Childbirth is arguably the most intimate and most life changing experience of someone can have. Deciding who is going to be there to support you is a big decision. Aside from family and close friends, the one person who you will rely most heavily on while in labor is your medical caregiver.
Choosing to have a midwife by your side rather than an OB-GYN is on the rise in the United States. While that is the case, most women still choose to give birth in a hospital with an OB-GYN rather than a birthing center, or at home with a midwife.
There is a common misconception that a midwife’s experiences cannot compare to the experience of an OB-GYN. An OB-GYN will get a bachelor’s degree that takes four years. They will usually get that degree in pre-med. They will then go to medical school which takes another four years. They then do a four year residency where they are practicing medicine, but not technically labeled an OB-GYN yet.
Midwives usually get a bachelor’s degree in nursing which also takes four years. They are then required to become a registered nurse and to gain at least one year of experience before going into a graduate level midwifery program which takes between two to four years. They must then get certified by the American Midwifery Certification Board, and that certification has to be renewed every five years.
While the OB-GYN has more experience in the way of years in school, they are also trained to perform surgery, which a midwife is not certified to do. Midwifes are the ideal choice for low-risk pregnancies because they are professionals in vaginal childbirth.
While OB-GYNs are certified to perform surgical options, midwives are certified to give pain medication, perform delivery and counsel the mother after birth. This may seem scary to some women because they fear what could happen if they choose a midwife, but need a C-section later.
Most midwives deliver babies at birthing centers, much more than at home. Birthing centers work in collaboration with OB-GYNs in case they need to be consulted in the event of an emergency, and are usually located close to hospitals and are able to quickly send you there if necessary, but this doesn’t generally happen .
According to many sources, choosing a birthing center over a hospital significantly decreases your risk of having a C-section while maternal and fetal outcomes are just as good as at a hospital. This means that OB-GYNs are quicker to intervene in a birth than a midwife, but midwifes can intervene when necessary.
Mothers and babies survive birth at the same rate with an OB-GYN as with a midwife. OB-GYNs are also more likely to perform interventions such as epidurals, episiotomies and instrumental deliveries. If you are looking to have a completely natural delivery, a midwife is definitely for you.
OB-GYNs will also have certain rules while you are in labor. Many require that you have an IV, stay in bed, deliver on your back (which can increase tearing) and wear a fetal heart monitor the whole time. Midwives support women moving around while laboring and using alternative methods of pain management such as using birthing balls, showers, massage, acupressure techniques, homeopathy and using alternative positions to laying on your back.
The rules mandated by OB-GYNs and hospitals have caused a recent outcry about violence against laboring women. Many mothers are coming out saying they were forced to have procedures they did not want or agree to. Women have been physically forced onto their backs for active labor (pushing).
While most OB-GYNs support the women they are serving, it’s a more prevalent problem among women who choose to deliver in hospitals rather than birthing centers.
The support you want also plays a large role in deciding between the two. Midwives are usually present for the entire labor, while most OB-GYNs are only present for active labor. If you choose to have an OB-GYN deliver your baby in a hospital, chances are you will be cared for by nurses until you start active labor.
A midwife will be there from the time you show up at the birthing center until you has safely delivered your child, and oftentimes even after that. Many midwives are also certified to give counseling on exercise and nutrition for you and the baby after it is born. Basically, midwives are usually there to support you every step of the way.
None of this is to say OB-GYNs are a bad option, but if you choose an OB-GYN you will want to make sure they are accepting of your birth plan before you settle on one specific doctor. You can also have an OB-GYN and a midwife. This gives you the support you want with the safety net you need in case of an emergency.
While deciding between a midwife and an OB-GYN is a big decision, it is also a very personal decision that only you can make for yourself. If I had a low-risk pregnancy, I would easily choose a midwife for the simple fact that I would get more support throughout labor and after the birth is over.
I would also make that decision because I would want a caregiver who is open to me laboring the way I need to. Childbirth is different for everyone, and you can’t really know what’s going to be right for you until you are in the middle of it, but I would rather have someone who would always support my needs in the delivery room.