How to Choose between an OB/GYN, a Midwife and/or a Doula

Intended parents may get worried when their surrogate mother tells them that she wants a midwife and/or a doula. But, are their concerns well-founded?


To try to answer this question, let’s start by understanding who a midwife, a doula, and an obstetrician are.

What is a Midwife?

A midwife is a trained health professional who supports healthy women during labor, delivery and the postpartum period. Midwives can deliver babies at birth centers or at home, and most of them can also deliver babies at a hospital.

Midwives may have different levels of training, the most common ones are:

    • Certified nurse-midwife (CNM): a nursing professional who is trained in midwifery or
    • Certified midwife (CM): a non-nursing professional who is trained in midwifery. Please note that not all the US states and Canadian provinces allow CMs to practice.

What is a Doula?

A doula is a trained professional who offers physical, emotional and educational support to mothers before, during and after delivery. However, doulas are not midwives because they are not maternity care providers.

What is an Obstetrician?

An Obstetrician-gynecologist or OB/GYN is a doctor who specializes in pregnancy, childbirth, and disorders of the woman’s reproductive system. Obstetricians are trained to manage and treat pregnancy complications. They work at hospitals and must work within their hospital’s policies.

What is the Difference between a Midwife and an OB/GYN?

An OB/GYN is a doctor who completed, in general, four years of medical school and specializes in obstetrics and gynecology. OB/GYNs always work at hospitals and they can do surgery.

A midwife is not a doctor, but someone who successfully completes a graduate program in midwifery. The most common type of midwife is the Certified Nurse Midwife. They are registered nurses who have graduated from an accredited midwifery education.

Certified Nurse Midwives can practice at hospitals, birth centers and also do home births, but they cannot perform surgery; if a problem arises, an on-call OB/GYN would do surgery.

midwife surrogacy infographic

What is the Difference between a Midwife and a Doula?

The main difference between the two is that midwives provide medical care and monitor the pregnancy, birth, and postpartum, while doulas just offer emotional and informational support like a birthing coach during the pregnancy, birth and shortly after the postpartum. A doula cannot replace your OBGYN or midwife.

Midwives and doulas can work in hospitals, birth centers, and home settings.

doula surrogacy infographic

Is There any Risk of Having a Midwife or Doula?

Obstetricians are the most common choice in the U.S. and Canada. However, many surrogate mothers would rather choose a midwife as their care provider, because of the specialized treatment and care they receive from them, while intended parents would rather have an obstetrician due to their experience and expertise.

When using a midwife, if any complication arises at any point in the pregnancy, labor, birth or postpartum, midwives will consult with specialists and if needed, will transfer the care to a physician.

On the other hand, if you choose to work with a doula, it is important that you also receive medical care during your pregnancy, labor and birth from either an OB/GYN or a midwife, because doulas don’t provide medical support.

Should you Choose an OB/GYN or a Midwife?

Midwives are not allowed to attend to high-risk pregnancies, as OBGYN doctors are.

A midwife is a good option if you are looking to have a more natural childbirth experience in a birth center instead of a hospital.

You could choose a midwife if:

    • You are looking for a natural birth;
    • You want to give birth somewhere other than a hospital;
    • You have a healthy and low-risk pregnancy.

An OB/GYN is a good option if you plan to have an epidural and prefer to deliver at a hospital.

You should choose an OB/GYN if:

    • You have a high-risk pregnancy;
    • You want a doctor to attend to you during your labor and birth.

Note: You can choose between having an OB/GYN or a midwife, although sometimes it is possible to have both.

Final Thoughts

When pursuing a surrogacy process, both intended parents and surrogate mother need to feel comfortable and confident with the professional they choose to assist them with the birth, either an OB/GYN or midwife. So, trust your instincts. If it doesn’t feel right, try to ask your surrogate to find someone else, even if the professional is highly recommended.

It is very important to stay on top of the communication and irrespective of whether your surrogate chooses an OB/GYN, a midwife or a doula, make sure that you set your expectations with that person. The professional should also feel comfortable working with heterosexual, same-sex or single parents (depending on your situation) and surrogacy. It is better to explain the situation to the professional to avoid unpleasant surprises when pregnancy is advanced.

Also, it is important for them to understand that the intended parents are the parents and that they should be the ones making the decisions with regards to the baby, and the ones receiving the communication about the health of their baby.

If you are looking for a midwife or a doula for your surrogacy journey, you can get helpful info in the following resources.

Learn more about how to become a surrogate mother

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Written by Carrie
Registered nurse (RN). My passion for surrogacy began back in 2011 when I felt a strong desire to carry a baby for someone who otherwise wouldn’t achieve their dream of becoming parents
1 Comment
  1. Congratulations!! I loved reading your blog. I’m considering my second surrogacy journey and it is really useful to read about how to choose between a OB and midwife form a surrogacy point of view.

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