When I first learned I was pregnant, my mind never considered choosing a midwife. I had learned to trust OBGYNs because I had worked so closely with them through my career. My education in nursing school veered away from traditional home births and focused solely on how to support and care for women in the hospital setting. It was all I knew so that is what I chose. There are great providers in both fields. When it comes to choosing between a midwife vs OBGYN it is such a personal decision and should be based on your goals for your delivery and what is most comfortable for your family.
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Midwife vs OBGYN: What’s the difference?
A Midwife vs OBGYN go through different levels of training. Based on the experience and training level the provider has received results in differing levels of care that they can provide and states they can practice in. A midwife is able to care for you in a variety of settings from your home, birth center, or a hospital. If you choose a Midwife make sure you understand, which level of certification and education they have obtained. It will help you understand what they are able to provide for you. This infographic from The American College of Nurse midwives breaks down the scope of practice for each level of midwife education and certification.
Certified Nurse Midwife (CNM)
- Bachelor of Science Nursing Degree (RN BSN) – 4yrs
- Nursing License
- Nursing experience – 1 yr or more
- Masters degree (MSN or DNP) – 2-4 yrs
- Pass CNM exam to become licensed
- Advanced Practice Registered Nurse License in your state
- Able to Practice in 50 states
Certified Midwife (CM)
- Non Nursing Degree – 4 yrs
- No Degree (science prerequisites and Birth support experience) – unknown
- Masters Degree in Midwifery – 3 yrs
- Pass Exam to become licensed
- Only able to practice in Delaware, Hawaii, Maine, Maryland, New Jersey, New York, Oklahoma, Rhode Island, Virginia, and the District of Columbia.
Certified Professional Midwife
- High School Diploma or Equivilant
- Obtain Prerequisite Education Science Background
- Experience as a Doula, Childbirth Education, and Lactation Educator
- Complete Accredited Program – 3 yrs
- Pass Written and Skills Practical Examination by the North American Registry of Midwives
- Licensed to work in 35 States
OBGYNs must go through the most rigorous training of any birthing provider. They may go through up to 14 years of postsecondary education depending on specialization. They are able to care for the most high risk patients and take on any surgical needs. They are licensed in all 50 states to provide care through all phases of pregnancy and postpartum care.
Midwives specialize in low risk pregnancies and births and focus more on overall health and wellness. They typically utilize less interventions and are very hands on. They want you to be in the driver’s seat of your birth and they are your guides to help you achieve the pregnancy and birth that you desire.
Most midwives practice in more relaxed settings outside of a typical hospital environment. They are able to order and evaluate all the tests or refer you to specialist for treatments throughout your pregnancy.
OBGYNs can handle all pregnancies and will care for you in their office and the hospital. OBs work within a practice team so someone within their team will always be available to provide your with the needed care. They have privileges at one or more hospitals for medical care through delivery. Your prenatal care will follow a prenatal schedule seeing your provider every month in early pregnancy and increasing in frequency as your pregnancy progresses.
If you are laboring and birthing with a midwife you can birth in one of three places at home, a birthing center, or a hospital. Your midwife will be present throughout your birth and provide advice, guidance, support, and medical treatments to improve your overall experience. Since midwives tend to use less interventions and promote more natural births. You will see less inductions, pain medication administration, and more water or home births. They will encourage more natural ways to induce labor such as membrane sweeps and other alternatives.
If you birth situation ever become beyond their scope of care they will transfer you to a nearby hospital and OB care. They will accompany you to the hospital and stay with you through your birth to ensure a seamless transition of care.
Midwives are trained and able to provide care for your baby as well. They care for newborns immediately after birth and up to 28 days.
If you choose a obgyn vs midwife you will find they have a more routine approach and follow very typical standards. You will see your doctor intermittently throughout your birth experience but a majority of the time you will spend with a registered nurse and doula if you choose. your doctor is going spend most of their time with you during the second stage of labor when you are fully dilated and actively pushing or if there are any serious concerns.
OBGYNs are able to provide inductions, epidurals, and any additional interventions that are needed (cesarean delivery, forceps, vacuum assisted birth, etc).
There are many pros and cons of midwife vs obgyn and one of the biggest difference in my opinion is in the postpartum care. The standard OBGYN postpartum care is one follow up appointment at 6 weeks postpartum. It is typically a quick visit to discuss how the mother is doing and a pap smear could be done if the mother is due for one. A Mental health questionnaire is completed to assess for mother’s postpartum mental health. If there are no other concerns then they will see the patient on their next yearly exam or when they are pregnant again.
The postpartum experience with a midwife vs obgyn is much different. You can expect to see your midwife multiple times within the first 6 weeks of your delivery. They will often check in with you in person or on the phone the first 24hr, 48hrs, and then at 2 weeks, 4 weeks, and 6 weeks postpartum. In those appointments they will discuss your recovery and assist with any questions or concerns you have with your newborn. They can also assist with lactation and breastfeeding support.
Choosing your Care Provider?
Whether you choose a midwife vs OBGYN it’s important to choose a provider that is a good fit for you. Checkout these 50 questions to ask at your first prenatal appointment to ensure you have the right provider for you. You want to choose someone that understands your goals and can support you in them. It should be someone you feel comfortable with and addresses your concern.
For example if having a VBAC delivery after your last C section is really important to you then you need to find a provider that will advocate for that and support you to your desired experience. Midwives and OBGYNs are both highly educated and have vast experience. You need to choose the provider that feels right for you and your circumstance.
OBGYN might be a good fit if…
- Pregnant with twins or multiples
- Chronic medical conditions
- High Risk Pregnancy
- Need a C Section
- Want an Epidural for pain management
Midwife might be a good fit if…
- Interested in a water birth
- Desire a home birth or Birth Center Birth
- Interested in Natural birth and alternative pain management methods such as hypnobirthing
Frequently Asked Questions
There is no right answer when choosing a midwife vs obgyn. There are so many factors that will go into making that decision. It comes down to your health and the type of experience that you desire. I personally have had two hospital births with a wonderful OBGYN that I would highly recommend. In future pregnancies I am considering choosing a midwife vs OBGYN. Both experiences have their pros and cons. Since I have very low risk pregnancies and would like a different kind of experience that maybe the right choice for me in the future. It is important to do what makes you feel most comfortable.
Jess is a registered nurse with over 6+ years of critical care experience for patients young and old and is the mother of two small children. After having her own children she felt inspired to provide mothers with real actionable guidance and education to make informed decisions throughout their pregnancy and postpartum experience.