The Difference Between a Midwife vs. OB-GYN

When you first find out you're pregnant, you will be filled with a range of emotions. You might think about whether you're having a boy or a girl, who you want to tell first, or even begin daydreaming about all the cute little outfits in your future. While these are all fun (and important) thoughts, you'll also want to start thinking about your prenatal care provider. But who do you choose: a midwife or an OB-GYN? To help you make the best decision for your pregnancy, here are some key differences between a midwife and an OB-GYN, some similarities, and additional pregnancy-related caregivers.

What is a Midwife?

A midwife is a trained healthcare professional specializing in women's health, particularly pregnancy, childbirth, and postpartum care. Midwives provide personalized support throughout the pregnancy journey, focusing on natural approaches to childbirth while minimizing medical interventions unless absolutely necessary. They offer various services, from prenatal checkups and nutritional guidance to labor support and newborn care.

Midwives may also assist with reproductive health issues, birth control, and annual wellness exams, extending their care beyond just childbirth. Their role is to support new moms physically, emotionally, and mentally, often advocating for the birth preferences and overall well-being of mothers and their babies.

What is an OB-GYN?

An OB-GYN, or obstetrician-gynecologist, is a medical doctor specializing in women’s reproductive health, pregnancy, and childbirth. OB-GYNs provide comprehensive care throughout all stages of a woman’s life, from puberty and pregnancy to menopause and beyond. They are trained to diagnose and treat a wide range of reproductive health issues, perform surgeries, and manage both low- and high-risk pregnancies.

In addition to prenatal care, OB-GYNs can perform deliveries, including cesarean sections if needed, and are equipped to handle any complications that may arise during childbirth. Their expertise allows them to offer medical interventions, such as pain management and emergency care, ensuring both mother and baby’s safety throughout pregnancy and delivery.

What's the Difference Between a Midwife and an OB-GYN?

Each provider brings unique skills and perspectives to prenatal and childbirth care. Understanding the distinctions between them can help you make an informed choice that supports your birth plan. Here are the primary differences between a midwife and an OB-GYN.

Credentials and Education

To become an OB-GYN, an individual must go through four years of medical school and an additional four years of residency, similar to doctors in other fields. OB-GYNs are doctors in obstetrics and gynecology and can provide medical intervention if needed.

After receiving their license, OB-GYNs can also undergo certification from the American Board of Obstetrics and Gynecology. This isn't necessary to complete education and training, but it does carry a degree of distinction that can help set them apart in their field.

To become a certified nurse midwife (CNM), an individual needs to become a registered nurse and then undergo a graduate program in midwifery. This means receiving either a master's degree or a doctorate in nursing. They must also pass a certification exam administered by the American Midwifery Certification Board.

Certified midwives (CM) are not registered nurses but have a postgraduate degree in midwifery and need certification from the American Midwifery Certification Board.

Finally, certified professional midwives (CPM) are specialists certified by the North American Registry of Midwives. They don't necessarily have a higher degree, but they have demonstrated their skills and expertise within the field.

High-Risk Pregnancies

Another one of the main differences between a midwife and an OB-GYN is the care options based on medical conditions. Since an OB-GYN is a medical doctor who has been trained in emergencies, they're able to handle any unexpected complications.

For example, high-risk pregnancies usually require the expertise of an OB-GYN since they're trained to perform c-sections in case of an emergency. Midwives are not trained to perform a cesarean section, which puts expecting mothers at a high risk of complications if a doctor isn't present. Women who are expecting twins or have a preexisting condition should choose an OB-GYN just to be safe. On the contrary, midwives can deliver babies for women who have a low-risk pregnancy.

It should also be noted that midwives are trained to recognize potential problems while expecting mothers are in labor. If they notice something that could result in a complication or require emergency surgery, they will call an OB-GYN for help.

Birthing Locations

OB-GYNs typically deliver babies inside a hospital or a hospital-sponsored birthing center. They can also have their own practice or work in clinics. This allows them to have access to everything they need in case of an emergency. Depending on their practice, OB-GYNs may also work out of freestanding centers as part of a bigger team.

Midwives offer various types of birth settings. They typically specialize in home births and allow expecting mothers the opportunity to experience a water birth if they'd like. However, they may also utilize birth centers that aren't associated with the hospital or hospital-based birth centers (if they’re a registered nurse). There's quite a lot of flexibility in where midwives work, and it usually depends on their affiliation and the personal preference of an expecting mother.

Similarities of Midwives and OB-GYNs

With that being said, choosing between a midwife or OB-GYN doesn't mean you're choosing between an amateur and a professional. Both are highly trained, certified professionals who require extensive experience to work with expecting mothers. They're both going to be focusing on you and your baby's safety throughout the entire process while working through your birth plan and talking about all of the possible scenarios.

Both midwives and OB-GYNs can also administer pain medications, even though midwives do tend to advocate more for natural births. But they can still provide an epidural for pain management if that's what's preferred.

They can both deliver your baby and are regulated by the state they operate in, but that doesn't negate their differences. If you're not sure whether you want to work with an OB-GYN or a midwife, you may want to schedule an appointment with each to ask any questions you have and find the right fit.

Are Doulas the Same as Midwives and OB-GYNs?

No, doulas are not the same as certified midwives or an OB-GYN. They do not deliver babies but instead focus on providing emotional, informational, and physical support for mothers during the birthing process. Doulas can be extremely beneficial for some women, especially those who may not have much family support or are nervous about having their first child. However, a doula cannot replace medical doctors or midwives, as they do not have the proper training to safely handle labor and delivery on their own.

Which One Should You Choose?

Deciding between a midwife and an OB-GYN ultimately depends on your unique health needs, preferences, and comfort level. If you’re hoping for a more natural birthing experience in a non-hospital setting, a midwife may be a great choice, especially if you have a low-risk pregnancy. Midwives often foster a nurturing environment and are focused on providing continuous support throughout labor.

On the other hand, if you have pre-existing health conditions or want the security of having immediate access to advanced medical care, an OB-GYN might be the more suitable option. OB-GYNs are well-equipped to handle potential complications and can provide a higher level of intervention if the need arises, which is crucial for high-risk pregnancies or those who are a bit more anxious about labor.

Many women actually choose a hybrid approach, working with both a midwife and an OB-GYN or opting for a midwife within a hospital setting where OB-GYNs are accessible if needed. Some healthcare practices now offer collaborative care models where midwives and OB-GYNs work together, combining a midwife's supportive, holistic approach with the medical expertise of an OB-GYN.

To support a healthy breastfeeding journey after delivery, don’t forget to get your free breast pump through insurance from Byram Healthcare. Connect with one of our specialists today to find lactation support or get started with your order.