(Closed) Mid-Wife, Doctor or both??

posted 3 years ago in Pregnancy
Post # 16
1192 posts
Bumble bee
  • Wedding: December 2012

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Misswhowedding :  Agreed.

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lolaj :  How old is your son?  If he isn’t more than a year old, then you probably won’t find any doctor that will even attempt a VBAC.

Post # 19
8751 posts
Buzzing Beekeeper

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lolaj :  I’m 8 weeks and I’m using a midwife (first appointment with her next week!) All of the ones at my practice are CNMs. They are there for a normal healthy pregnancy/delivery but should a complication arise they work closely with a team of OBs that will step in to assist in my care. I will still deliver in a hospital, but I preferred the more natural approach the midwives offer, and they have less patients so they still with you through labor where the docs have to continually make rounds. My practice will do VBAC with the midwives, but again it’s hospital based in case of complications. 

Post # 20
505 posts
Busy bee
  • Wedding: August 2012

It really also depends on the practice. I would compare different practices- whether OB or midwife, as you’ll find they vary significantly. Some publish their statistics (rates of c-sections, rates of episiotomies, pitocin/induction rates, VBAC success rates, etc), many will give you information on their facilities and philosphy, etc. You may find you love one OB practice and not another, love one midwife practice and not another, etc. 

Interesting to note that both te American College on Obstetrics and Gynocology and the American College of Nurse-Midwives both respect each other as “expertse in their respective fields” and value evidence-based research, credentialing, and collaborative practices. I think the major difference in their stances on home births. See statement here: https://www.acog.org/-/media/Statements-of-Policy/Public/sop1102.pdf?dmc=1&ts=20161208T1531401123 

I switched into a midwife practice because I wanted a less interventionist approach (which is often appropriate for a textbook pregnancy with no risk factors- the reason why for such pregnancies in many countries the midwife is the default) AND because I liked this particular practice. The midwives spent much more time with me than my OBs previously. They stress diet, exercise, conduct mental health screenings/underscore the importance of sunshine and moving around outside, learning about birth, encouraging douals, encouraging birth outside of stirrups, etc. The midwife practice I go to is fanatical about evidence-based/research-based methods, which I love, and they publish regularly in peer-reviewed journals.

My OB practice just took urine and Bridal Party samples each visit, and not much else. At my very first visit, when my ob heard I had a minor surgery three years ago five minutes into my appointmen said I was most likely looking at a C-section before even examining me or having me talk with my orthopedic surgeon. (Note- turns out my ortho said his patients go on to have normal vaginal births and have no increased risk for c-sections. But my OB didn’t even get that far. I was shocked at how quickly they defaulted to intervenion without further discussion or review.)

Again, this isn’t to say all mw practices are amazing and all OB practices are not- which is why it’s important to understand the particular practice, not just whether they are an OB or midwife group.

VBACs are totally possible with the right practice (midwife or OB) if that’s what you want and your provider deems it medically appropriate. My midwife practice publishes extensively on VBACs and is known for their VBAC success rate. They deliver in a hospital and work cloesly with OBs, referring out any cases which require more intervention than they can provide. 

Good luck!

Post # 21
198 posts
Blushing bee

Raises hand. Hi! I’ve never given birth, but I am a mad student, and I’d totally recommend a midwife! They’re honestly so great. They perform gynaecological examination, help with preconception planning, provide antenatal and care, assist during labour and delivery, offer guidance about breastfeeding and other newborn care issues, and more! And they have more time than medical doctors, which means more time to be spent talking to the mother-to-be about her concerns and needs.

Of course, just because a stranger on the internet tells you to, doesn’t mean you should. Definitely put research into it, look into books and websites written by midwives, ask people who’ve used one, and talk to your doctor! But just for the record, this stranger on the Internet is honestly so in awe of midwives, and is definitely planning to use one when she gives birth in a few months. 

Post # 22
127 posts
Blushing bee
  • Wedding: May 2013

I gave birth at a hospital with a midwife. You can look for an OBGYN practice that has midwives on staff. If you end up needing a doctor to deliver then you get the one from your practice who is on call. I highly recommend this route. I also was still able to get an epidural so midwives aren’t only for 100% natural births.

Post # 23
1206 posts
Bumble bee
  • Wedding: September 2015

At my OBs practice if you are thinking of a midwife you alternate appointment with the midwife and the OB. Then you have to decide which you’ll want at your birth. They don’t let you have both because there’s no need to have them both at the birth and it can take away from others that might need a clinician. 

I’m 29 weeks and am going with a midwife for a few reasons. First, the midwife spends a lot more time with you through labor while the OB really mostly comes in to deliver you. Also, I want a low intervention birth with hopefully no medication which is more likely with a midwife. They tend to have a more natural philosophy and believe a woman’s body is meant to have a baby. 

You do need to look in to the credentials of the midwives. If they are at a medical practice and deliver in a hospital they need to be certified nurse midwife so they have gone to graduate school for it. I’m not sure how it is in birthing centers but if you choose a home birth not all midwives that do them have that degree. 

Post # 24
195 posts
Blushing bee
  • Wedding: November 2015

Watch “The Business of Being Born” to get a better feel for the difference between a midwife and ob. It’s biased but, it does help show why there is a resurgence of midwifery happening in the U.S. Depending on the specifics of your last procedure, many women are able to to have a vbac and a midwife will be much more supportive of that, if that is what you want. Regardless of where/with whom you give birth, they should be licensed and have a contingency plan to get you to a hospital in case of emergency. 

Post # 25
412 posts
Helper bee
  • Wedding: September 2016

There is the misconception that VBACs are risky (they really aren’t compared to the risks of c-sections).  There is a very minimal increase in the risk of uterine rupture but with c-sections there is a higher risk of maternal death and hysterectomy.  If you can find a midwife that will do a VBAC that is great because they are experts at managing normal childbirth.  You will need to give birth in a hospital with an OB and anesthesia in case you end up needing a c-section.  I assume you are planning to try for a VBAC… if you are going to have a repeat c-section then you might as well just stick with your OB.

Post # 27
1310 posts
Bumble bee
  • Wedding: April 2015

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MrsBG :  same situation here! My OB’s practice is both doctors and midwives. All my checkups are with one of the four midwives, and I LOVE them all. They gave me the option of having appts with my dr or the MW, and I chose MW. My doctor is always there for any issues and one of the dr’s will be available during delivery in case she’s needed. But the midwives are soooo much more personal to me. They are so excited still about everything, really make you feel like your pregnancy is just as important to them, even if they’ve done it hundreds of times. I can tell that all my midwives really love what they do. 

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