Post # 1
I’ve been going to a practice with both OBs and midwives, and I’ve seen both OBs and midwives from the practice for prenatal care so far, but pretty soon I have to choose one and stick with it through the last trimester + labor. I thought maybe you guys might have some thoughts on one vs the other, because I keep going back and forth on it.
I’m not highly opposed to intervention, but I’d rather avoid an epidural, c-section, use of pitocin, etc. if possible. Overall, both the OBs and midwives lean towards non-intervention, and their c-section rates are really low, so it doesn’t make a difference one way or the other in that sense. And I’m definitely going with a hospital birth, so that’s no difference (midwife or OB) either. The midwife panel rotates being on-call, just as the OBs do, so when it comes to delivery, it only comes down to whether I get an OB or a midwife– I won’t necessarily get to deliver with my doctor or my midwife.
After talking to one of the OBs and one of the midwives, it seems like there are 5 differences between them (as a group) at this particular practice:
- The midwives check on you more often/are more present during labor whereas the OB will mostly leave you alone.
- The midwives are more into using warm & fuzzy language whereas the OBs are more likely to be matter-of-fact. The midwives also have a more prevention based and holistic approach overall.
- If I end up needing a c-section (and so far, signs point to no c-section needed in my case according to the OB), the OB supervising my labor will be the one to do the c-section. With a midwife, I’d (obviously) be turned over to an OB to do the c-section– so it would be starting with someone new during a stressful time.
- At my particular practice, it’s easier to get an appt with and see an OB on a consistent basis than with the midwives– often, you end up with a new midwife at each appt.
- I had a great OB that I LOVED, but she’s moving next month– to Australia (boo!). I don’t have strong feelings about the midwives I’ve seen– I like them, but I don’t LOVE them. The OB said she’d help me select an OB from the practice to see for the rest of my pregnancy, if I decide to go that route.
With that in mind– any other considerations I should be thinking through in this decision? Overall, I think I’m leaning towards going with the midwives, but I’m not seeing any major differences (these all seem little), so I’m trying to think through how much those little difference matter.
Post # 3
I would choose the midwife, no question! Midwives are experts in labor and delivery, whereas OB’s are more generally trained. I want the experts! My son was delivered by two midwives and they were awesome.
Post # 4
I’m going with an OB. The midwife in my practice is nice and very informative, I’d rather just go with an OB, especially since this is my 1st and I’m no sure what will go on.
Post # 5
I second the Midwife. The OB would most likely literally just be there for the birth, as a nurse would probably be who checked you, watched you, etc.
A midwife, like pp said, are highly skilled in birthing… unlike many Dr. who are more skilled in surgery.
It is really great that you’ve found a practice that has OBs with a low c-section & intervention rate….
I think you should really think about how you want your birth to go… a Midwife would be there much more with you, coaching you, and adjusting postitions, etc for your birth & the OB would be more along the lines of what a nurse has seen (not that she’d be coaching you… just checking you) and then making their decision from there.
I think in the event of a needed c-section, a Midwife who had been there & knows that would be best is better than a Dr. getting 2nd/3rd hand info and making that decision.
Post # 6
I was at Swedish and the NPs and the OBs I saw were great, but I waited until my OB’s call day to go into labor!
Post # 7
I plan to use a midwife. I like having the more attention, plus in my experience, I like their bedside manner much more.
Post # 8
I strongly disagree about midwives being the experts over OBs. OBs trainings is longer and more comprehensive- they are the experts on the entire female reproductive system. An OB is well-trained in surgery IN ADDITION to having far more training in OB. In the shorter training the midwives do, there is no way for them to understand pathology, medications and other things at the level of OBs. The only advantages are that midwives are generally more warm and fuzzy and generally have lower C-section rates. (This doesn’t necessarily mean good things though, as midwives almost always only take the cases that appear easy to start with, and I have seen way too many women who should have had a c-section but the midwife incorrectly delivered vaginally or delayed it, thus lowering the rates.)
Number 4- continuity is a big reason. I want someone who has seen enough pathology and knows me well enough to catch a complication- that means an OB who is good at continuity. I have seen WAY too many bad outcomes to ever consider a midwife, including some of my patients. As a family physician no longer doing ob, I have already forgotten more than most midwifes will ever know, and (in this area) I am still not as competent as an OB.
Post # 9
I recommend a midwife!! Mine was awesome during a very long/stressful labor!!
Post # 10
I would also recommend a midwife! I had an amazing experience. I went to a practice with several of each. I’m in a small city and I think there were only 2 other women in labor at the hospital the 24 hours I was there in labor. I wanted as few interventions as possible, and loved the attention from the midwives. Very little wait at apts, long appointments, more involved but hands off approach… I got very lucky that despite it being quiet on the maternity ward, my favorite midwife came in for my delivery even though she wasn’t on call. I got basically one on one attention from her for the last 12 hours of my delivery.
I think that OBs and midwives are both very knowlegable, but in almost all cases if you go with an OB, they show up for the delivery and you are cared for by nurses during your entire labor. With a midwife, you have more attention during labor from the midwife. I felt like it was hit or miss with the nurses. I had 3 over the 24 hour period, and really wasn’t a fan of some of them, so it was nice to ask for the midwife to get my questions answered.
Post # 11
I feel like it’s such a personal decision. I went with an OB because I just feel more comfortable with them. I’m paranoid and think everything bad will happen to me so I just want a doctor just in case. There’s both OBs and midwives where I go so if something did happen they would have an OB there on call for me, but it still just freaks me out.
Post # 12
Is there anyone you just click with? Most likely theyre all competent in their field so its who makes you feel comfortable and takes the time to answer your questions. The two midwives at the practice I went to retired before I got pregnant so midwives were not an option. But as far as OBs, some I went to I really liked, they answered questions and took time to ask questions to make sure everything was going well even if just briefly at each appt. Some I went to though were really not that good so I’d come home to google and pubmed to answer questions. So if there’s someone you have a good repertoire with that might be more important than title.
Post # 13
@MrsDG: I’m going to be delivering at Overlake (GroupHealth), if all goes as expected. I’ve heard Swedish is fantastic. Lucky that you delivered with your OB!
@troubled: I think you’re making a good point. I guess one thing I’m trying to figure out is if it makes any sense to make a decision based on one particular OB or midwife when they won’t necessarily be the one to deliver me. Did you find that who you saw for prenatal care mattered more than who was with you for labor and delivery?
Post # 14
i also think this is a personal decision and just depends on what you’re looking for. both OBs and midwives are fully trained to deliver your baby, but obvs an OB would step in either way if you ended up needing a c-section or if there’s some kind of emergency. i think it has more to do with what you are looking for as far as the CULTURE of the practice you visit and the way your provider talks about and treats your pregnancy – as others said, a midwife is probably going to be more warm and fuzzy and lean towards hoalistic approaches to your care, while an OB will be more medicine-focused and may have a more direct bedside manner (although that’s not always true…plenty of OBs are easy to talk to and appreciate hoalistic approaches too…you just have to find them!).
i also started out seeing both and was sure i wanted to stick with the midwife since i was interested in a natural water birth. however, i changed my mind about the water birth and after a few visits, i found that the waits for appts were insanely long, the midwife staff was so small that they were stretched extremely thin (appts rescheduled several times, no guarantee that a midwife would be available when i go into labor) and didn’t actually have the time/energy to provide the kind of care i was looking for. i decided that FOR ME, ease of appts, a small hospital with few delivery rooms (aka a little more attention from nurses), an open-minded response to my desired birth plan, and an OB that i was generally comfortable with was what i really needed. so again, it’s not that one is better than the other; it really is about what you feel most comfortable with.
i would also echo @guitargirl in that midwife practices usually only accept very healthy pregnancies with no signs of problems, so they are bound to have lower c-section rates. also women who wish to have a c-section for whatever reason are probably not very likely to seek care from a midwife either (although i do believe they are not as quick to go that route).
Post # 15
My biological Dad and Step mom have gone both ways. An OB the first, and a midwife the second. The preffered the midwife (and home birth).
However, since this is our first, DH and I are going with an OB since we don’t know what will happen. This OB did both of my bff’s pregnancies, so I trust him.
Post # 16
I think they are both trained in their own ways, so either one should be capable of handling your pregnancy.
I personally will be going with a midwife. My midwife will deliver the baby vaginally and will actually assist the OB in the case of a c-section, so she will still be involved in the process no matter what.
One of the things I like about the midwife is the extra amount of time I receive.
I was recently pregnant (but miscarried) so my experience being pregnant is very short. However, while everything was happening, my midwife was great. She took as much time as I needed, and she did an ultrasound at every visit. She also let me come back in after 1 week after we noticed something was wrong, instead of waiting for 2 weeks as the OBs require. I told her that I couldn’t possibly go 2 weeks without knowing anything, so she allowed me to come back in sooner. I did have to see an OB (in the same practice) to confirm the missed miscarriage, and he did the D&C procedure. He was a lot shorter in my appointments– he barely had any time and only answered the quick question before leaving the room.
My midwife on the other hand, had me come to her office after each appointment, and we talked about what was going on. She was so much more available to me, both time-wise during our appointments, and emotionally.
Overall, I feel like my midwife is more caring and more personal. I want my pregnancy experience to be a good one, so I appreciate the attention and time.
GOOD LUCK with your decision!