Doula Chats: Midwife or OBGYN?

May 3, 2022


Throughout all of history, Midwives have served women as they have entered motherhood, but within the last century or so, Obstetric Gynecologists (OBGYN) have become a normal part of birth. Though they both operate as medical caretakers for women, their method of care is very different.



METHOD OF CARE: MIDWIFE



Midwives serve mothers in a client-centered way. They treat the mother as a whole person, asking various questions about her health - physically, mentally, and emotionally. Midwives understand that much of birth is tied to a mother’s mental and emotional state. The better Mothers are supported in these ways, the more she trusts her midwife, the safer she feels, and the more likely the mother is to reach her birth goals and have a safe, and positive birth experience.

Although midwives are typically associated with unmedicated births - and studies show that low-risk mothers under the care of midwives are associated with decreased intervention and c-sections - there are midwives who serve mothers in hospitals who desire a medicated birth. Regardless of whether the mother chooses medicated or unmedicated birth, it is commonly heard from mothers that their experience under the care of a midwife was more connected, and more personal than that with the OBGYN.


*Note: There are three levels of midwifery credentials. Certified Professional Midwife (CPM), Certified Midwife (CM), and Certified Nurse-Midwife (CNM). For more information on what they are, click here.

https://www.webmd.com/baby/what-is-a-midwife-twins#:~:text=A%20midwife%20is%20a%20trained,deliver%20babies%20at%20a%20hospital


METHOD OF CARE: OBGYN



The method of care with an OBGYN is what I would describe as formal. Typical low-risk pregnant mother’s appointments usually last somewhere around 15 minutes and cover health concerns and current physical status of the mother and the baby. Rarely do OB’s take time to ask you how you’re feeling emotionally, how your family is doing, or other personal questions having to do with your emotions, though there are some OB’s out there who do ask those questions. At low-risk births, the doctor may come in once, maybe twice to see how things are going, but are largely uninvolved unless an intervention is needed or asked for. Depending on the circumstance, this may be just a phone call, and the doctor doesn’t arrive on site until the mother feels pressure to push.

That being said, with the ability to perform Cesarean sections, hysterectomy, removing ovarian cysts and other surgical procedures, an OBGYN is a capable provider for birth, and conceivably the best option for those with additional health problems, especially for those mothers considered high-risk. However, it is important to note, that if your doctor is not on-call when you go into labor, whatever doctor is on call will be the one to catch your baby and perform any deemed necessary interventions.


MY OPINION:

I love the midwifery model of care because I love the connection between members of the birth team and the birthing mother. I love the idea that mothers bring their babies into this world surrounded by friends who are more invested and more intimately involved, rather than a stranger.


I think that mothers who desire an unmedicated birth and are low-risk are most likely to achieve it and have a positive birth experience with a midwife, whether they are in a hospital, birthing center, or at home. And for those women who are afraid of the “what-ifs,” an in-hospital midwife is a wonderful option as the on-call doctor is available for those emergencies.


Those who choose to have an OBGYN instead of a midwife because they are high-risk or just feel more comfortable with an OB should do their research and take time to learn about the various providers available to them so that they can find one who agrees with their philosophy of birth. If they do not, or if you thought they did and later discover some red-flags, it is time to find a new one.


Whatever you decide, decide with intention. Think about the birth experience you want and take your time interviewing providers until you find the one who will help you achieve your goals.


Best of luck, Mamas!


References

https://www.webmd.com/baby/what-is-a-midwife-twins#:~:text=A%20midwife%20is%20a%20trained,deliver%20babies%20at%20a%20hospital

https://www.healthline.com/health/parenting/midwife-vs-obgyn#the-difference

https://www.healthpartners.com/blog/midwife-vs-obgyn-whats-the-difference/

https://pubmed.ncbi.nlm.nih.gov/31599830

https://www.raleighob.com/differences-between-a-midwife-and-ob-gyn/


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*Susan Joy is a Doula and Birth Documenter serving the families of Mesa, Gilbert, Chandler, Scottsdale, Queen Creek, San Tan, and other cities in the East Valley. The information presented here is not medical advice. All medical decisions should be made after discussion with your medical provider.*

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