Midwife vs OB: Which is Right for You?
Understanding the Dynamic Between OB/GYN and Midwives
When someone discovers that they are pregnant, they have a wide variety of decisions to make. In the past, and in most places still in the world, someone with a low-risk, healthy pregnancy would routinely work with a midwife for their pregnancy and birth care. In the United States, the care of pregnant people moved from being primarily the purview of midwives to being in the scope of practice of OB/GYNs during the mid 20th century. Now, following a movement back to natural birth methods and away from instrumental and surgical delivery, people are interested in figuring out how to best achieve their birth goals. We encourage you to ask yourself: midwife vs. OB- which is right for you?
Working with a Midwife
Midwives are trained health professionals who help healthy people during pregnancy, labor, birth, and in the postpartum period. Midwives provide family planning and preconception care and comprehensive prenatal care, including labs and ultrasounds. Midwives assess each client’s physical psychological health during the prenatal and postpartum time and assist in the development of a birth plan. At Hearth and Home Midwifery, our care is holistic and client-centered, meaning we focus not only on the clinical picture, but on a person’s entire well-being picture: how are they doing emotionally, and mentally? How are they doing socially? What is their movement pattern like in their daily life? What kind of food do they eat? How do they feel about their body? How do they feel about becoming a parent? As midwives, we see wellness as a product of the entire system’s well-being, not just the medical or clinical aspects. Midwives provide emotional and clinical support during labor, and make referrals to other practitioners when needed. Essentially, if someone has a low-risk, healthy pregnancy, and they desire to have a natural, unmedicated, and physiologic birth, they might choose to be in the care of midwives.
An important note about midwife vs. OB consideration is that sometimes low-risk pregnancies become high-risk. This is always a potential outcome of any pregnancy. Midwives are trained to know when someone’s pregnancy has moved out of the range of normal and when further evaluation or specialization is needed. Sometimes, someone has considered the midwife vs. OB question and has decided on a midwife. If something changes during the course of prenatal, labor, or postpartum care, the midwife will make recommendations and referrals to higher-level specialists as needed. That often means transferring care to an OB/GYN, who is equipped to handle high-risk pregnancies, especially those that require surgery. It’s important for everyone to know that midwives refer to OB/GYNs when someone is no longer an appropriate candidate for a homebirth, community birth, or unmedicated birth. This is an important part of a midwife’s job and it must be taken into consideration when someone is trying to decide whether to hire a midwife vs. OB. Most people who choose midwifery will stay in midwifery care, and are in fact likely to remain low-risk just by virtue of being in midwifery care, but some people will have to “risk out” to care with an OB. Midwives stay with their clients after the transfer of care to provide emotional and informational support, so even if you have to change providers your midwives will stay part of your care. That can be helpful to know when deciding between midwife vs. OB.
The Role of OB/GYN
An obstetrician-gynecologist, or OB/GYN, is a healthcare professional that specializes in the reproductive health of people assigned female at birth. They are specialists in obstetrics, which includes pregnancy and delivery, and gynecology, which can involve a wide range of conditions, including STIs and chronic pain. OB/GYNs can do Pap smears, STI testing, pelvic exams, ultrasounds, and blood work. They are surgical specialists when it comes to labor and delivery, meaning that they perform Cesarean sections. They can also perform instrumental deliveries during childbirth, hysterectomies (the removal of the uterus), removal of growths such as ovarian cysts and uterine fibroids, and surgery to repair pelvic organ injuries. OB/GYNs can also do fertility treatment, such as egg retrieval for IVF or egg-freezing. OB/GYNs also manage urinary issues, such as urinary tract infections and urinary incontinence. They can treat infertility and offer counseling on infertility.
Many OB/GYNs are specialists in high-risk pregnancies and are equipped with the training and tools to assist people with high-risk deliveries. If a person is experiencing a high-risk pregnancy, or has a pre-existing medical condition that complicates their pregnancy, care by an OB/GYN would be an appropriate choice.
Midwife vs OB: Making the Decision
Midwife vs. OB is a very personal decision. The decision about how and where to give birth is something that each individual might consider on their own and arrive at independently. We recommend meeting with healthcare providers in your community and asking your questions about midwife vs. OB care. Find out what you want to know, and figure out who makes you feel at home and welcome. Who answers your questions to a satisfying degree? Who do you feel trust with? Who do you feel is best equipped to walk with you down the path of prenatal and birth care? Each individual is very different when it comes to deciding on a midwife vs. OB, and everyone has their own assessment about what is right for them. If someone is unsure, we recommend they meet with different providers and get a sense for what they are looking for. The most important thing is that each birthing person feels confident and safe with the people they are planning to birth with, and that is the ultimate decision maker when deciding between midwife vs. OB.
For more information about our midwife services in Portland, OR (and nearby areas), give us a call or schedule a free consultation, we look forward to hearing from you!
