A midwife is a primary care provider who offers complete prenatal, birth, and postpartum care. A doula gives physical, emotional, and informational support to families throughout the childbearing year. A monitrice combines these roles by offering the traditional support of a doula in addition to performing clinical skills (such as taking maternal blood pressure, analyzing fetal heart tones, and assessing cervical dilation) during labor.
A monitrice is often a midwife or a nurse hired to help the family labor at home as long as possible before transferring to the chosen care provider and birthplace (usually the hospital). The main difference between a midwife and a monitrice is that the monitrice is not in a position of primary responsibility for the birth (monitrices don’t catch babies except in the case of a precipitous birth).
The main doula certifying organizations (DONA, CAPPA, ALACE) have a written scope of practice that prevents the doula from performing any clinical skills while serving a family. Like a doula, a monitrice provides education to the family, assists with comfort measures during the birth, and helps with breastfeeding; however, the monitrice is also trained to provide clinical assessment of the health of mother and baby. This can be very reassuring to families (particularly first time parents and women choosing a vaginal birth after cesarean (VBAC)), and allow them to stay out of the hospital longer, thus avoiding many interventions and increasing the likelihood of a natural, vaginal birth.