Differences Between a Midwife and OB/GYN

Raleigh OB/GYN Centre recently began offering midwifery services. This service is not commonplace among most OB/GYN practices, so we wanted to highlight the key differences between a midwife and an obstetrician.

Education

Perhaps the most notable difference, midwives and OB/GYNs complete different levels of medical training. An OB/GYN completes four years of medical school followed by an additional four years of residency plus three years of specialized training. To become a certified nurse midwife (CNM), you must first become a registered nurse then complete a graduate program in midwifery and pass a national certification exam. This certification allows a CNM they are able to practice in any of the 50 states.

While both types of practitioners are trained and experienced in labor and delivery, nurse midwives cannot provide all of the services that a doctor can. In the event surgery is needed to deliver a baby, such as a cesarean section, only an obstetrician has the training to deliver the baby under those circumstances.

Services

Both a midwife and OB/GYN offer family planning, pre-conceptual care, delivery and postpartum care. Additionally, they both offer gynecological care including preventative screenings. Midwives are able to care for women during pregnancy who are considered low risk, while physicians can provide care for both low and high-risk pregnancies. Your first visit to our office will include a thorough medical history and exam to determine whether your pregnancy is considered high-risk.

While many midwives are advocates for natural childbirth, they are able to prescribe medications and provide an epidural for pain relief if that is your preference during labor. However, it is important that you understand your midwife’s position on pain medication before you select midwifery care.

While research shows that OB/GYNs are more likely to use interventions during birth such as instrument deliveries, that is simply because midwives are legally prohibited from doing so. In a study published by the American Journal of Public Health comparing two groups of women with low-risk pregnancies, research indicated that fetal and maternal outcomes are equally good when comparing midwife and OB/GYN births.

Birthing location

An OB/GYN offers delivery in a hospital setting, whereas midwives have the option to work in a variety of settings. These may include private practice, private homes, birth centers and hospitals.

Which should you choose?

Whether you choose a midwife or OB/GYN for your pregnancy care is a personal choice. You must consider the type of birthing experience that you would like. Start by answering these basic questions:

  • Is a vaginal birth your priority? Ask your doctor about his or her C-section rate and philosophy. If a vaginal birth is important to you, make sure your care provider supports it.
  • What kind of support do you during labor? Midwives are able to spend more time with patients to offer labor support because they generally are not pulled in as many different directions as a physician. If having a caregiver through your entire labor is important to you, you may want to consider hiring a doula who is trained to support and advocate for you throughout the labor and delivery process.
  • What are your plans for pain management? While they are able to administer pain medication, midwives are likely to encourage medication-free methods of pain management. This might include showers, massage, acupressure, trying different positions or using a birthing ball.
  • What are your expectations while at the hospital? Make sure that your expectations align with your caregiver’s policies for childbirth in the hospital. Will you be restricted to a bed and hooked up to a continuous fetal monitor or are you able to move around freely while taking pause for intermittent monitoring?
  • Are you considered high-risk? If you have a condition that will make your pregnancy high-risk you should seek care from an OB/GYN and deliver in a hospital setting. A high-risk pregnancy is defined as one that threatens the life of the mother or her fetus. These may include women with pre-existing health conditions such as diabetes or high blood pressure, advanced maternal age, and pregnancies with multiples (twins or more). A collaborative practice may allow for a midwife to co-manage higher-risk patients alongside OB/GYNS during a pregnancy. Which one delivers your baby will ultimately depend on your medical circumstances.
  • Is this your first birth? If you had a C-section in a previous birth, that doesn’t necessarily mean you cannot choose midwifery care for a future pregnancy. However, you should discuss with your current OB/GYN and prospective midwife whether you are a candidate for vaginal birth after Cesarean section (VBAC). In some cases, the answer may be dictated by hospital policy.

About Raleigh OB/GYN Centre

At Raleigh OB/GYN Centre, we believe in empowering women to make the best birthing choices for her and her family. This includes offering midwifery services. By offering this collaborative approach with a certified nurse midwife and a team of obstetricians under the same roof, we can better achieve our goal of helping parents have a positive birthing experience. To learn more about our midwifery services or to schedule an appointment, call 919-876-8225 today.