A Doctor vs Midwife. Which is Best for Your Pregnancy?
Whatever stage you are in your pregnancy, choosing the right health care provider is an important decision. Through your pregnancy to delivery and beyond, you want the best care for both you and your baby. Many women choose an obstetrician, though a growing number are opting for a midwife. How do you know which to choose? We’ll examine the difference between a doctor vs midwife.
As soon as you know you’re pregnant, you’ll want to start looking for someone to care for you and your growing baby. It is one of the most important decisions you will make during this time. You have three major options: an obstetrician, a family doctor, or a midwife. They each have different training, skills, and outlooks on pregnancy. Which one you choose depends on the type of experience you want to have. You’ll also have to consider where you want to give birth, what your insurance will cover, and whether or not you are at risk for any complications. Knowing the difference between an obstetrician/gynecologist (OBGYN) and a midwife can help you make the choice that’s right for you.
The Good Doctor
OBGYNs and family physicians are both medical professionals who have graduated from an accredited medical school. The main difference between the two is in their specialty. According to the National Library of Medicine, family physicians have studied family practice medicine. They are experienced with primary, maternal, and pediatric care. They can treat a variety of illnesses and can treat men and women of all ages. The level of care they can provide for pregnant women varies based on their training, experience, and preference. Some will only offer prenatal care, while others can will care for you during your pregnancy and delivery. Family physicians can also help care for your baby after delivery.
An obstetrician is specialized in pregnancy, delivery, and post-childbirth care. Gynecologists specialize in disorders and diseases of the female reproductive system. Typically, doctors complete the training for both fields at the same time. OBGYNs provide women with medical and surgical help for a wide range of pregnancy and reproductive care. They’re trained to be able to deal with any complications that arise during pregnancy and delivery. During delivery, they are able to administer medication, such as epidurals. They can also perform caesarians and routinely use constant electronic fetal monitoring.
Finding an OBGYN doesn’t have to be an arduous task. If you have a friend or family member who has recently given birth, ask her for a recommendation. Alternately you can also speak to your current healthcare provider for a referral. You could also visit the American College of Obstetricians and Gynegologists’ website and search for a doctor in your area. Obstetricians and family physicians are excellent choices as health care providers for any of your pregnancy needs. But they are not your only option.
Midwives as health care providers for pregnant women date back millennia. For much of history, midwives received very little formal training, learning mainly from other such women within the community. It wasn’t until the mid-1500’s that the first formalized licensing and regulating of midwives began in Paris. The practice didn’t take off in England until the early 1900’s. Like their English counterparts, many early American midwives received little formal training and weren’t educated in scientific advances in fighting infection, according to Kids Health.
Doctors began campaigning against midwives and the rate of midwife-attended births dropped. Eventually, this led to the establishment of a certified nursing-midwifery school in 1932. The goal of the school was to train them in the necessary medical knowledge, as well as the more traditional attitudes and approaches to pregnancy. Today, more than 90% of women continue to choose an OBGYN. However, according to a June 2015 report released by the ACNM, midwives attended a total of 8.2% of all U.S. births in 2013. This number has risen nearly every year since 1989.
There are different kinds of midwives and their legality is usually based on their level of training and certification. Direct-entry midwives aren’t certified nurses and are independent practitioners. Some are certified by the North American Registry of Midwives (NARM), but others aren’t. Those who aren’t certified may not be legally allowed to practice in some states. Because they have no formalized medical training, it is best to seek out a direct-entry midwife only if you are set on a home birth and have very low risk for complications.
Certified midwives (CM) have passed exams and received their certification, but aren’t nurses. Only some states recognize their certification as qualification enough for licensing. Certified professional midwives (CPN) are certified by NARM. CPNs are only legally recognized by some states, so take that into consideration when choosing one.
The most highly trained and widely licensed midwives are certified nursing-midwives, or CNMs. CNMs are qualified nurses in addition to their training as midwives. According to the National Library of Medicine, CNMs must complete the minimum of a bachelor’s degree in nursing, a master’s degree in midwifery, and receive certification from ACNM. They typically work in hospitals, often alongside obstetricians, or in birthing centers. Regardless of training level, midwives are restricted from administering pain medications or performing caesarians.
Making the Choice
Now that you know a bit more about your available choices, it comes down to choosing which one is right for you. There are a few additional things you should consider before making a decision or finding a new doctor. All of them can affect your choice in fairly significant ways, so consider them carefully.
- Do you already see a practitioner with whom you are comfortable? If you already have a good rapport with a health care provider, it is ok to stay with him or her. You should consider changing if you have doubts or concerns about your practitioner or their hospital. If you’re curious about OBGYNs or CNMs in your area, it is a good idea to check around.
- Do you have any medical conditions or are you at risk of complications? As much as you might want a natural birth, sometimes they just aren’t feasible. Midwives are great for women who are at low risk, but they will refer you to an OBGYNs if there are any complications. However, since many CNMs work in tandem with OBGYNs, it is possible to have both seeing you through your pregnancy.
- Do you want a more individualized, holistic approach? If this is the case, then a midwife is probably a better option for you. They view pregnancy as a natural process and typically use fewer interventions when it comes to birth. In fact, many studies have shown that midwife-attended births have excellent outcomes for both mother and child.
- What sort of setting do you want for your pregnancy? Doctors and some CNMs work in hospitals, so they have access to appropriate tools if a problem arises. However, there are also birthing centers, which are usually staffed by CNMs. They tend to focus on fostering a supportive environment conducive to intervention and problem-free natural births. You can, of course, give birth in the comfort of your own home, you’re looking at a CNM or direct-entry midwife.
There are, of course, a myriad of other factors to consider, as well. Don’t be afraid to explore your options before making your final decision. You’ll feel more secure if you do a bit of research. Ultimately, this choice is about what fits you and your baby the best.
Have you considered or used a midwife during your pregnancy? Share your thoughts with us in the comments below.