A midwife is responsible for the health and safety of the mother and baby. It is up to her to assess conditions through observation and the taking of vital signs and determine if all is proceeding normally or not. If the birth proceeds normally, she can usually be the one to 'catch' the baby. If she determines that all is not proceeding normally, she may have to turn the care of mother and baby over to a doctor who will then probably be the one to deliver the baby.

In addition to performing such clinical duties, many midwives offer emotional and physical support to help keep the laboring woman comfortable and calm, hence significantly increasing the chances that the situation does stay healthy and normal.

When push comes to shove, however, the midwife's primary role is clinical, and if she has other clients in labor or if she is deeply involved in the actual act of catching your baby, she may not be able to fully support you emotionally and most likely will not be able to help hold you up physically.

Such emotional and physical support is a doula's primary role. She is devoted entirely to the emotional care and physical comfort of the laboring woman (and sometimes her family), but she is not responsible for any clinical duties. Some doulas are also nurses and may possess certain skills such as the ability to check dilation or take fetal heart tones, but if they employ these skills while helping at a labor, then they are truly functioning as a Monatrice, not a doula and should identify themselves as such.

A true doula does not use clinical skills, nor does she make decisions about her client's healthcare. When she does offer assessment, it is usually based upon her observation of her client's emotional progress combined with physical signs that can be seen without doing an exam – signs such as close contractions, bloody show or nausea. Laboring women can use the assessment the doula provides to decide if it's time to go to the hospital or call in their midwife if it is a home birth, but the doula does not make the decision.

As for doulas catching babies, I'm sure it has happened on occasion, however I cannot imagine it was planned. Like most doulas, I do not possess the skills to be a primary birth attendant and when I attend labors, I do not carry oxygen or suction. And while I believe that in most cases, that if the woman experiences no interventions, the baby will come out just fine, I'd hate to catch one who did not.

Even when using a doula, it is always best to arrive at the hospital or have your midwife arrive at your home, before the baby comes out. Then both you and your baby can benefit fully from the distinct advantages of both types of care.

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