I think we can all agree that we don’t want just anyone caring for our unborn child or being “up in our business.” Finding the perfect care provider to help you have your perfect birth experience can often be really stressful. Thankfully, women are given many more options than they were even just 10 years ago. But sometimes, more options can cause even more problems! The first step though is deciding which care provider you want: a midwife or a doctor.
Basic Differences Between Midwives and Doctors
An OB/GYN (obstetrician and gynecologist) specializes in all women’s related healthcare. Obstetrician means that they care for pregnant women and the challenges that can arise related to pregnancy. Gynecologist means basic women’s health (i.e. pap smears, yearly exams, etc.). OB/GYNs get a bachelor’s degree (4 years), go to medical school (4 years), and then residency (usually 4 years). They can perform c-sections, take care of multiples (twins, triplets, etc.), handle 3rd and 4th degree tears, manage high risk pregnancies, and of course, do all normal pregnancy care.
There is quite a range with a midwife’s education. If a midwife is a CNM (certified nurse midwife) they have received a bachelor’s degree in nursing and then they went on to get a master’s specializing in midwifery. Many have also received a doctorate in midwifery.
But if they are a CPM (certified professional midwife) they usually went to school at a certain midwifery college and/or did a lot of work through apprenticeships. After schooling, every state has different licensing laws and requirements in order to practice.
CNMs are almost always universally accepted to practice in or out of hospitals. CPMs on the other hand, are unable to practice in a hospital, but depending on the licensing laws, can either do home births, birth center births, or both. Midwives also typically only care for healthy, not high-risk women. They also typically don’t manage multiples.
Don’t doctors know more?
Yes and no. Doctors typically have many more years of education, and are also able to take more complex cases, but that does not make a midwife unqualified. Midwives specialize in normal pregnancy and birth. If you are a woman who is healthy, with no pre-existing conditions, and with no complications throughout your pregnancy, a midwife, either CNM or CPM, is more than qualified to care for you.
If you are someone with a typical pregnancy (and most women are) then it comes down to personal preference, but here are some questions that you can ask yourself to better make a decision:
1. Are you someone who likes to make decisions for yourself or do you prefer a care provider to tell you what is best for you?
Neither is bad when it comes to being pregnant! If you trust your care provider, then there is no harm in letting him or her tell you what is best. In that case, a doctor is probably a better choice.
Midwives have a tendency of letting you choose every aspect of your care. You, as the mother, are very hands on when it comes to your prenatal care and then labor and delivery as well. Midwives like to present all options, but often won’t tell you what the “best” choice is since they understand that “best” can mean different things to different people.
2. Are you more comfortable giving birth in a hospital or would you rather have an out of hospital birth experience?
Luckily, if you want to give birth in a hospital, then you can frequently have your choice of either an OB/GYN or CNM. But if you want to have your baby out of a hospital, then only in very rare circumstances will you find a doctor willing help you with that. In that case, a midwife will probably be your best option.
3. Are you using insurance or paying out of pocket?
If you are using insurance, then you have the potential to choose either kind of care provider. Even some midwives who work out of hospital accept, and are covered by, different insurances.
However, if you don’t have insurance and plan to pay out of pocket, you may want to consider a midwife. And more importantly, an out of hospital midwife. The costs associated with a birth center or home birth tend to be much lower than those through a hospital especially a medicated birth in a hospital.
Something to consider though, is your own financial status. Both midwives and doctors (hospitals) frequently offer payment plans or financial aid, so if you are dead set on a certain type of provider, be sure to ask what is available!
4. Are you planning on having a medicated or unmedicated birth?
You can often have a midwife even if you plan on having an epidural, since CNMs can be found in or out of hospital, . Keep in mind though, if you are wanting an out of hospital birth AND an epidural, that just isn’t possible. It is an anesthesiologist who administers the epidural NOT the OB/GYN or midwife, and anesthesiologists aren’t available out of hospital.
Do you want a midwife and to be out of hospital, but you’re afraid of having a natural birth? IT IS POSSIBLE! I am someone who has the world’s lowest pain tolerance (just ask my family) but I was able to have a birth center birth naturally! There are so many techniques to help with pain relief, so don’t let that be what stops you from choosing the provider you truly want.
5. Are you more natural minded?
Now this question is tricky. There are doctors who are very natural minded and there are midwives who can be very medically minded. There isn’t just a “mold” that doctors and midwives fit in. BUT there are some generalizations that you can make and that is that midwives trend toward natural remedies and doctors don’t. There is nothing wrong with either viewpoint, you just need to know what YOU feel most comfortable with.
I have actually had the pleasure of experiencing both types of care providers. My first was with a midwife in a birthing center and the experience was PHENOMENAL. I had actually worked at that same birthing center (if you are in Utah or Salt Lake county, check out BetterBirth) before giving birth to my son. So let’s just say, I trusted those midwives with my life!
With my second, I unfortunately moved out of state and then didn’t have the same options that I had had in Utah. I eventually chose a doctor, and he was great, but after having a midwife, it was a hard transition for me.
I have definitely experienced both the pros and cons of both options, and obviously there are a lot of factors at stake when choosing a care provider. But what it comes down to is what YOU feel most comfortable with! Not your mom, not your friend, not even your partner (but take their opinion into consideration too). But if you ask yourself all of these questions, you will be able to really narrow down what you want! You will also find out what kind of care provider will be right for you throughout your pregnancy.
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