Midwife or OB? Facts to Consider

If you are healthy during a pregnancy, you might want to consider a midwife for your care instead of an obstetrician (OB). Midwives are well trained in how to handle pregnancy and childbirth. You will find that appointments with the midwife are longer, and much more thorough. Keep reading to see how a midwife is trained and how else they differ from an OB.

Training and Roles

An OB/GYN is who you want if there are complications during pregnancy, labor or birth. They are skilled surgeons if you need gynecological surgery or a caesarean. They are trained and experienced to deal with any pregnancy and labor complications.  Normal labor and birth, not so much. In countries that save obstetricians for complications and surgical needs and have midwives care for everyone else, the caesarean rate is lower, and outcomes are better. 

In our area, we have certified nurse midwives who work in several area hospitals.  

To be a certified nurse midwife (CNM), an individual must have a bachelor’s degree, ideally in nursing or a related field, and have some experience (typically one year) as a registered nurse (RN) in one’s state of residence. Then they earn a master’s or doctorate in midwifery which takes a minimum of 24 months to complete. They complete a lengthy clinical time under an experienced CNM and then sit a board exam. 

We also have certified professional midwives (CPM) who do home births. These midwives do not usually have nor is it required to have a nursing background but go straight to a midwifery training program along with a 2 year apprenticeship with a qualified and experienced CPM, where they must care for mom and baby at a minimum of 55 labor and births before qualifying to sit their board exams.

Routine Practices

At prenatal appointments with an OB they often quickly do heart tones and measurements and are out the door before you can even form a question. Midwives, on the other hand, are focused on you and your overall well-being, taking time for questions, explaining things and discussing options. Midwives encourage you to read, take classes, and hire a doula.  

During labor and birth with a midwife you will most likely see them more often and they tend to encourage movement, and being out of bed, in the shower, walking, in the tub, and generally letting you labor how is best for you. They do not watch the clock, but rather watch you. 

Midwives will work with moms wherever they are. Even getting wet when helping mom out of the tub!

Viewpoints on Intervention 

OB’s are on the alert and tend to expect things to follow a certain path and want to move things along. Midwives don’t intervene if all is well with you and baby and promote intermittent monitoring. If you desire pain medication, midwives will make sure you get it, while working to keep side effects to a minimum. Midwives encourage you to push in whatever position you need to, and whatever position you need to birth in. Most obstetricians tend to want you on your back with your knees up so they can sit between your legs to catch baby in a position they are trained and used to.

OB’s are always available

You can feel safe in your care at the hospital with a midwife that they are very well trained. If there is any issue, the OB’s are close at hand. You can also feel safe and cared for if you choose a home birth. We have some great CPM (Certified Professional Midwives) in Northeast and Central Pennsylvania who care for women throughout their pregnancy and can come to your home for labor and birth. If there are concerns or issues during pregnancy, they would refer you to an OB; if concerns come up during labor and birth, they would transfer you to a hospital.

Midwives are overall a very good option for pregnancy and labor care for a woman with a normal and uncomplicated pregnancy.  Certainly look into midwife options when you become pregnant or are not entirely satisfied with your current care. Midwives are professional, experienced, and most of all, respectfully honor the wishes, priorities and abilities of the pregnant and laboring woman. Being under the care of a midwife for your medical care, hiring a doula to provide emotional and physical support and taking a good childbirth class is the trifecta of care and preparation for your labor, birth and postpartum experience.

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