As soon as you see those two lines indicating you’re pregnant, (or the word pregnant if you’re using a digital test!) you might think to yourself, “Now what?” Before birth options, pain management, or postpartum care are even on your mind, you’re likely thinking about making an appointment with your doctor. While it’s a good idea to visit your primary care doctor to touch base, you’ll also have to choose a provider for your prenatal care. In most cases, you’ll choose between a midwife and an OB.
There are plenty of differences between these two types of pregnancy providers, but if you’re pregnant for the first time, the process of deciding can seem overwhelming. Since most pregnancy doctors won’t see you until you’re at least 8 weeks pregnant, you have some time to weigh your options and find the right provider for you.
If you’re worried about making the right choice, don’t worry. You’re able to switch providers during your pregnancy if you realize your current one doesn’t align with your values. Let’s get into the difference between a doctor and a midwife for pregnancy.
Should I Choose a Doctor or Midwife for Pregnancy?
From deciding on a provider to choosing how and where you want to give birth, you have a lot of choices to make during your pregnancy. It’s going to take some time and research to make the right decision for you and your baby.
When deciding between a doctor or midwife for pregnancy, first determine where you plan on giving birth. Doctors and midwives often have different rights regarding where they can practice and attend births. Some of these regulations will depend on the type of midwife or the birth laws in your state.
Generally, there are four different options for where you can give birth:
- Hospital
- Birth center attached to a hospital
- Freestanding birth center
- Home
If you give birth in a hospital, certain states allow you to choose a doctor or a certified nurse midwife. Essentially, a certified nurse midwife is a trained midwife who also holds a nursing degree. If you give birth in a birth center or at home, you’ll most likely have a midwife as your provider.
Although there are OBs who specialize in out-of-hospital births, it’s not common. Let’s take a closer look at the difference between a pregnancy doctor, or OB, and a midwife.
Midwife vs. Doctor: What’s the Difference?
An OB, or OB/GYN, is a doctor who specializes in caring for women and babies during pregnancy and birth. The OB stands for an obstetrician, which is a doctor who specializes in pregnancy care, childbirth, postnatal care, and fertility treatments. The GYN stands for gynecologist. A gynecologist is a different kind of doctor who doesn’t focus on pregnancy or birth. Instead, they specialize in reproductive care, cervical and breast cancer screenings, and other women’s healthcare concerns.
An OB is not necessarily a gynecologist and a gynecologist is not necessarily an OB. All you need to know at this point is that an OB is the type of doctor you can choose to see for your pregnancy. If you’re looking for a pregnancy provider, they don’t need to be a gynecologist.
Your other option is a midwife, which is a healthcare provider with training in pregnancy, birth, newborn care, and postpartum care. There is a common misconception that midwives aren’t actually healthcare professionals, but most types of midwives have extensive training in pregnancy and birth, and they can also provide routine care for women such as Pap tests, breast cancer screenings, and pelvic exams.
It’s important to note there are several different types of midwives, each of them with different training and credentials.
Certified Nurse Midwife (CNM)
A certified nurse midwife (CNM) is a trained midwife who also holds a nursing degree. For a CNM to be certified, it requires a graduate level degree in nurse midwifery. Certified nurse midwives are registered nurses who specialize in midwifery. The majority of certified nurse midwives practice in hospitals. However, they can also choose to practice in birth centers or attend home births.
Certified Midwife (CM)
A certified midwife (CM) is similar in many ways to a certified nurse midwife, but they don’t hold a nursing degree. CMs do have a graduate-level degree in midwifery and are also certified by the American Midwifery Certification Board like CNMs. Not every state recognizes certified midwives. This makes their ability to practice limited compared to certified nurse midwives. Depending on the state, certified midwives can attend births in hospitals, birth centers, or homes.
Certified Professional Midwife (CPM)
Unlike certified midwives and certified nurse midwives, a certified professional midwife (CPM) is certified through the North American Registry of Midwives. This type of midwife certification doesn’t require a degree, but it does require an aspiring midwife to either go through a midwifery program or complete the Portfolio Evaluation Process set in place by the North American Registry of Midwives. Certified professional midwives are licensed in 35 states and can practice in birth centers or attend home births.
Lay Midwife
Lay midwives are midwives who don’t have an official certification or midwifery license. While some lay midwives may have learned through an apprenticeship or similar program, there isn’t a set program or curriculum for this type of midwife. The practice of lay midwives is mostly unregulated, and they’re prohibited from attending births in some states.
Midwife vs. Doctor: Pros and Cons
If you’re trying to choose between a doctor or midwife for pregnancy, you’ll need to think through what type of birth you want before you decide on a provider. There are pros and cons to both choosing an OB and a midwife and it’s going to depend on your overall health and unique situation.
Midwives are a great option for those who want to avoid unnecessary interventions during birth and are thinking about giving birth in a birth center or at home. If you’re planning on giving birth in a hospital but want to avoid unnecessary interventions, you might choose a certified nurse midwife or certified midwife for your hospital birth.
There are many pros to choosing a midwife for your prenatal care. A certified midwife, whether it’s a CNM, CM, or CPM, has training specifically in the physiologic birth process. They’re trained to deal with every aspect of pregnancy and can attend births in a variety of settings.
On the other hand, an OB may be the better choice for women with a high-risk pregnancy. Most midwives who practice at birth centers or attend home births only bring women with low-risk pregnancies into their care. Not to mention, if you plan on receiving an epidural during labor, you won’t be able to receive one at a birth center or at home.
While OBs are equipped to handle high-risk pregnancies, especially when an emergency c-section is necessary, they’re often not as familiar with supporting moms in unmedicated births. Regardless of where you choose to give birth or what type of pregnancy provider you choose, it’s most important that they’re aligned with your values and are willing to support your preferences during pregnancy and labor.
Which Provider Is Right for You?
Pregnancy is such an exciting time, whether you’re having your first baby or your fifth. Each pregnancy is unique and the sheer amount of decisions you have to make can be overwhelming.
If you’re trying to decide what type of pregnancy provider is right for you, determine what your birth preferences are first and go from there. Once you know where you plan on giving birth, it will be easier to weigh the pros and cons of an OB vs a midwife for your specific situation.
Above all, you deserve to find a provider you can trust who treats you with dignity and compassion. Don’t settle for a provider who doesn’t align with your values or belittles you due to your choices. There are many excellent pregnancy providers out there and it’s worth taking the time to find the right fit.
Frequently Asked Questions (FAQs)
Is it better to give birth by midwife or doctor?
Whether you choose a midwife or pregnancy doctor, also known as an OB, depends on your preferences. There are pros and cons to both types of pregnancy providers.
Can I switch from OB to midwife?
No matter how far along you are, you can always switch providers if you realize yours isn’t the right fit. Many women choose to switch from an OB to a midwife when they decide a midwife is a better fit.
Can a midwife deliver a baby without a doctor?
Certain types of midwives can attend hospital births in many states. Certified nurse midwives and certified midwives are most likely to practice in the hospital. Other types of midwives, such as certified professional midwives, can attend births in a birth center or attend home births.
Can a midwife deliver a baby in a hospital?
Depending on the state, certain types of midwives can practice in a hospital setting. The most common type of midwife to attend hospital births is a certified nurse midwife. This type of midwife is a registered nurse trained in midwifery.