What would be better – a private midwife or a doula?

What would be better – a private midwife or a doula? Understanding the difference and making the right choice for your birth.

When preparing for birth, many women explore ways to build a supportive care team that aligns with their values, needs, and birth preferences. A common question that often arises is:

“Should I hire a private midwife or a doula?”

The answer isn’t straightforward because these two roles are not interchangeable. In fact, they serve very different purposes – both incredibly valuable in their own right. So rather than asking, “which is better”, it’s more helpful to ask: “what kind of support do I need most?”

Let’s unpack the differences, explore the benefits, and help you decide what might work best for you – especially if finances are a factor.

Private midwife vs doula: what’s the difference?

A private midwife is a fully qualified health professional who provides clinical care throughout pregnancy, birth, and the postnatal period. This includes conducting antenatal checks, monitoring the baby’s wellbeing, attending the birth as your primary care provider, managing emergencies, and offering medical advice or interventions if needed. In Australia, many private midwives have admitting rights to some hospitals and if they are endorsed, this means they can provide Medicare rebates, prescribe medications, and order tests and ultrasounds.

A doula, on the other hand, is a non-clinical birth support professional. A doula offers emotional support, physical comfort measures, education, and advocacy throughout pregnancy, birth, and postpartum. They do not perform medical tasks or offer clinical advice – but their presence has been shown to significantly reduce birth interventions, increase birth satisfaction, and help women feel more supported, heard, and respected.

In simple terms:

Midwife = medical care provider

Doula = continuous emotional and physical support

Benefits of hiring a private midwife

Choosing a private midwife often means you are receiving continuity of care – the same care provider throughout your entire pregnancy, birth, and postnatal journey. This has been consistently linked to better outcomes, such as:

Lower rates of induction, caesarean, and instrumental births

Higher rates of physiological birth and breastfeeding

Improved maternal satisfaction and emotional wellbeing

A deeper sense of trust and familiarity with your care provider

Private midwives also:

Attend your birth at home (if planning a homebirth), and some have admitting rights at certain hospitals

Offer longer, more personalised appointments

Can often be contacted directly when you have concerns, rather than going through the hospital system

Benefits of hiring a doula

A doula is dedicated solely to you and your emotional and physical experience. While a midwife may be focused on clinical tasks during birth, a doula remains continuously by your side, helping you feel calm, confident, and connected.

Research shows that continuous support from a doula can:

Shorten labour duration

Reduce the need for pain medication and interventions

Lower caesarean rates

Improve outcomes for both mother and baby

Increase feelings of empowerment and satisfaction

A doula can also:

Help you prepare a birth plan

Teach comfort techniques and partner support strategies

Support your partner as well, so they can be more confident and involved

Stay with you no matter where or how you birth – including hospital settings where your midwife may not be your primary carer

What if I can’t afford both?

This is often where the decision gets tricky. In an ideal world, every woman would have access to both – a private midwife for consistent, personalised medical care, and a doula for unwavering emotional and physical support. But let’s be real: these services are an investment, and not everyone has the resources to afford both.

So here’s what to consider when weighing your options:

If you’re planning a homebirth…

A private midwife is essential. You need a trained medical professional to monitor you and your baby, ensure safety, and legally attend your birth. In this case, hiring a doula as additional support can be incredibly valuable, but your midwife comes first.

If you’re birthing in hospital…

You may already be receiving clinical care through the hospital system, whether public or private. But this often means you’ll see different midwives during your pregnancy and won’t know who will be at your birth. A doula can bridge this gap by being the one constant person on your team, supporting you emotionally and helping you navigate hospital protocols.

If you have limited financial resources…

Consider what kind of support will make the biggest difference to your experience:

Do you want medical continuity and personalised clinical care?

Or do you feel confident in the hospital’s medical team but want someone by your side who’s focused entirely on you and your choices?

Some doulas offer payment plans or reduced rates depending on circumstances, and some private midwives offer shared care options to reduce costs.

The bottom line: it’s not about better – it’s about different.

There should be no rivalry between private midwives and doulas. They should work beautifully together, complementing one another with their unique skill sets.

A private midwife will monitor your health and your baby’s health and provide evidence-based medical care.

A doula will walk beside you, helping you feel safe, heard, supported, and emotionally prepared for birth.

They’re not either / or. They’re both / and…..

But if you’re only able to choose one, take some time to reflect on what you need most – and what will give you the greatest sense of confidence, comfort, and support during your pregnancy and birth.

What’s the cost difference between a private midwife and a doula?

When finances are part of the decision-making process (and let’s face it, they usually are), it helps to have a general idea of what each option might cost.

Here’s a rough guide to the price range in Australia, though fees may vary depending on location, experience, qualifications, and what’s included in the service:

Private midwife costs

Full continuity of care (antenatal, labour, birth, and postnatal care):

Typically $5,500 – $8,000
May include Medicare rebates if the midwife is endorsed
Covers prenatal appointments, birth attendance (home or hospital if they have admitting rights), and postnatal visits
Includes medical equipment, birth pool hire (sometimes) and 24/7 on-call support

Some private midwives may also offer payment plans and shared care options that are more affordable.

Doula costs

Birth support package (prenatal visits, birth attendance, and postnatal follow-up):

Usually $1,200 – $2,500
Student doulas may offer heavily discounted rates – but please don’t expect a free service – that would be very unfair
Some experienced doulas may charge more, especially if they offer specialised support (e.g. VBAC, trauma-informed care)

Postnatal doula (ongoing in-home support):

Generally $60 – $120 per hour depending on experience and services offered

Many doulas offer payment plans, discounts for low-income families, or reduced rates for repeat clients.

Doulas don’t come with degrees or titles — doulas come with presence. A doula meets a woman and her partner in the rawness of birth, steady and grounded, holding space for whatever unfolds.

Final thoughts

Choosing between a private midwife and a doula doesn’t have to be about which one is better – it’s about choosing what’s right for you.

Ask yourself:

What kind of birth do I visualise having?

What do I want to feel during my labour and birth?

Where do I feel least supported in the current system?

Who will help me feel seen, respected, and safe?

You deserve to feel supported, cared for, and informed – no matter where or how you birth.

And if you can build a team that includes both a private midwife and a doula?

Even better.

All the best for your preparation for birth and an incredible postpartum journey.

You only get one chance to birth this baby – make it count. Choose the kind of support that honours you, uplifts you, and helps you walk away feeling strong, respected, and heard.