Whom to Choose: Ob-Gyn or Midwife?


Pregnancy is a time in a woman’s life when her body undergoes a large number of hormonal, physical and psychological changes. Choosing the right care provider during pregnancy makes the journey happy and easily manageable. Apart from the personal care of eating right, not drinking or smoking, resting enough, doing light exercises and keeping your body and mind stress free, professional medical care is required during the entire term of pregnancy.

Whether you choose an ob-gyn or a midwife depends on the kind of birth plan you want to experience. It would also depend on your health history, whether you want to deliver at a hospital or at home, whether you want a caesarean or a normal delivery, whether your pregnancy is normal or high risk and what your health insurance plan covers.

Should I Use a Midwife or Ob-Gyn?


What are the Primary Differences Between Ob-Gyn and Midwife?

An Obstetrician-gynecologist or more commonly known as OB-GYN is a medical doctor who is specialized training to deal with medical and surgical care issues of women. OB/GYNs spend four years after medical school in a medical residency where they observe and practice operations and care related to pregnancy, reproduction, and female physical problems. Ob-gyns are certified by the American Board of Obstetrics and Gynecology.
Obstetricians mainly provide help related to pregnancy delivery and complications, whereas gynecologists deal with broader problems of the female reproductive system.

The majority of midwives earn bachelor’s degrees, then work as registered nurses, gain some experience by working as a registered nurse in a hospital and go back to school for a two- or three-year master’s degree program in midwifery. Certified midwives earn their professional degree and certification from the American College of Nurse-Midwives (ACNM). Certified nurse midwives can prescribe most drugs depending upon the state laws, and they can prescribe pain medication. However they cannot perform any sort of surgeries legally. They can use limited technology, like a fetal monitor.

Ob-gyns are specifically trained to conduct high risk pregnancies and use epidural anesthesia, vacuums and forceps to facilitate pregnancy but midwives cannot do that legally. Midwives can only assist during a C-section but they cannot directly intervene. A 2017 study published in the American Journal of Public Health made a comparison between the two groups of women with low-risk pregnancies. The researchers found that midwives intervened 12.2 percent less than the physicians. The study also found that if women consulted midwives during their pregnancy term and not gynecologists then they had a 4.8% less chance of choosing a C-section delivery.


When Should You Choose an Ob-Gyn?

You should choose an ob-gyn if you have a high risk pregnancy due to your health history (diabetes, heart problems, blood pressure), advanced age or the nature of your pregnancy. If you have had complications with your previous pregnancy or if you have had miscarriages, it is best to choose ob-gyn over a certified nurse midwife. If you are carrying multiple babies, like twins or triplets, it is best to use ob-gyn. Keep in mind the fact that Ob-gyns offer highly specific, specialized, technology oriented medical care and are licensed to operate in case of emergencies.

Ob-gyns can perform natural and surgical deliveries. The same advantages are not available if you choose a nurse midwife as they are not allowed to perform surgeries. If you choose to deliver at home, a midwife cannot assist you with an epidural but only with natural pain relief techniques like changing the position and breathing better. However in a hospital both nurse midwives and ob-gyns can provide pain medication. If you want a cesarean birth, or a birth that may require pain medication, choose an ob-gyn. 8 out of 10 women in the US choose ob-gyn, according to The American College of Obstetricians and Gynecologists.

When Should You Choose a Midwife?

If you are dealing with a low risk pregnancy and your health conditions do not indicate complications, it is a good idea to choose a midwife. If you choose a natural delivery of a single child, midwife is the way to go. Remember that midwives and ob-gyns perform the same prenatal care. They test the weight, urine, measure the belly and check for fetal heartbeat. Both perform medical ultrasonography to show the image of the baby in the mother’s womb. A midwife focuses more on the emotional and physical experience of childbirth. They can spend more one on one time with their patients whereas ob-gyns, in order to get through all of their appointments efficiently, allot specific time limits for each patient.

If you want a natural birth experience at home among your loved ones, then a midwife would be a better option. They will assist you the whole day of the birth, and provide mental and medical support. 10% of all childbirth is assisted by midwives, according to American College of Nurse-Midwives.

Do You Already Consult a Practitioner You are Comfortable with?

If you are already in touch with a medical practitioner, it is best to consult them for advice. If they are certified ob-gyns or midwives then they can be the person to assist you throughout your pregnancy. Given the fact that they have complete and comprehensive knowledge of your medical background, they will be able to provide sound medical advice on this issue.

If you are still confused, do not worry. This is an important and challenging decision in your life and it is natural to feel apprehensive and second guess yourself. Talk to your partner; consult your friends who have just given birth, meet medical practitioners with experience who can provide you the answer to all your queries. Lastly, listen to your instinct and trust your mind and body. Choose the delivery method that you feel comfortable and safe after assessment of your physical and mental condition.