Midwife or OB/GYN -- which is best for me?

by Julie Snyder

Midwife or OBGYNWomen are discovering that the hospital isn't the only option for safe birth. You labor best in safe environment, with someone that you know and trust. This could be your home or in a birth center, with an attendant trained in gentle, natural, safe childbirth.

Do you think you'd feel more comfortable birthing with a midwife or an OB/GYN? How do you decide? These two separate approaches to prenatal care began in ancient history and led to the development of two different professions -- midwifery and medical obstetrics.

Midwifery developed out of the network of social, knowledge, physical, and material support women have traditionally provided to one another in times of need.

How do I know which is right?

If you have a serious chronic illness, are carrying twins or anticipate other potential problems, you may want to consider an OB/GYN. Otherwise, a midwife could be the right choice for you.

Recent studies indicate that women with high-risk pregnancies who have appointments with an OB and midwife have lower rates of c-section and higher rates of normal births.

In most places around the world, obstetricians only deliver babies during emergencies with midwives handling the rest of the births. The U.S. is moving in that direction, a well. Nationwide, 10 to 20 percent of all pregnant women choose midwives.

The midwives model of care

This plan is based on the fact that pregnancy and birth are normal life processes.

✓ Focuses on health, wellness and prevention
✓ Provides the mother with individualized education, counseling and prenatal care
✓ Minimizes technological interventions
✓ Identifies and refers women who require obstetrical attention.

Types of midwives

A midwife is a healthcare professional that provides an array of services for women that may include medical histories and genealogical examinations, contraceptive counseling and prescriptions. They also provide care during labor, delivery and after birth.

Certified nurse-midwife (CNM)

They complete two years of graduate work in midwifery after nursing school and are certified by the American College of Nurse Midwives. They can be affiliated with an OB's office and usually attend births in a hospital or birthing center. CNMs seldom accept high-risk pregnancies. They always have a doctor on call even for seemingly uncomplicated deliveries. In general, they use fewer medical interventions. Several studies show that women who choose certified nurse-midwives are just as likely to have healthy babies as those who choose obstetricians.

Certified professional midwife

This person has trained in midwifery. She or he has passed rigorous competency testing by North American Registry of Midwives. Most CPMs are independent practitioners. They provide complete prenatal care and attend births, primarily in free standing birthing center and in the client's home.

Direct-entry midwife

This individual learned midwifery through self-study, apprenticeship, a midwifery school, or a college program that is not a nursing program. Usually these birth attendants provide complete prenatal care and attend births in homes or birthing centers.

Lay midwife

This person may not be certified or licensed as a midwife. They may have trained informally through self-study or apprenticeship or trained in another state and the credentials do not transfer. They may provide complete prenatal care and primarily attend births at home or in birth centers.

What you can expect from a midwife?

Respectful treatment: A midwife offers nurturing care that respects you, your beliefs and family.

Personal attention: Your prenatal appointments leave plenty of time for questions, usually 30 to 60 minutes. Use that time to explore and resolve concerns and fear that your family may have.

Plenty of information: Your midwife shares information about pregnancy, birth, breastfeeding and newborn care. She encourages healthy lifestyle choices, including nutrition.

Appropriate monitoring: You receive regular, thorough checkups for you and your baby, as well as recommended diagnostic testing.

Natural comfort measures: Encouragement, relaxation, laboring in water and changing position are among the effective comfort measures your midwife may suggest. She'll encourage you to give birth gently and lovingly.

Photo courtesy of iStockphoto.