Is an OB-GYN or a Midwife Right for You?
When it comes to childbirth and reproductive health, expectant parents often face a crucial decision: choosing between an OB-GYN or a midwife.
Both options have unique benefits and considerations, which can greatly influence the pregnancy care, birthing, and postpartum experiences. Understanding the differences between these two types of healthcare providers — and the services they offer — can help you make an informed choice that aligns with your personal needs, preferences, and plans.
This post explores the roles of OB-GYNs and midwives, the care you can expect from each, and factors to consider when deciding which one is right for you.
What's an OB-GYN vs a Midwife?
A good place to start is defining what OB-GYNs and midwives are.
OB-GYNs
OB-GYNs (obstetricians-gynecologists) are medical doctors who specialize in all areas of women’s health, including both obstetrics and gynecology. This dual focus allows them to provide a wide range of services, including:
Routine examinations
Preventive care
Treatment for various reproductive health concerns
Gynecological surgery
Prenatal care
High-risk pregnancy management
Delivering babies
Crucially important specialists, OB-GYNs help ensure the hormonal, reproductive, and general well-being of women throughout the seasons of their lives. OB-GYNs' extensive training, ability to manage high-risk situations, and surgical expertise make them a vital resource for parents before, during, and after childbirth.
MIDWIVES
Midwives are trained healthcare professionals who specialize in providing services to women during pregnancy, labor, and the postpartum period. They're dedicated to supporting expectant parents through a holistic — often less invasive — approach to prenatal care and childbirth.
Services commonly offered by midwives include:
Prenatal care
Labor support
Delivery assistance
Postpartum visits
While different from OB-GYNs, midwives also play a vital role in maternity care of their clients. They provide compassionate, personalized support throughout pregnancy, labor, and the postpartum period. Their focus on natural childbirth, combined with their extensive training and expertise, makes them an excellent choice for many expectant parents seeking a holistic approach.
Key Differences Between OB-GYNs & Midwives
Training & Certification
OB-GYNs
OB-GYNs are MDs who've completed a four-year undergraduate degree followed by four years of medical school. After that, they do a residency program, where they receive specialized training in obstetrics and gynecology, which usually lasts four years.
Upon completing their residency, OB-GYNs must pass a rigorous board examination to become board-certified. Their extensive training prepares them to handle complex medical situations, including high-risk pregnancies and surgical interventions.
MIDWIVES
All midwives are equipped to support pregnancies and births. However, midwives can have varying levels of education and credentials, depending on their specific jobs. For example:
Certified Nurse Midwives (CNMs) are registered nurses who have completed advanced education and are trained to provide a range of reproductive health services, including prenatal care and labor support. In the United States, CNMs are trained to practice in hospitals.
Certified Professional Midwives (CPMs), have completed an undergraduate college degree, attended scores of births during their training, and hold professional licenses. Their training focuses primarily on lower-risk pregnancies with healthy women, emphasizing natural childbirth and holistic care. In the United States, CPMs are the experts on out-of-hospital birth. They are the most experienced care providers when it comes to home birth.
Other types of midwives are also highly trained through formal educational programs, apprenticeships, and specialized programs.
Emphasis of Care & Services Offered
OB-GYNs
OB-GYNs take a more conventional tack to care that emphasizes monitoring and interventions throughout pregnancy and childbirth. The structured care model OB-GYNs offer can be particularly beneficial for women with pre-existing conditions or high-risk pregnancies that require more oversight.
The range of services related to reproductive health and prenatal care OB-GYNs can provide is comprehensive. OB-GYNs are adept at addressing various medical conditions (e.g., hormonal issues and infertility) and their ability to perform surgical interventions is crucial, especially in emergencies.
MIDWIVES
Midwives aim to ensure that mother’s physical, emotional, and psychological needs are met throughout pregnancy, labor and delivery, and the postpartum period. As such, you'll find that midwifery tends to focus on:
Empowering women
Promoting natural birth
Minimizing interventions
Fostering a supportive environment
Advocating for informed decision-making
Active participation of non-birthing partners
Because of this, the service you get from a midwife will be more attentive and personalized to you. Midwives provide prenatal check-ups, education and counseling, birth planning, labor support, delivery assistance, and postpartum visits.
While trained to recognize (and handle many) complications, midwives will refer patients to physicians when necessary.
Birth Settings
OB-GYNs
OB-GYNs usually operate within a medical campus, hospital, and/or birthing center setting. These facilities often have specialized wards, equipment, and staff trained for maternal and newborn care. They are primed and ready to handle emergencies, which is essential for high-risk pregnancies or unforeseen complications.
MIDWIVES
Midwives can provide care in various environments.
Prenatal care is often provided at the midwife's office, clinic, or the client's home.
Many families work with midwives because they want a home birth or water birth. However, some midwives may also assist labor and delivery at birthing centers and hospitals.
Additionally, midwives are able to accommodate more of a client's birthing experience wishes — like incorporating music, aromatherapy, or family and friends.
Costs & Coverage
OB-GYNs
The cost of care from an OB-GYN can be higher due to specialized services, the use of hospital facilities, receiving interventions, etc. Many OB-GYN services are covered by insurance, but out-of-pocket expenses can vary based on the patient’s plan, including co-pays and deductibles.
Additionally, patients sometimes don't know the full cost of a hospital birth until much later — even months after the baby is born.
MIDWIVES
Midwifery services can be more affordable than care from an OB-GYN, especially in non-hospital settings like home births. The natural practices and strategies midwives leverage are also more economical than standard medical alternatives. And, because care from a midwife is less invasive and in a nurturing environment, maternal recovery can be less resource-demanding.
Some insurance plans cover midwifery services, but coverage can vary widely. Families considering midwifery care should check their insurance policies to understand coverage options and any potential out-of-pocket expenses.
Midwife or OB-GYN — Things to Consider Before Choosing
Deciding what kind of care to get is consequential. You have to account for a lot of different factors, like:
Your preferences. Consider your desired pregnancy and birth experiences (e.g., home birth vs. hospital birth). Reflect on your openness to medical interventions versus a more natural approach. Understand the level of flexibility and accommodation each type of care affords you.
Your medical profile. Assess any pre-existing medical conditions that may require more specialized care. Identify any past pregnancy complications that might necessitate closer monitoring. Evaluate your pregnancy risk level (e.g., high-risk pregnancy may lean toward OB-GYN care). Discuss with healthcare providers about any specific risks that could influence your choice.
Comfort and rapport. Think about which type of provider you feel more at ease with and trust. Consider the importance of having a personalized and supportive environment during pregnancy and childbirth. Determine how important open communication and shared decision-making are to you. Evaluate the willingness of the provider to answer questions and involve you in the care process.
Care philosophy. Explore your values regarding childbirth and how they align with the care offered by a given provider. Understand the approach of each option (OB-GYN’s medical focus vs midwife’s holistic and supportive approach).
Comprehensiveness of support. Explore the scope, duration, and timing of care options. Consider the importance of education and counseling. Assess the level of postpartum care and support each provider offers.
Costs. Review insurance policies to understand coverage for OB-GYN versus midwife services. For almost everyone who has a low-risk pregnancy in the United States, giving birth with a midwife is a much lower-cost option than giving birth in a hospital with an OB-GYN.
Tips for Picking the Right Provider for You
Selecting the right provider for your pregnancy and childbirth experience is a big deal — it can significantly impact your care. Here are some tips to help you make the best choice.
Have a Consultation
Schedule interviews with potential OB-GYNs and midwives. Many providers offer free consultations, allowing you to discuss your preferences, ask questions, and get a sense of the practitioner. Use this opportunity to assess their communication style and approach to care.
Sample questions you might ask:
What's your experience with my specific medical history or risk factors?
How do you handle emergencies or complications during pregnancy and childbirth?
What is your philosophy regarding interventions, pain management, and support during labor?
Can you describe the types of birth settings you work in and what options you provide for labor and delivery?
Do you support postpartum care? If so, how?
What resources do you offer for new parents?
Why should I pick you?
Explore Birth Setting Options
Reflect on your preferred birth environment. Do you envision a home birth, water birth, or a hospital setting? Discuss the available options with your provider and understand their policies regarding where you can give birth.
If you're considering a hospital or birthing center, see if you can tour the facility.
Do Research & Get Recommendations
See what your trusted family and friends have to say. They may have valuable insights on care providers, birthing environments, and more. Online mom forums, professional associations, and so on can be gold mines for referrals. OB-GYNs and midwives may also be able to share testimonials.
So, Which Is It Going to Be — OB-GYN or Midwife?
Choosing between an OB-GYN and a midwife involves considering many different dimensions — like a provider's training, care philosophies, birth settings, and costs.
Because midwives and OB-GYNs each have their strengths and every expectant family has its own needs and preferences that must align with its care plan, there's really no one-size-fits-all solution.
That said, there are many advantages and benefits that go with selecting a midwife: individualized care, focused attention on you, and the ability to craft a pregnancy and birthing plan that resonates with your desires, just to name a few. When you’re ready to take the next step, we invite you to reach out to us. We’re here to help!