(Closed) OB or Midwife?

posted 5 years ago in Pregnancy
Post # 2
Member
2902 posts
Sugar bee
  • Wedding: June 2013

An OB is a medical doctor, and a midwife is a registered nurse who has specialized training in pregnancy and childbirth. If you get along better with the midwife you’ve seen, I’d stick with her. It sounds like she’s part of a practice with OBs, so if your pregnancy becomes higher risk or if you develop complications, she’ll be able to transfer your care to another member of her team. 

Midwives are great for most healthy, normal, uncomplicated pregnancies. An OB is probably better if you have complications along the way. Here’s a good article about how to choose between a midwife and an OB: http://www.fitpregnancy.com/pregnancy/labor-delivery/ob-or-midwife

I have an OB, because I have a higher risk pregnancy and I really like the extra medical attention. My OB probably errs on the side of too many interventions, but I’d rather have someone watching me like a hawk even if it gets annoying at times. Lots of my friends have delivered with midwives and really enjoyed the experience. If I wasn’t so paranoid,mid probably choose that route myself. 

  • This reply was modified 5 years, 2 months ago by  KatieBklyn.
Post # 3
Member
9670 posts
Buzzing Beekeeper
  • Wedding: August 2012

I would only choose an OB. I just prefer the person with the maximum amount of medical training when it comes to my health. Even if I was not high risk I would still see an OB.

Post # 4
Member
571 posts
Busy bee
  • Wedding: May 2013

 

Daizy914:  Hey there, just thought I would chime in for the thread.  I’m choosing a Midwife over an OB because of my personal experience.  Where I live I would see my doctor for basic prenantel appointments and then the OB.  My doctor is very rushed and doesn’t explain anything.  And is away a lot. I also wouldn’t be able to contact them at any time throughout the day.  The midwife is very personalable and our appointments are longer so I can specifically ask questions.  I like her better because of this and the fact that I feel like she is more caring about me.  I am a bit nervous because it is my first so maybe that is why I want someone who is more caring. I like everything explained if that makes sense.

That being said I believe that it matters more about who you are comfortable with.

Post # 5
Member
1953 posts
Buzzing bee
  • Wedding: October 2013

 

KatieBklyn:  great explanation regarding the differences.

I’m choosing a team of midwives but there are OBGYN’s in the practice as well so if there are complications, I can easily be transferred. From what I understand, midwives are a little more supportive if you prefer a labor and birth with little intervention. Obviously, some doctors are supportive of that as well, but not all.

You can read more about midwifery philosophy here http://www.midwife.org/Our-Philosophy-of-Care

Post # 6
Member
3696 posts
Sugar bee

Daizy914:  It sounds like you have the best possible situation on your hands that you could wish for! In your shoes, since you have a good rapport with her I would start care and plan on staying with the midwife unless and until a complication develops that requires more specialized care. At that point she would have to transfer your care to an OB anyway (that’s what midwives are required to do by their scope of practice). Since she is already part of a practice with an OB she knows, etc., that should be very seamless (and depending on the situation, she might still be able to be somewhat involved in your care).

As long as things are normal and healthy, a midwife is a great option. OBs are trained as surgeons and trained to deal with pregnancy related abnormalities. Midwives are trained to recognize them and know when to call in someone with more expertise. So working with a practice like what you describe is a really nice situation for getting just the right amount of care – not too many interventions, but still get the ones you need in a timely fashion.

Post # 7
Member
7310 posts
Busy Beekeeper
  • Wedding: October 2011 - Bed & Breakfast

I think it’s best to approach this as a sliding scale of intervention and personalization. At one end of the scale are midwives in independent or midwife-only practices associated with home births and free-standing borth centers. They tend to be the least intervention-oriented (both in pregnancy and in birth) and most holistic, personalized care-oriented. At the other end of the scale are MFM OBs in large teaching hospitals. They tend to throw every intervention and the kitchen sink at you, and their pregnancy visits tend to be very short and curt. Everything else is somewhere in the middle. OB practices are usually more intervention-minded, and midwives connected to these OBs tend to pick-up some of those habits along the way. Midwife-only practices that do hospital deliveries are maybe a bit less intervention-focused than midwife-OB practices, but they will still have to play nicely with hospital policies come delivery day. There is no right or wrong in choosing one. There is only what feels right to you.

We are going to begin fertility treatments soon. One of the big factors in choosing the fertility clinic that I did was that they strongly believe in single-embryo transfers whenever possible. I REALLY want low intervention, whole-person care, and to deliver with a midwife only practice in a small, free-standing birth center. I can only do that if I am carrying a singleton pregnancy. I went to a large, hospital-based OB practice for my first pregnancy. BTDT, hated it. I hated delivering in a hospital. I hated being “just a number” in that large practice. I hated being a show in the delivery room for a bunch of medical students. Nothing about the experience was positive for me, so this time I am taking more control, planning what I want, and seeking out the providers who deliver care in a manner that is consistent with my personal preferences and goals.

Post # 8
Member
1621 posts
Bumble bee
  • Wedding: September 2012

As a midwife, I’ll admit my bias.  BUT I will say that the spectrum of individualized care/woman centred care/less intervention vs. more intervention exists both with midwives and OBs.  We are not the only ones that provide a less-interventionist and woman centred perspective, but we are more likely to do so as compared to the average MD.  I personally know several OBs that are just as “midwifey” as I am LOL; and at the same time I’m more “OBish” than some other midwives I know of.  It’s totally a spectrum and the goal is to find a provider that is a good fit for your particular needs.

I can say that at my practice, we practice a very evidence-based way, we respect and follow guidelines for best practice routine care that ALL care providers SHOULD follow (e.g. no routine breaking of the waters) and as such our clinical care varies very little from an OB that is intervening *appropriately* but the flavour or style is where the difference lies in that we consider the woman the primary decision maker and we give the information she needs to make that decision but we don’t make the decision for her (although we sometimes will recommend one course of action over another).

For a healthy woman with a low risk pregnancy, I think midwives with hospital privileges or midwives attached to an OB group are the best of both worlds.  It’s varies a lot more in the US than it does here, here midwives always work in stand alone practices (no OBs in house) but we have great relationships with our OBs and work well and closely with them so I would always recomend starting with a midwife if you’re low risk and she will transfer your care if necessary.

Post # 9
Member
2190 posts
Buzzing bee
  • Wedding: March 2013

Daizy914:  Just throwing my perspective in here. I don’t have any personal experience with a midwife,  but my OB is in the middle of the spectrum. He is an MD, very knowledgeable and experienced, but on the minimal intervention side. He is also in solo practice, just has a PA (whom I LOVE), so it is a very personal experience and he knows all about my health. I will deliver at a hospital, but again, he won’t push induction or anything like that (my good friend also had his as an OB a year ago). 

Post # 10
Member
3339 posts
Sugar bee
  • Wedding: April 2013 - Rhode Island

Midwives are fantastic for low risk pregnancies and births, especially if you want to have a low-intervention, vaginal birth. I HIGHLY HIGHLY recommend reading “Ina May Gaskin’s Guide to Childbirth.” It is an amazing read and completely opened my mind to what birth can/should really be like. Half of it is birth stories and the other half has all the research and science to back up why non-medicated vaginal births are best for both mother and baby.

Another great book is “Pregnancy, Childbirth, and the Newborn” by: Penny Simkin, Janet Walley, April Bolding, Ann Keppler, & Janelle Durham. It has a great section that describes your options for maternity care and the benefits/tradeoffs of each.

By The Way, not all midwives are nurses. There are different types of midwives certified in the U.S. and only one type is also a nurse. You can read more about that here: http://associationofmidwiferyeducators.org/aspiring-midwives.html 

ETA: I’m almost 8 months pregnant and am having a midwife deliver my baby. There are 4 midwives in the practice and a few OBs too. So in the event that I need an emergency C-section or something, there is an OB in the practice who can do it. I’ve met all 4 of the midwives and I really really love them. The baby turned head down last week so I’m pretty confident that I will be able to have the non-medicated, low to no intervention, vaginal birth that I want. I’m so glad I left my former OB. She was completely incompetent and I had no faith in her medical ability/expertise at all.

Post # 11
Member
2600 posts
Sugar bee
  • Wedding: October 2010

To me, it’s a GREAT sign that your office has OBs working alongside midwives. Choose whomever you feel comfortable with, and take advantage of the resources. 

For the record, I would myself be fine having a midwife deliver my baby so long as I was in a hospital setting and could secure necessary medical intervention if I needed it. 

Post # 12
Member
7879 posts
Bumble Beekeeper
  • Wedding: October 2010

My OB delivered both my girls. I was very happy with both deliveries and if I were to have another baby I would do the same thing again.

Post # 13
Member
2315 posts
Buzzing bee
  • Wedding: October 2015 - Ruby Princess

as an L & D nurse, I have enjoyed working with midwife-assisted births the best. I worked in a hospital where there were midwives on call as well as OBs. The consulted with each other, and tried to get the best experience for the patient. Midwives were less likely to recommend and perform episiotomies routinely, unless absolutely necessary for getting a baby out quickly if there was trouble. OB docs were great, but they tend to like to intervene more. In the hospital setting, where midwifes attend rountine births, and co-manage more complicated ones, was alwasy the best of both worlds to me.

Post # 14
Member
3378 posts
Sugar bee
  • Wedding: December 2011

I actually chose a practice that’s both OBs and midwives (we recently moved to a new city, so I had to find a new provider when I got pregnant).  I chose it because I have the security of already having an OB if any problems should arise, but for the most part, as long as my pregnancy continues to progress normally, I’ll see the midwives.  I wanted to work with a midwife because they tend to come from the perspective that pregnancy and birth are a normal processes that don’t necessarily need medical intervention.  I’m aiming for a natural delivery, and I want a supportive provider who not only is familiar with natural birth processes (most OBs do not actually witness a natural birth – and by that I mean without medication or medical intervention – from start to finish.  They are usually only there for the pushing or to oversee interventions), but who will support my efforts to have a natural birth and not push for unnecessary procedures or medications.

I’ve known people who have loved their OBs, and I’m sure there are people who have had bad midwife experiences, but that’s why I made the choice I did.  In addition to being comfortable with your provider (which it sounds like you are with your midwife), I’d recommend thinking about what kind of birth experience you want to have and choosing the provider who is most consistent with that.

Post # 15
Member
2425 posts
Buzzing bee
  • Wedding: July 2015

When I was pregnant I went with an Ob and I am truly grateful I did I end up needing an emergency c-section and mid-wives can’t really help you with that. 

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