Comparing OB/GYNs and Midwives
Midwives and OB/GYNs are health professionals responsible for the medical care of women and their babies at birth. They provide pregnancy and primary women’s care. OB/GYNs are doctors and midwives are most often nurses with two additional years of school involving reproductive care, pregnancy, childbirth, and postpartum. These are the two most commonly used providers for pregnancy care in the US. They differ in their models of care and training. Nearly all OB/GYNs have never witnessed or been a part of a natural birth as this is not normal for their medical training. Midwives have a more natural approach to childbirth and provide care for low-risk pregnancies.
OB/GYN Training
Obstetrics (OB) is the area of medical training involving childbirth and surgery. Gynecology (GYN) involves medical training in the reproductive function and diseases of women and adolescents. OB/GYNs have extensive medical training including four years of medical school and a residency specific to OB/GYN that typically lasts four years. This residency involves gaining experience in normal and high-risk pregnancy and surgical procedures such as cyst removals and cesarean or C-section birth. They gain experience in both outpatient (office) and inpatient (hospital) settings.
Midwife Training
Midwifery training varies and there are different types of midwives. Every state has differing practicing regulations for the different types of midwives. For example, in North Carolina, Certified Nurse Midwives (CNMs) lead births in various settings and only CNMs can manage home births. In Tennessee, a Certified Professional Midwife (CPM) can manage home births and it doesn’t have to be a CNM. CPMs are commonly birth assistants, assisting CNMs in birth center or home births. Their training focuses on births outside of the hospital setting. CPMs have various educational backgrounds and all must have a high school diploma. Often, training is through self-study or apprentices and there are some college programs available.
CNMs are nurses who complete 2 years of midwifery graduate school. This is the most common type of midwife and is widely accepted. Certified Midwives (CMs) have graduate education in midwifery but an undergraduate degree in something other than nursing. Both CNMs and CMs take the same exam to practice as a midwife.
Choosing a Good Fit
Choosing your provider during pregnancy is a very big deal. You want someone who aligns with your values and makes you feel safe and comfortable. Not all OB/GYNs or midwives are the same. Being open and asking questions of your potential provider are a must. Every time you see a provider during your pregnancy it should be like an interview to see if they are who you want leading your birth team. Most practices will have you rotate through with all providers so you should be able to get a sense of the culture. If you are in an outpatient setting planning a hospital birth, you will often see OB/GYNs and your appointment times will be very limited. Midwives working independently or in a birth center setting have more time to get to know you and discuss your plans for birth.