Certified nurse midwives offer the same non-surgical obstetric care as obstetricians. A midwife acts as your coach and guide from the early stages of your pregnancy all the way through delivery. If you are hoping for a drug-free pregnancy and are not at high-risk, a midwife may be a good choice for you.
While midwives attend births mostly in hospitals, you can have a midwife with you in whatever setting you choose and, with her as your advocate, you are less likely to have a C-section, episiotomy, or epidural. Even if you have a midwife within a hospital setting, it can feel much more personal. If labor and delivery are going well, you will likely be with the midwife almost exclusively throughout your birthing experience. If the midwife has been your primary caregiver throughout your pregnancy, it can be comforting to have her with you at delivery.
Select your midwife with the same consideration you'd give to choosing a doctor. Ask her about her experience, if she is in a group practice, the obstetricians and hospitals with whom she's affiliated, and lastly, determine whether you are comfortable with her.
A doula is a private labor coach, often certified as a childbirth assistant. Unlike an obstetrician or midwife, a doula does not provide services during pregnancy but rather focuses specifically on labor and delivery. While she doesn't offer medical advice or deliver the baby, a doula can be a tremendous support—both emotionally and physically—to the laboring mother and the expectant father.
Choose What's Right for You
You may opt to use the "Chinese menu" approach to your decision, where you mix and match the above options. For example, you can opt for a home birth with a doula, a home birth with a midwife, a water birth at home with a doula or midwife attending, a hospital birth with an OB and doula, a birthing center delivery with or without a doula, and so on.
What's most important is that you find the solution that feels right for you. Everyone will have an opinion and advice about what you should do. Listen to what your friends, colleagues, and caregivers have to say, and then make your own decision based on what's best for you and your baby-to-be. And, when choosing home births, they should be done with at least a midwife and not just a doula.