Birth Pregnancy

Midwife vs OBGYN: Which is Right for You?

Written by Stephanie McClane

In 2016, there were almost 4 million births in the US.

Although the majority of those births took place inside a hospital, the number of births outside of hospitals is growing. But the difference between a midwife vs OBGYN is more complicated than home vs in-hospital delivery.

When choosing between a midwife and an OBGYN, there’s a lot to consider. If you’re deciding which health practitioner to choose for your pregnancy and delivery, you should understand what the differences are. Keep reading to find out which is best for you.

Midwife vs OBGYN: Differences

OBGYN’s are obstetrician-gynecologists. Midwives are officially known as certified nurse midwife’s (CNM).

Most women in the US choose an OBGYN to care for them throughout pregnancy and delivery. But more women every year are turning to midwives for this care.

Knowing which is right for you means knowing their differences. Below is a comprehensive list of the major differences between these two practitioners.

Medical Training

Both OBGYN’s and midwives have extensive medical training.

OBGYN’s are doctors that have graduated from 4 years of medical school. They also have to complete a 4-year obstetric residency program.

To become board certified by the American College of Obstetricians and Gynecologists, they have to pass both a written and oral exam. Some OBGYN’s will also pursue specialized training. This may be in an area such as infertility or gynecologic-oncology.

Midwives hold bachelor’s degrees in nursing. They’re registered nurses who have passed a certification exam from the American College of Nurse-Midwives. Many midwives also pursue a master’s program in midwifery and all hold a license from the state in which they practice.

Approach to Pregnancy and Birth

Midwives take a more holistic approach to pregnancy and birth. Although many OBGYN’s are also adopting a holistic approach in their practice.

Midwives are supporters of natural births. They focus on emotional health and wellness and provide support before, during, and after birth.

Range of Services

The services you receive from a midwife and OBGYN are identical. Both midwives and OBGYN’s offer nonsurgical, gynecological, and obstetrical services. These include exams, prenatal care, hospital and birth center access, and postpartum services.

Limitations

A midwife will work with a physician during your prenatal care as well your delivery. Midwives are unable to perform surgery, but the physician they work with can. This includes Cesarean deliveries.

Some midwives may not be able to accommodate high-risk pregnancies. These are better suited to an OBGYN. Talk to the midwife if you’re a high risk and they can recommend who should provide your care.

Prenatal Care

During your pregnancy, you’ll visit your OBGYN or midwife regularly. These visits are very much the same. The main difference is that an appointment with a midwife is typically longer in duration.

You meet with your practitioner about once every month. Between the 28th and 36th week, you’ll see them once every 2 or 3 weeks. At that point, you’ll see them once per week until you give birth,

At these visits, you’ll be weighed and the practitioner will check the baby’s heartbeat. They’ll measure the growth of your belly and also test your protein and sugar levels.

Pain Medications

Because they focus on birth as a natural process, many midwives are against medications. Instead of medications, they utilize pain management. This includes techniques such as breathing exercises and massage.

Like OBGYN’s, a midwife can provide epidurals. They are only able to authorize this if you’re giving birth at a hospital. This is because an obstetric anesthesiologist must perform the epidural.

If you give birth at home or at a birth center that isn’t equipped with an obstetric anesthesiologist, you will not have access to an epidural. However, your midwife may provide you with other pain relief medications. Whether your midwife can and will provide this medication during delivery is something you should discuss before labor.

Legality

Midwives are legal across the US. All 50 states and the District of Columbia license and regulate midwifery.

They’re also covered by health insurance as long as you deliver your baby in a hospital. Some insurance will cover a portion of the cost of a birthing center but giving birth at home isn’t usually covered.

Midwife vs OBGYN: What Is Important to You?

When deciding between these two health practitioners, you should decide what’s important to you. Prioritize what you want from your health practitioner. Consider these items:

  • Medical credentials
  • Their views on pain medication
  • Whether you wish to give birth at home, in a hospital, or at a birthing center
  • Whether you wish to give birth vaginally
  • Whether you require support after giving birth (i.e. support in parenting and caring for a newborn)
  • If you’re a high-risk pregnancy

You might not get everything you want from one or the other. But deciding what is most important to you can help you choose between a midwife vs OBGYN.

Midwife vs OBGYN: When Do You Have to Choose?

Whether you’re choosing a midwife or an OBGYN, you should make the choice as soon as possible after conceiving. In fact, the best time to make the choice is before you conceive.

If your pregnancy is planned, then choosing before you conceive gives you plenty of time to find the person best suited to you and your needs. If you wait until you’re pregnant, the pressure of needing to start prenatal care may affect your decision making.

Having a practitioner ready means you’ll be able to start taking care of your baby immediately upon conception. That means changing your diet and exercise routines. It also means taking prenatal vitamins right away and avoiding things like alcohol and tobacco.

If you’re pregnant and still haven’t decided between a midwife or OBGYN, let the provider know that you’re pregnant when you call. They may be able to schedule you sooner than they normally would. This way you can begin getting proper care right away.

More Pregnancy Tips

Choosing between a midwife vs OBGYN is a big decision.

Before making your choice, list your priorities. Consider things like whether you want a more holistic approach and where you want to give birth. Knowing what you want from your pregnancy and your practitioner can help you decide between these two professionals.

And for more tips and advice on pregnancy and parenting, check out our blog.

About the author

Stephanie McClane

Hi, I’m Stephanie. I graduated college with a business degree and a minor in biology. I met my husband at a business convention and was happily marriage and pregnant within the first two years after saying the words “ I do”.

Jennifer is the eldest of the three. Being pregnant with her, my first, I researched everything pregnancy related and read nearly every book. Giving birth to Anthony and Matty seemed more natural and less stressful the third time around.

I’m happy to share what knowledge I have gathered and learn new things from other mothers. From morning sickness to Anencephaly, or potty training to thumb sucking, I have books and resource guides to share.