The person you choose to provide for your healthcare during your pregnancy, labor, and delivery can have a big impact on the kind of experience you have. And just as the type of experience you want to have is highly personal, so is choosing who you want to deliver your baby. In this piece, we’ll break down what an OB-GYN vs. midwife are and why OB-GYNs vs. midwife delivery rates are starting to shift and give you some resources for how to make the decision. The bottom line, though, is that you should consider what is important to you in pregnancy, labor, and birth—and who you would trust to guide you.
While OB-GYNs remain the most popular professionals delivering babies in the United States, midwives are growing in popularity. In 1989, certified nurse-midwives delivered just 3.2 percent of births in the United States. In 2013, the most recent year for which statistics are available, that number was close to 9 percent (and 12.1 percent of all vaginal births).
There are a few concrete differences between OB-GYN vs. midwife, namely, their education and training. But they’re commonly distinguished by their differing philosophies when it comes to birth.
What is an OB-GYN vs. midwife?
An OB-GYN is a doctor trained to provide medical and surgical care to women. They spend their residencies studying pregnancy, reproduction, and female medical and surgical problems. An OB-GYN will only deliver your baby in a hospital and is trained to manage and treat pregnancy complications.
There are different types of midwives, and licensing varies by state. Certified Nurse Midwives (CNMs) are registered nurses who have earned their master’s degrees in nursing, with a strong emphasis on maternity care. The different certifications makes a difference: Because CNMs are nurses, they can prescribe medication. Other midwives cannot.
Midwives work to provide individualized, family-centered obstetric care from the first prenatal visit until after the birth of your baby. They train in natural births, and they often work with a supervising OB-GYN who is available to assist should complications arise during labor or childbirth. Critically, midwives don’t handle serious complications—and their definitions of risk may differ. Some, for example, don’t handle multiple births, gestational diabetes, or attempted VBACs, while others do.
OB-GYN vs. midwives birth philosophy
OB-GYNs, as doctors, tend to approach birth as a medical process. Midwives, on the other hand, believe that birth is a natural physiological process.
There is little specific training for an OB-GYN in natural, uncomplicated birth.
Because OB-GYNs may have tight call schedules, midwives tend to be more present during labor and tend to allow more space for the labor to unfold naturally before moving to medical interventions.
Often midwives will deliver babies at hospitals, birthing centers, and family’s homes, but some midwives only deliver at hospitals, and sometimes those practices are affiliated with sister OB-GYN groups that help in the event of complications.
It’s important to note that midwives cannot perform emergency C-sections or operate if labor complications arise. They will help recommend pain medication if needed, but as is the case with OB-GYNs, pain management will be given by anesthesiologists or nurses on call.
Comparing reasons to use an OB-GYN vs. midwife
Reasons you might consider using an OB-GYN vs. midwife:
- Strongly desire to have a licensed medical doctor present at your birth
- Have a high-risk pregnancy or other health complications that you wish to be—or that have to be—closely monitored by a doctor
Reasons you might consider using a midwife vs. OB-GYN:
- Desire to have few medical interventions if possible
- Prefer a vaginal birth without the use of pain medication
- Have anxiety about birth and wish to be coached more through pregnancy and labor
- Have a low-risk pregnancy
- Wish to give birth at home or somewhere other than a hospital
No matter which type of healthcare provider you choose, you should feel comfortable asking him or her questions and should feel confident and safe as labor approaches.