together
For a hospital birth, midwife-led care is the default for safety and outcomes because your CNM can evaluate what’s happening in real time and act on it, looping in the OB/GYN if escalation is needed.
“As a certified nurse midwife, I’m basically a women’s health nurse practitioner with extra training and specialization that allows me also to deliver babies,” says Honig.
Some families also choose to hire doulas for optional, extra hands-on comfort during childbirth, but that support doesn’t replace the clinical leadership from midwives.
Midwife-led hospital labor and delivery benefits
When a certified nurse midwife leads a hospital birth, you have clinical support that can shift in the moment. Your midwife can fine-tune an induction or augmentation plan, watch how your baby is tolerating labor, and—if something changes—loop in anesthesia or the on-call OB without delay so care keeps moving.
“Inductions can be long,” says Honig. “We talk through the plan, check in before each decision, and if we need to change the plan, we explain why so you know what’s happening.”
A midwife can also personalize pain management. Honig keeps the routine evidence-based and straightforward, adding medications as needed. “I work with each patient’s body and their goals for delivery—unmedicated or medicated,” she says. “Because things can change during labor, I keep checking in so care fits how my patient is actually feeling.”
That same approach to support continues after delivery. Baby-friendly practices are built into bedside care, including immediate skin-to-skin contact, assistance with the first attempt at breastfeeding, and rooming-in when it’s safe.
“The golden hour is such a special time with lots of quiet bonding time for the family.”—Chrissy Honig, Certified Nurse Midwife
Where a support person fits
Some families choose to hire doulas for optional, extra hands-on comfort and encouragement during childbirth, but their support doesn’t replace the invaluable clinical leadership from midwives.
As Honig puts it, a great helper during labor and delivery—whether it’s an independently-hired doula, partner, relative, or friend—is someone who “knows the patient’s wishes, learns a few comfort skills, and works alongside the nurses and OB/GYN.”
This help might include reminders to sip water, applying a cool cloth, using hands-on counter-pressure, cueing breathing, or maintaining eye contact during tough contractions. “Doulas are definitely an option for additional support for mom and dad, especially throughout labor because they’re trained in positioning and comfort measures,” Honig says.
Comfort and coaching during hospital labor and delivery
Many comfort measures can start the moment you arrive. Your midwife and nurses can guide you through position changes, help you stay mobile when it’s safe to do so, use warming or cooling cloths, and apply counter-pressure.
Additionally, simple tools (such as peanut balls and birth balls) can make a long induction more manageable, and minor environmental tweaks (such as dimmed lighting and streaming music from your playlist) are other small things that can help you settle in. Medications are available when you want them. In the hospital, midwives can write orders and coordinate with nursing staff to ensure optimal timing for IV medications or epidurals.
If the birth plan needs to change
Sometimes the plan needs to change. Common reasons include fetal heart rate concerns, stalled progress despite rest and position changes, high blood pressure or fever, meconium, or signs of infection. In those moments, your midwife consults with the on-call OB, discusses the options, and collaborates with you on the plan.
“As a certified nurse midwife, I’m explaining everything along the way so my patients know what’s happening with their bodies.”—Chrissy Honig, Certified Nurse Midwife
Midwife-led hospital care provides clinical support at the bedside, offering you rapid access to higher-level interventions without delay. If you’ve invited a support person or doula, they’ll remain a steady presence through plan changes, focusing on comfort and communication while the hospital’s maternity care team directs medical care.
FAQs about midwife versus doula care
Below you’ll find answers to common questions about midwives and doulas.
What’s the primary difference in a hospital birth: midwife versus doula?
A certified nurse midwife is a licensed clinician who manages labor. They can deliver your baby in the hospital and help manage any complications. Their top priority is keeping you and your baby safe and healthy, and most have over three years of full-scope training.
A doula is a non-medical support person with training and certification in providing physical and emotional support during labor and childbirth. Their entire focus is on your well-being during a hospital birth, and they may join you at any point you feel you need encouragement. Their focus is on meeting your needs to ensure you feel supported (and as comfortable) as possible.
Who manages pain medication and epidurals in the hospital?
Your midwife places the orders, the anesthesia team places the epidural, and your nurse manages timing and monitoring.
Does a midwife-led approach lower the chance of a cesarean?
Evidence suggests it can for many low-risk patients. Reviews of midwife-led or continuity models show fewer interventions and lower cesarean rates with similar outcomes for babies.
Can I switch between midwife-led and OB-led care during labor?
Yes. If your needs change, the clinical lead can transition to the OB/GYN, with your midwife continuing to provide bedside support. If things settle, your certified nurse midwife can resume the lead role.
Why choose HCH’s midwife-led hospital care
At Henry Community Health, you don’t have to choose between safety and support. Honig, our certified nurse-midwife, works side by side with the rest of the OB/GYN providers during labor and delivery.
Baby-Friendly Hospital practices—such as immediate skin-to-skin contact, assistance with the first feed, and rooming-in—are built into our routine, ensuring that bonding and breastfeeding get off to a strong star
Here, your plan stays personal, your options are explained in plain language, and your maternity care team moves with you from labor through postpartum.
Interested in midwife-led care for a hospital birth?
For questions or to schedule a prenatal visit with Henry Community Health’s maternity care team, please call HCH at 765-521-1217.
Last updated: October 2025.
OB/GYN medical reviewers: Chris Carls, DO; Chrissy Honig, CNM.
Additional sources: American College of Obstetricians and Gynecologists (ACOG); Centers for Disease Control and Prevention (CDC); Baby-Friendly USA.