This is a question that I get a lot!
First of all when you are deciding who should provide your prenatal care there are typically three different types of people who are granted privileges at local hospitals to 'catch' your baby.These are obstetrician, a general practitioner or a midwife. Depending on your needs and desires one of these may be more desirable than another so please ask your doula to help you sort through these options!
The biggest difference between a midwife and a doula is their scope of practice. Your midwife is your primary health care provider. You will see her in the same way you would see your doctor throughout your pregnancy. You will see her in her office, monthly, then biweekly and eventually weekly for your prenatal appointments. Her care is typically focused on the health of the pregnant woman and her baby.
A doula is typically a much more intimate role. This is someone you invite into your home and get to know on a very personal level. While your appointment with your healthcare provider typically lasts less than 15 minutes, our visits typically last a couple of hours. By the time your birthing day comes, many women consider their doula one of their most trusted companions.
Birth doulas and midwives have similar but different roles and priorities
While in the care of a midwife, a woman will receive much more highly individualized care and support than they will with most any other type of provider. The midwife however has specific duties to attend to. Additionally, midwives often have more than one woman in labor at once, in which case, you typically do not have the continuous presence of your midwife. A midwife's job is the clinical management of labor and delivery. Her top priority is to the health of both the mother and the baby. She will perform vaginal exams, monitor fetal heart tones, and assess contraction patterns. She will regularly check a mother's blood pressure and temperature and she will keep an extensive record of all the medical information related to a labor. At delivery, a midwife will help a mother birth her baby, catch the baby, and assess if the newborn needs any resuscitation. After the delivery, the midwife will need to tend to the delivery of your placenta and examine it. She will check the mother for any damage to the birth canal and perineum, and stitch any tears that might have happened at birth.
The birth doula's job is to help the mother in any non-medical way that she desires
She works for the mother and her partner, and not for the midwife, physician, or the hospital. She will be available from fairly early in labor to be with the mother and her partner, if they desire it. As labor progresses, her role shifts. She may begin by answering general 'is this labor?' questions, giving suggestions on positions and techniques to get baby in optimal positioning to encourage labor patterns, helping the mother to be more comfortable, fetching supplies or helping with siblings. As labor becomes more challenging, a birth doula begins to offer the mother and her partner more hands-on support through massage, position changes, verbal support, relaxation exercises, and suggestions for effective movement during contractions. She can help a mother with verbal and emotional support during labor and help a partner find effective ways to help the mother. She will never, ever give up in her belief in the mother and her abilities. She will be available in the first few hours after the birth to make sure the mother is comfortable, the couple is fed and refreshed, and will help with breastfeeding as needed.
Midwives and doulas make a wonderful team!
Primarily, the midwife's responsibility peaks at the time of the birth, which is when she must be at her most alert to perform her job effectively. This means that she must conserve her energy throughout your labor to perform her job as best she can. This does not mean that midwives do not provide labor support--they do--just that they have many other responsibilities that must take precedence. In contrast, a doula's responsibility peaks during active labor and transition, when the laboring woman needs the most help coping with her contractions.
When midwives are attending to clinical matters, birth doulas are focusing on the mother and helping her get through her contractions. Where the midwife's first priority is the safe delivery of mother and baby, the doula's first priority is the mother's mental well-being, and the support of the growing family as a unit.
With help from http://www.birthblessingsdoula.com/