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Midwife or OBGYN: Which is Right For Me? (15 Questions to Help You Decide)

One of the first choices to make after finding out you’re pregnant is who you want as your care provider. Will a midwife or an OBGYN be better for you? These 15 questions will help you know.

pregnant woman with prenatal care provider

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So you’re seeing double – two little pink lines. Congratulations! Pregnancy is an exciting time and you’re probably feeling all the feelings.

With the feelings come lots of questions, including wondering what to do first. One of the first and most important things you’ll choose during your pregnancy is who you want as your care provider.

The person you choose as your care provider will be the one you’ll see regularly for prenatal appointments. He or she will also be the main attendant at your birth. For both of those reasons, you’ll want to hire someone you’re comfortable with and someone you trust. 

You Have Options: Midwife or OBGYN

When I got pregnant with my first, I automatically called the OBGYN because that’s all I knew. Everyone I’d heard about had had their babies in the hospital with a doctor, so I didn’t know any different. I didn’t know I had options.

But I did! And so do you, and it’s important you know what those options are.

To learn about your options for where to have your baby, check out Birth Center vs Hospital: What They’re Like and Factors to Consider and Birth Center vs Home Birth: Similarities and Differences.

Even more important than where you give birth, though, is who attends your birth. When it comes to that, you have two options: a midwife or an OBGYN.

RELATED >> What Makes Midwives and OBGYNS So Different

Midwives and OBGYNS: Safe But Not the Same

Both midwives and OBGYNs are medical professionals. Both have educational backgrounds that ensure they can provide safe care for mothers and babies. 

Beyond that, your choice between a midwife or an OBGYN can drastically change the kind of pregnancy, birth, and postpartum care you receive.

I go over the differences between OBGYNs and midwives in this blog post. But even with that information, you may not be sure which is right for you. 

That’s why I wrote this blog post. I wanted to help you know whether a midwife or OBGYN will be right for your specific circumstances. The following 15 questions (and explanations) will help you know just that.

You ready for this? Let’s go.

Note: Keep in mind that if you choose an OBGYN, you are choosing the hospital. That alone has lots of implications.

1. Am I high-risk? 

The #1 question you need to answer before deciding which care provider to hire is whether or not this pregnancy is high-risk. Pregnancies can be high-risk for several reasons.

Some of those reasons are pre-existing conditions that the mother has, such as like cancer, diabetes, lupus, or heart problems. Some high-risk factors develop during pregnancy, such as preeclampsia, infection, or problems with the placenta.

The good news is that only 6-8% of pregnancies are high-risk.

If your pregnancy is high-risk, you will need to be cared for by an OBGYN rather than a midwife. That is their specialty. Midwives care for low-risk pregnancies.

2. Is holistic, preventative care important to me?

If you prefer to use natural remedies instead of medication or if you value preventative care, like prioritizing nutrition and exercise to stay healthy, a midwife might be the best choice for you.

Most midwives give their clients specific guidance on what to eat and how to exercise to have a healthy pregnancy and a safe, comfortable labor. They spend a lot of time educating women on how to care for themselves and on the safest ways to address the discomforts that can come with pregnancy. 

OBGYNs rarely receive more than a few hours of nutritional training throughout all of their schooling. The focus of medical school isn’t on prevention, but on treating disease and sickness that has already developed.

That is how OBGYNs approach pregnancy, too. They don’t usually emphasize healthy habits. And when complications arise, it is far more likely they will prescribe a medication than teach you, for example, how to lower your blood pressure with your diet.

3. Is vaginal birth important to me?

Studies have shown that women cared for by midwives have significantly higher rates of spontaneous vaginal birth – meaning vaginal birth (not a c-section) without the use of instruments like forceps is much more common.

If you have a strong desire to give birth vaginally or if you want to avoid the risks of a c-section, you may want to consider choosing a midwife.

(Let me remind you here that not all midwives are the same. Midwives who practice alongside OBGYNs in the hospital often have very similar outcomes to OBGYNs. You can learn all about the different types of midwives in So You Want a Midwife…What Kind?

4. Do I want a care provider I can contact directly 24/7?

My midwife was available to me 24/7 through text or phone call. Of course she had a life and a busy schedule too, so she wasn’t always able to answer right away, but if I had a question, I could text her directly. If I had an emergency, I knew I could call her cell.

Every midwife will have a different policy, but generally a midwife will be far more accessible and available to talk with you outside of appointments than will an OBGYN.

5. Is it important to me that labor starts on its own or would I be okay with an induction?

About 1 out of every 3 women in the US have their labor induced (begun) artificially. (In some places the rate is nearly 1 out of 2!)

The most common methods of inducing labor are artificial rupturing of membranes which is often called “breaking your water”; giving prostaglandin to ripen your cervix; or administering Pitocin (the synthetic version of oxytocin) through an IV.

Occasionally, induction is necessary for the safety of a mother or her baby. Most of the time, waiting for labor to begin on its own is safe – safer, often, than induction.

Midwives usually discourage artificial induction. Conversely, OBGYNs commonly recommend induction for women after 39 weeks.

6. Do I want my care provider to be with me during labor?

Regardless of who your care provider is or where you plan to give birth, a large portion of your laboring will be done at home with only a few people around – namely, your husband or partner and a doula if you choose to hire one.

Your midwife or OBGYN will likely join you as you are nearing or beginning the pushing stage of labor. 

Though timing may be similar, involvement varies.

An OBGYN will be caring for multiple patients at a time, so they may need to leave your room to check on other women while you continue to labor. Midwives provide more one-on-one support and will stay with you the whole time until your baby is born.

Additionally, if you give birth in a hospital, it’s possible that the OBGYN you’ve been meeting with at your prenatal appointments won’t be there because it isn’t their shift. If you want to ensure that the person who’s cared for you prenatally is the one at your birth, you may want to hire a midwife.

7. Do I want family members at the birth?

Some women want lots of family and friends around when they give birth. Some don’t.

If you do want several people to be present, you may want to give birth with a midwife in a birth center or at home. Many hospitals limit the number of people you can have at your birth (a common limit is 3 people). 

8. Do I want to breastfeed?

Breastfeeding is by far and away the best way to provide your baby with the nutrition he or she needs. If you do want to breastfeed, a midwife (especially outside of the hospital) may be better able to help you get started successfully.

Breastfeeding requires learning and practice. Because of time restraints and the lack of one-on-one care in the hospital, breastfeeding support tends to be less effective.

Studies have shown that women cared for by midwives have better rates of initiating breastfeeding and of continuing to breastfeed after the first few weeks.

9. Am I okay having a needle in my arm during labor?

Most hospitals require laboring women to get an IV. Even if you don’t get one initially, you’ll need one if you want an epidural or other pain medication, if the doctor wants to use Pitocin to speed up labor, or if you get a c-section.

IVs may be placed in the crook of your arm or, more commonly during labor, in the back of your hand or your forearm. Wherever it is, once you get it, it will stay in until after your baby is born.

Beyond being uncomfortable or unpleasant, being connected to tubing and a stand may restrict your movement. 

Midwives outside of the hospital rarely use IVs. 

10. How much flexibility do I want when it comes to newborn vaccines?

It is routine for newborn babies to receive the Hepatitis B vaccine immediately after they are born.

It is possible for mothers who have Hep B to pass it on to their baby and Hep B can be dangerous. That said, a mother who does not have Hep B cannot pass it to her baby.

If you do not want your newborn to receive this or other vaccines, you may want to receive care from a midwife. While most midwives can provide the vaccine, they are far less likely to encourage it for mothers who do not have hepatitis B. 

11. Is it important to me to be able to move freely during labor?

Many women find it helpful to move around and change positions often during labor. Not only can it make things more comfortable, it can also help your baby move down quicker and easier.

If you are being cared for by a midwife at home or at a birth center, you will have far more freedom as to where you can go and how much you can move. Midwives usually encourage movement, and they are ready to help you change positions as often as you like.

In the hospital, with an OBGYN and nurses, you will likely be restricted to your labor room. Most hospitals routinely use monitors and IVs, so even if you don’t have an epidural it may be hard to move around because you are attached to so many things.

RELATED >> The Cascade of Interventions [Explained]

12. What’s more important to me: avoiding discomfort and pain or being mentally present and in tune with my body during labor and birth?

If you are worried about experiencing pain during labor, an OBGYN can provide you with multiple pain medications. Your options will include anesthetics (an epidural) and painkillers (opioids). You can learn more about both in Medications During Labor: Is it Worth the Risk?.

Instead of offering medication, midwives teach women how to use their bodies and minds to cope with contractions naturally.

For most women, choosing pain medication is a trade off; numbing the pain also means giving up the ability to feel what’s happening in your body and being less in tune with what you are experiencing.

(If you get a really good anesthetist and your body responds well to the epidural, you may get the best of both worlds, but that is more rare than common.)

13. How do I feel about frequent cervical checks during labor?

Cervical checks (also called vaginal exams) are a way for a care provider to assess the condition of your cervix as labor progresses. Cervical checks are usually not necessary. They can be uncomfortable for many women – physically and emotionally – and can increase the risk of infection.

Generally, OBGYNs will check your cervix every few hours.

Midwives will often leave it up to you. My midwife didn’t do a single cervical check until I had been laboring for more than 13 hours, when I asked her to. 

14. Am I comfortable with a man (other than my husband) being in the room during labor?

Most OBGYNs are men. Most midwives are women. That’s the fact of the matter.

Labor is a vulnerable time. If you don’t feel safe and comfortable, it’s going to make labor more difficult.

15. Do I want my first few postpartum appointments to be in my home?

After your baby is born, you’ll have a few checkup appointments with your care provider to monitor both your baby’s health and yours.

If you give birth with an OBGYN, your baby will be seen by a pediatrician in the hospital the day after you give birth. In the weeks following, you’ll need to schedule a few visits with your pediatrician and your OBGYN. 

If you give birth with a midwife, you will still have checkups but she will likely come to you for the first few, meaning you won’t have to leave your home until at least a month after you’ve given birth.

Conclusion

Choosing your care provider is a big deal. Deciding whether a midwife or an OBGYN is right for you has HUGE implications for how your pregnancy and birth will go. With these 15 questions, I hope you have a better idea of which is right for you and your current pregnancy.

As always, I encourage you to feel it out and pray it out. This decision matters. Make it intentionally.

Until next time,

Allison

READ MORE >> Who to Hire: Benefits of Hiring a Midwife

What was the biggest thing that affected who you hired as your care provider? Let us know in the comments!

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