What is the Difference Between a Midwife, a Doula and a Birthkeeper.
A midwife is a registered medical professional who monitors the wellbeing of women, birthing people and their babies during pregnancy, birth and postpartum. A doula is a non medical support who offers education and advocacy for those usually engaging with the medical system. And a birthkeeper is a non medical, holistic support, who often works with those choosing a ‘wild pregnancy’ or freebirth. Both doula and birthkeeper are unregulated roles, may or may not have undergone training and by law are not allowed to monitor, advise or provide clinical care in pregnancy and birth.
Let’s break down each one.
Midwife: A Registered Medical Professional
In the UK, a midwife is a registered clinical professional. They’ve completed a degree-level qualification (usually 3 years full time), trained within the medical system, and are regulated by the Nursing and Midwifery Council (NMC).
Their role includes:
Antenatal monitoring and medical screening
Referrals to obstetricians
Diagnosing and managing complications
Catching babies, suturing, administering medications
Attending births both in hospital and at home
Midwifery is a protected legal function in the UK. It is a criminal offence to:
Attend a woman or birthing person in labour in place of a midwife unless in an emergency
Falsely claim to be a midwife or use the title without being on the register
Midwives are trained and employed within the system. Their work is essential, but their hands are often tied by guidelines, protocols, and NHS policies. Their role is shaped by risk management, liability, and institutional procedures.
Doula: Emotional, Practical, and Advocacy Support
A doula is a non-medical birth supporter. Their role is rooted in emotional support, advocacy, and continuity of care. Most doulas offer informational birth preparation sessions during pregnancy and support during labour and postnatal support is a big part of the doula’s role. Their role in providing information and advocacy for clients navigating a medicalised risk based maternity system can change outcomes.
Research shows that doulas can:
Reduce the need for caesarean and instrumental births
Improve breastfeeding outcomes
Increase satisfaction with the birth experience
The role of the doula historically has been about supporting all clients, regardless of choice of place of birth, being non judgemental and available to all. And I feel this is where the use of the word birthkeeper has come into play - alongwith a rejection of the roots of the word ‘doula’ meaning slave, birth workers are seeking an alternative name that speaks to their calling.
Birthkeeper: Reclaiming Traditional, Autonomous Birth Support
The word birthkeeper was coined by Jeannine Parvati Baker — combining the terms Earthkeeper and Birthworker. The birthkeeper movement is grounded in a desire to step outside of the medicalised system and return to trusting birth, women, and physiological processes.
A birthkeeper might look like a doula — but often works with a deeper emphasis on:
Autonomy
Relationship-based care
Intuition and inner knowing
Decolonising birth
Attending births outside the system, including freebirth
For many birthkeepers the work is not about simply navigating the system — it’s about honouring the choice to opt out and walking alongside those who are choosing a self-directed path through pregnancy and birth.
We are not midwives. We do not take clinical responsibility or perform medical tasks. We walk beside our clients as wise companions — sharing knowledge, offering tools, building confidence, and helping people reconnect with the innate intelligence of their body and baby.
Where Does the Law Stand ?
This is where things get serious — and important to understand clearly.
In the UK:
Midwifery is regulated by law
Doulas and birthkeepers are not regulated
It is legal to support someone through pregnancy and birth, as long as you are not acting as a midwife or pretending to be one
You can:
Share evidence-based information
Support people to make their own decisions
Offer companionship, reassurance, and holistic tools
Attend freebirths — as a companion, a ‘wise woman’ - not a clinical professional
You cannot:
Take clinical responsibility for the birth
Perform medical procedures
Make decisions for your client
Misrepresent yourself as a midwife
The safest — and most powerful — approach is to be clear, honest, and boundaried about your role. Clients need to know what you do (and what you don’t do), and you need to protect yourself by staying within the law.
Why Birthkeeping?
So do I use the term birthkeeper or doula?
Both. Doula is still by far the most recognisable term for a non medical support person during pregnancy and birth. And because the term birthkeeper has been taken by some people to infer a role that blurs the boundaries as a non registered or lay midwife. For me it’s about:
Holding a deeply trusting space
Walking with women and birthing people through the whole journey of pregnancy
Supporting physiological, undisturbed birth - with this we don’t need more interfering non medical ‘midwives’ - we need wise presence and intelligent tea drinking.
Reclaiming holistic prenatal support
Sharing practical skills like belly mapping and palpation for connection
Attending to the emotional, physical, and spiritual journey of pregnancy and birth
A birthkeeper is:
A witness and a ‘wise woman’
A calm, grounded presence
An extra pair of hands who knows birth
Someone who has studied, sat at the feet of women and birthing people, and continually learns from them
We don’t diagnose. We don’t rescue. We walk beside.
What Should You Call Yourself?
The language you use matters — to clients, to your legal protection, and to your wider message.
Some people still use the word doula, as it’s better known to the public. Others feel the word birthkeeper better reflects a deeper, more autonomous style of support — especially for homebirths, wild pregnancies, or freebirth.
You can decide based on who you are and how you work. But know this: the title is less important than your clarity, integrity, and alignment.
For Students & Aspiring Birthkeepers
If you’re exploring this path, it’s vital to know where you stand — legally, ethically, and personally. Being a birthkeeper is not a loophole or a title swap. It’s a way of being, a calling, and a responsibility.
Be clear. Be honest. Keep learning. Walk with love.
