Doc, midwife, or doula?


You know which friends and family will be at the birth—but have you considered which experts you want there? The journey of labor and delivery isn’t a solo trip. Besides your family and partner, a whole team of supporters can guide you through. We checked in with Marisa Cohen, author of Deliver This: Make the Childbirth Choice That’s Right For You, to help you decide the right additions to your crew.


What they do: Doctors are called when it comes time for delivery. They’re also the only care providers who can perform a surgical birth.

Pros: Have the skills and authority to handle any serious problems, including performing a C-section if needed. For high-risk pregnancies, delivering with a doctor provides better access to emergency services.

Cons: No guarantee your doctor will be available when you go into labor. Some practices are actually set up so you get whomever happens to be on the schedule when your time comes.

Costs: With insurance, out-of-pocket costs can range from $500 to $3,000.

Who should use them: Women who want the option of painkillers during labor and women with high-risk pregnancies.

Did you know? Doctors only check on you once in a while during labor. The rest of the time, you’re under the care of nurses.


What they do: Certified Nurse Midwives (CNMs) are registered nurses and midwives; they provide full prenatal and postpartum care. Some think midwives are involved only in home births, but CNMs work in hospitals, birth centers, and at home.

Pros: Cheaper than doctors and more willing to try for a birth that is drug and intervention-free. They typically offer a very personal experience. The women Cohen interviewed told her that at their midwife appointments they “felt more like a person.”

Cons: May not be an option in every hospital and may be hard to find outside of a hospital. Often only permitted to attend low-risk births.

Costs: Anywhere from 33% to 66% less than birthing with an ob/gyn.

Who should use them: Women who would prefer to avoid a C-section, who want to be more involved in the birthing process, or who would like to have a drug-free delivery.

Did you know? Legal and financial concerns are forcing more medical centers to restrict the use of midwives. The number of birth centers is dwindling, too.


What they do: “Very few people know what a doula is, or assume it’s all burning incense and chanting,” Cohen says. “It’s not.” Doulas care for women (and their partners) both physically and emotionally (but not medically) during labor, birth, and the postpartum period.

Pros: A doula’s job is to support the mother and no one else. Studies have shown that women who use doulas are more likely to have shorter labors with fewer complications, are more successful with breastfeeding, and are less likely to suffer from postpartum depression.

Cons: Doulas’ roles are not always understood—by doctors, nurses, even spouses. It can be a challenge to find the right fit, so interviewing is important, especially to find one who “plays well with others” in the delivery room.

Costs: $500 to $2,000, depending on location. If you’re OK with a doula in training, you can get services at a lower cost.

Who should use them: Women who want to feel nurtured during labor and delivery, or who want an experienced person to advocate for them.

Did you know? “Men can feel useless or helpless during labor,” Cohen says. “A good doula knows how to make the dad feel like he’s part of it.”

— Sandra Hume would so hire a doula if she were to try for a third child. She also writes for Parenting.

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