Using a midwife in the US is considered extreme or weird. Really only used by people classified as hippies. (Not how I feel, but that is the general vibe I get. Even poor people use hospitals - the people you think midwife's might be useful for. Not many home births going on here...)
That explains a lot. In the UK the term midwife is more or less synonymous with obstetric-specialist nurse. The term for a tie-dyed woman who comes into your home and burns incense to help you through delivery in a birthing pool is a 'doula'.
actual doulas may not wear tye dye or burn incense and I'm sure many provide an excellent service to facilitate some mothers through the childbirth process. Every labor is different. They may also be qualified midwives. And many midwives will also facilitate home births where appropriate for the mother and child. Basically, the US hospital and OB doctor-centric system is ... weird.
