Baby, Pregnancy

OB vs. Midwife: Which Should You Choose?

 

Let me get something straight right off the bat: I am NOT anti-doctors!!! This is not an OB-bashing post.

Also, this post is written under the assumption that births take place in hospitals, whether you choose an OB or a midwife. I only have experience with giving birth in hospitals.

Okay, now that that’s out there, I’ll give some background to this post, if you don’t mind…

I saw an obstetrician (OB) during my first pregnancy, and I had a great experience. The doctor team during this pregnancy was friendly, I loved their office, and I felt confident in their care. I LOVED the hospital I delivered my baby at. However, there were some things about the delivery experience that made me consider looking into different care options the next time I was pregnant.

At the beginning of my second pregnancy, I was undecided about what I wanted in terms of doctors. I had done some research and thought that a certified nurse-midwife (CNM) just might be a nice option. But due to my family’s circumstances at the beginning of that pregnancy, I didn’t have the luxury of “shopping around” for prenatal care. But halfway through the pregnancy, we were finally settled into a new home and I was feeling kind of unsatisfied with my care up to that point. Actually, it wasn’t even that I was really unsatisfied with the doctors themselves; there were some specific experiences from my first labor and delivery that I didn’t want repeated in my second. So, I went out on a limb and switched from an OB to a CNM. My experience was amazing! And, again, I LOVED the hospital I had my baby at (a different one from my first baby’s delivery).

Based on my experiences, here are the differences I have found between an OB and a CNM:

OFFICE VISITS

-OBs are usually busier, with more patients to care for, making it difficult to spend a lot of time with each patient.

-CNMs are less busy, so they can spend more time with each patient.

—I enjoyed that the CNMs took the time to get to know me a little bit beyond the medical stuff; that the visits did not feel rushed; and that they did all of the same things the OBs did.

LABOR

-OBs are typically not a very active part of the labor process unless there is a complication.

—During my first labor, I think I only saw the OB twice- one of those times being when he actually helped my baby come out. J I didn’t talk to him at all about my pain management. But he was really friendly and respectful.

-Midwives are typically more involved in the whole labor process. The hospital nurses are still the main ones in charge of your labor care, but the midwife is an active participant, and your main advocate.

—I definitely saw my midwife more often during my labor. She wasn’t with me the entire time because she had other patients to be with, but she checked on me often. She was an active participant in the conversation about my pain management. She encouraged me to do what I wanted to do, which included getting an epidural.

DELIVERY & RECOVERY

-OBs deliver the baby, and they can do it vaginally or by C-section. Usually the mother will be lying in the hospital bed on her back, using stirrups as the position to push and deliver the baby. OBs “fix” the mother up after the delivery (including doing stitches if tearing was involved).

-Midwives also deliver babies, but they can only do this vaginally- they do not perform C-sections. Generally speaking, midwives are more flexible with the birthing process. If the mother wants to push and deliver in an unorthodox position, she’s more likely to get what she wants with a midwife. Midwives also “fix” up the mother after the birth, including giving stitches if needed.

—The delivery of my second baby was my favorite part of my midwife experience. Even though I had an epidural in me, I could still feel the need to push when it was time. I felt like it was easier to push while on my side and without stirrups, so this is what my midwife let me do (even though it was harder on her back than delivering the conventional way J ).

THE BOTTOM LINE

Overall, I honestly did not feel that there was a HUGE difference between the OBs of my first pregnancy and the midwives of my second, until I was at the hospital in labor. There were some nice subtle differences during prenatal visits, but the biggest differences I experienced were in the labor and delivery process: I absolutely LOVED being able to push in whatever position I felt most comfortable in; I loved that my midwife was more available and a more active part of the labor and pushing; and I loved that the midwife supported me and encouraged me to do whatever I wanted to do (as long as it was safe for me and my baby).

That being said, my midwife was still busy with other patients while I was in labor. I think she was with me during the whole pushing process, but she wasn’t there the whole labor. (Both of my labors have been over 11 hours, so I can’t really blame her for not being there the whole time. 😉 ) She knew my birth plan, which was something I appreciated. I didn’t even have a strict birth plan: I mainly wanted to labor for as long as I could without an epidural. (I received my first labor and delivery’s epidural early on and I was COMPLETELY numb, so I wanted to feel a little more the second time around.) I liked that the midwife asked me several times what I needed and wanted. When I said I wanted an epidural, she said “Are you sure you want it? Okay, I support you.”

Another thought: It seems like OBs and all prenatal healthcare providers in general are becoming more focused on mother and baby-centered care. I feel like as long as you feel your doctor or midwife is your advocate and is good at what they do, then that’s the best type of person to delivery your baby.

WHO SHOULD YOU CHOOSE?

In my opinion, if you want A) as typical/conventional of a birth experience as possible B) a medical doctor caring for you and your baby C) a simple choice for prenatal/labor and delivery care, then an obstetrician is probably right for you.

Also in my opinion, if you have A) different expectations in regards to birth that are not completely typical/conventional B) a desire to be in close contact with your provider C) a desire to make decisions with your provider (you want to have a large say in the process), then you might fit well with a certified nurse-midwife.