Doctor or Midwife: How to Decide

The first kind of doctor that comes to mind for most women who are pregnant or planning to become pregnant is an obstetrician. Even if the doctor is in a group practice (meaning that he’s not the only doctor in the office) that has midwives who are often overlooked when it comes to prenatal care and delivery. Who you are comfortable within the OB/GYN office is important and this can be one of the determining factors in choosing who you want to deliver your baby.

A Certified nurse-midwife, CNM is a well-trained healthcare professional whose primary focus is the natural birthing experience for their patients. They hold a Bachelor’s Degree as a licensed RN in addition to a Master’s degree for Midwifery. Midwives deliver babies in the hospital, at a clinic as well as in the comfort of your own home. Unfortunately though, home births are not typically covered by insurance companies. CNM’s are a wonderful choice if you have a normal pregnancy and desire a vaginal birth. During labor, midwives are very involved and encourage natural techniques to help bring your baby into the birth canal as well as help your body prepare for the delivery that is ahead. Some of these techniques they use are: walking, acupuncture, soaking in a warm bath, massage therapy and a gently bouncing on a birthing ball. They can administer pain medications as well even though that is their last resort. The only down-side to having a midwife is that they cannot perform a C-section if necessary; however, they can assist in the operating room and still be a support for you in that way.

An OB/GYN is a licensed medical doctor who has had 4-years of medical school, a 4-year residency program, and a 3-year fellowship specializing in a specific area such as reproductive endocrinology. They also have surgical training for numerous operations including C-sections. OB/GYN’s are covered by medical insurance companies. These doctors do not encourage home deliveries because it puts the mother and baby at risk should there be an emergency during labor and delivery. Your OB will monitor your pain level and keep you as comfortable as possible throughout your labor and delivery. For the most part, obstetricians encourage vaginal births, some are a bit too quick to suggest a C-section though. They are removed from the labor process and do not have much contact with their patient until it is time to deliver the baby. The plus to having an OB as your caretaker during labor and delivery is that should you need help delivering the baby, she can use different techniques to help you, such as a vacuum or forceps. Obstetricians are more qualified if you have a high-risk pregnancy than a CNM is because they have more training and are better suited to address the issues, concerns, and possible complications that go along with high-risk pregnancies.

To help you decide which kind of care is right for you, consider a few questions:

  • How important is it to you that you deliver naturally? Meaning, how do you plan to endure the increasing pain as your labor progresses and how important is it that you have a vaginal delivery?
  • How open are you to pain medicine? If you have a high pain tolerance, you may not need much pain medicine.
  • Are you considered to have a high-risk pregnancy?
  • Is it important for you to have your midwife or doctor with you during the labor process?

Choosing a healthcare professional to assist you during your labor and delivery is a personal decision that only you can make. You know what you are looking for as far as how you may want to be treated during labor. Do you usually prefer physical touch to sooth you, or maybe you are not a “touchy-feely” person? Either is perfectly fine, just keep this in mind as you decide who you would like to assist you as you bring your little one into the world. Trust your instincts.