Deciding who will care for you during your pregnancy and childbirth is one of the first and most important choices you’ll make after seeing a positive pregnancy test. You have several options for your healthcare provider, and two of the most common are a midwife and an obstetrician-gynecologist (ob-gyn). While both are highly skilled professionals dedicated to maternal and infant health, understanding the differences between a Midwife Vs Doctor is crucial for making the best decision for your unique needs and preferences.
Understanding Your Pregnancy Care Options: Midwife vs. Ob-Gyn
Both midwives and ob-gyns are extensively trained and educated to provide care during pregnancy, labor, and delivery. However, their training, areas of expertise, and approaches to care differ in key ways.
What is a Midwife?
Midwives are healthcare professionals specializing in pregnancy, childbirth, and postpartum care. There are several types of midwives, with Certified Nurse-Midwives (CNMs) being the most common in the United States. CNMs are registered nurses who have also completed graduate-level education in midwifery and are certified by the American Midwifery Certification Board (AMCB). Certified Midwives (CMs) are similar to CNMs but have a graduate degree in midwifery without a nursing background. Certified Professional Midwives (CPMs) have different certification pathways, often focusing on out-of-hospital births.
Kristin Cohen, DNP, CNM, WHNP-BC
Midwives are experts in normal, healthy pregnancies and births. They often emphasize a holistic approach, viewing pregnancy and birth as natural physiological processes. Midwives are skilled in providing personalized care, focusing on patient education, shared decision-making, and minimizing interventions during labor and delivery when possible. They are trained to deliver babies in hospitals, birthing centers, and even at home, depending on their certification and the regulations in their state. Midwives are also proficient in alternative birthing methods, such as water birth, and often support natural childbirth preferences.
What is an Ob-Gyn?
Obstetrician-gynecologists (ob-gyns) are medical doctors (MDs or DOs) who specialize in obstetrics and gynecology. Obstetrics focuses on pregnancy, childbirth, and the postpartum period, while gynecology deals with the female reproductive system outside of pregnancy. Ob-gyns complete four years of medical school, followed by a four-year residency in obstetrics and gynecology. Many ob-gyns are also board-certified by the American Board of Obstetrics and Gynecology (ABOG), signifying advanced expertise in their field.
Karen Miles
Ob-gyns are trained to manage the full spectrum of women’s health, including both normal and high-risk pregnancies. They are equipped to handle complex pregnancies, pre-existing medical conditions, and pregnancy complications. Ob-gyns are surgeons and can perform cesarean sections (c-sections) and other surgical procedures if needed. While some ob-gyns embrace holistic approaches, their training is rooted in a medical model that prioritizes intervention when necessary to ensure the safety of both mother and baby, especially in situations deviating from low-risk pregnancies.
Key Considerations When Deciding Between a Midwife and an Ob-Gyn
Choosing between a midwife and an ob-gyn involves considering several important factors related to your health, preferences, and desired birth experience.
Your Health History and Risk Factors
Your medical history and the presence of any pre-existing conditions are crucial in determining the most appropriate care provider. If you have chronic health issues such as high blood pressure, diabetes, epilepsy, or heart disease, or if you experienced complications in a previous pregnancy, you may be considered high-risk. In such cases, an ob-gyn or a maternal-fetal medicine (MFM) specialist (perinatologist) is usually recommended. MFMs are ob-gyns with additional training in managing high-risk pregnancies.
A healthcare provider examining a pregnant woman on a couch
While midwives are highly skilled in managing low-risk pregnancies, they are trained to recognize and refer patients to ob-gyns or MFMs if complications arise during pregnancy or labor. In some situations, collaborative care between a midwife and an ob-gyn can be an option, allowing you to benefit from the expertise of both types of providers.
Desired Birth Experience and Philosophy of Care
Your preferences for the birth experience and your philosophy of care are also important considerations. If you desire a more holistic approach that views pregnancy and birth as natural processes, with interventions only when medically necessary, a midwife may be a good fit. Midwifery care often emphasizes patient empowerment, natural childbirth methods, and a lower rate of medical interventions like continuous fetal monitoring, epidurals, and episiotomies, when medically appropriate. Studies have shown that births attended by midwives often have fewer interventions without compromising outcomes for mothers and babies. Women opting for midwifery care also tend to have lower cesarean section rates.
Midwives typically dedicate significant time to prenatal education, addressing your questions and concerns, and helping you create a birth plan that aligns with your wishes. They focus on the emotional and physical changes of pregnancy and aim to provide continuous support throughout labor and delivery.
However, it’s important to note that some ob-gyns also offer personalized and patient-centered care, while some midwives may have a more medically oriented approach depending on their practice setting and individual philosophy. It’s beneficial to research providers in your area and even consider interviewing both midwives and ob-gyns to find someone whose approach resonates with you.
Birth Setting Preferences
Where you envision giving birth is another key factor in your decision. If you are interested in a home birth or a birth center birth, you will need to choose a midwife, as ob-gyns typically attend births in hospitals. Birthing centers, often staffed by CNMs, are designed to provide a comfortable, home-like setting while still offering a safe environment for labor and delivery. They are known for supporting natural birth and minimizing routine interventions.
If you prefer a hospital birth, you have the option of choosing either an ob-gyn or a midwife. Hospitals provide access to advanced medical technology and are equipped to handle emergencies and high-risk situations. If you desire the option of pain relief methods like epidurals or feel more secure knowing that medical interventions are readily available if needed, a hospital birth with either an ob-gyn or a midwife within a hospital practice might be preferable.
Insurance Coverage and Costs
Insurance coverage and out-of-pocket costs can also influence your choice. Generally, midwifery care tends to be less expensive than obstetrician care. However, insurance coverage varies widely. It’s essential to contact your insurance provider to understand your coverage for both midwife and ob-gyn services, as well as for different birth settings (hospital, birthing center, or home). Confirming your potential out-of-pocket expenses will help you make an informed financial decision.
Midwife vs. Ob-Gyn: Making the Right Choice for You
While obstetricians are currently the more common choice for pregnancy care in the United States, the popularity of midwifery care is growing as more women seek personalized, less interventional birth experiences. Ultimately, the “best” choice between a midwife vs doctor is a deeply personal one.
The most important step is to choose a provider with whom you feel comfortable, safe, and respected. Your provider should be someone who listens to your concerns, answers your questions thoroughly, respects your preferences, and is qualified to meet your individual health needs. Whether you choose a midwife or an ob-gyn, establishing a relationship built on trust and open communication is paramount for a positive and healthy pregnancy and birth journey. If at any point you feel your current provider is not the right fit, remember that you have the option to seek care from another professional who better aligns with your needs and expectations.
Conclusion: Partnering with Your Pregnancy Care Provider for a Healthy Journey
Choosing your pregnancy care provider is a significant decision. Understanding the distinctions between a midwife vs doctor empowers you to make an informed choice that aligns with your health needs, birth preferences, and overall philosophy of care. Both midwives and ob-gyns play vital roles in supporting women through pregnancy and childbirth. By carefully considering the factors outlined above and engaging in open communication with potential providers, you can confidently select a partner who will guide and support you towards a healthy and fulfilling birth experience.
Key Takeaways: Quick Summary of Midwife vs. Doctor
- Both midwives and ob-gyns are highly trained pregnancy and birth professionals, but their training and areas of focus differ.
- Ob-gyns are medical doctors trained to handle a wide range of pregnancies, including high-risk pregnancies and surgical interventions like c-sections.
- Midwives specialize in normal, healthy pregnancies and often emphasize a holistic, less interventional approach to childbirth.
- Consider your health history, desired birth experience, birth setting preferences, and insurance coverage when choosing between a midwife and an ob-gyn.
- The best choice is a provider you trust and feel comfortable with, who respects your wishes and meets your individual needs.
Sources and Further Reading
BabyCenter’s editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you’re seeing. Learn more about our editorial and medical review policies.
ACNM. 2020. Core Competencies for Basic Midwifery Practice. American College of Nurse-Midwives. https://www.midwife.org/acnm/files/acnmlibrarydata/uploadfilename/000000000050/ACNMCoreCompetenciesMar2020_final.pdfOpens a new window [Accessed August 2024]
ACNM. 2014. Position Statement: Appropriate Use of Technology in Childbirth. American College of Nurse-Midwives. http://midwife.org/ACNM/files/ACNMLibraryData/UPLOADFILENAME/000000000054/Appropriate-Use-of-Technology-in-Childbirth-May-2014.pdfOpens a new window [Accessed August 2024]
Loewenberg Weisband Y, et al. 2018. Birth Outcomes of Women Using a Midwife versus Women Using a Physician for Prenatal Care. Journal of Midwifery and Women’s Health 63(4):399-409. https://pubmed.ncbi.nlm.nih.gov/29944777/Opens a new window [Accessed August 2024]
March of Dimes. 2022. Nowhere to Go: Maternity Care Deserts Across the U.S. https://www.marchofdimes.org/sites/default/files/2022-10/2022_Maternity_Care_Report.pdfOpens a new window [Accessed August 2024]
Osterman M, et al. 2022. Births: Final Data for 2022. National Vital Statistics Reports 73(2). https://www.cdc.gov/nchs/data/nvsr/nvsr73/nvsr73-02.pdfOpens a new window [Accessed August 2024]
Sutcliffe K, et al. 2012. Comparing midwife-led and doctor-led maternity care: a systematic review of reviews. Journal of Advanced Nursing 68(11): 2376-2386. https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2012.05998.xOpens a new window
