OBGYN VS. MIDWIVES
- Nikita Johnson COBST, CD(BAI), DT, LC, CNA
- Nov 5, 2020
- 3 min read
As soon as you find out that you are pregnant, many questions come your way. Will you give birth in a hospital or at home? Will you opt for a natural birth or an epidural? What kind of practitioner are you going to choose to deliver your baby? Planning and knowing what options are available is an essential step in selecting a caregiver. Today on the blog, I will discuss the vital differences between OB/GYNs and midwives and what factors you should consider before you make your decision.

EDUCATION
The most notable difference between Midwives and OBGYN's is the years of medical training. An OB/GYN has to complete four years of undergraduate school, four years of medical school, and three-four years as a resident doctor rotating throughout OBGYN office visits, surgery, and working on Labor and Delivery. To become a certified nurse-midwife (CNM), you must first become a registered nurse, complete a graduate program in midwifery, and pass a national certification exam. A certified professional midwife must have a previous background as a doula or labor and delivery health professional, complete a direct-entry program for three years, and pass a national certification exam.
Although all three practitioners are trained and experienced in labor and delivery, nurse midwives and professional midwives have a different scope of practice and provide care in various birth environments. OBGYN doctors are only allowed to practice inside a hospital where medical interventions and surgery can take place. A nurse-midwife can work in hospitals, birth centers, or at home. Professional Midwives can only support home births and provide holistic health care.
SCOPE OF PRACTICE
An Obstetrician-Gynecologist, or OB-GYN, is a medical doctor and surgeon specializing in female reproductive health, including delivering babies vaginally and via c-section. They support high-risk and low-risk pregnancies. OB-GYNs provide a wide range of preventive care services, including pap smears, STI testing, pelvic exams, ultrasounds, and blood work, in addition to working on labor and delivery units and performing Gynecological surgeries. OBGYN's are trained to prevent(or as we like to call it) intervene, sometimes unnecessarily, whereas midwives are laid back and refer to the holistic approach of childbirth.
A certified nurse-midwife is an advanced practice registered nurse specializing in reproductive health and childbirth. They are allowed to support low-risk pregnancies and VBACs (Vaginal Birth After C-section). Nurse-Midwives provide gynecological care such as pap smears and birth control as an OBGYN but aren't trained to perform surgery. Many midwives advocate for natural childbirth. They will allow you to labor in the water but under hospital policy, they cannot deliver babies in the water. If you choose to opt for an epidural, they can prescribe medications and provide an epidural for pain relief if you prefer during labor.
Certified Professional Midwives work in the home birth environment only and can only support low-risk pregnancies and cannot support VBAC's unless they've partnered with a Certified Nurse Midwife. They follow a holistic approach, support water births, lotus birth, and will support your birth plan to the fullest extent. They also work closely with doulas to help their clients achieve an unmedicated ("Natural Birth"), especially if the parents' requests are to avoid transferring to the hospital unless it's medically necessary.
WHICH PROVIDER SHOULD I CHOOSE?
Whether you choose a midwife or OB/GYN for your pregnancy, care is a personal choice. You must consider the type of birthing experience that you would like. Start by answering these basic questions. Who will support my birth plan? Is my pregnancy considered low-risk or high-risk? Is Natural birth my overall goal? Do I want the freedom to birth my way? These are fundamental questions you should consider when weighing your options relevant to your ideal birthing experience.
Next week on the blog, I will speak more about OB providers and identifying your voice when advocating for yourself during pregnancy, labor, and birth.
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