Ob-gyn or midwife: Which one is right for you?
What's below:
• How can I decide what kind of practitioner should deliver my baby?
• Is it safer to choose an ob-gyn over a midwife?
• What do most women choose?
• See also
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How can I decide what kind of practitioner should deliver my baby?
As soon as you decide you want to start trying to conceive, you should start looking for the practitioner you want to care for you during your pregnancy. Whether you choose an obstetrician-gynecologist (ob-gyn), a certified nurse-midwife (CNM), or a direct-entry midwife will depend on what kind of a birth experience you want to have, where you want it to take place, and whether your pregnancy is normal or high-risk.
Here are the primary considerations:
Do you have a serious chronic medical condition?
If you have a medical condition such as high blood pressure, epilepsy, heart disease, or diabetes, or certain prior complications, your pregnancy will most likely be considered high-risk, and you'll need to see an obstetrician or, if possible, a perinatologist (a physician who specializes in high-risk pregnancies). Once you're pregnant, if you're having twins or multiples or certain problems develop, you'll also be put in this category and will need to have your care transferred to an ob practice, if you're not with one already.
Do you have an ob-gyn whom you trust and feel comfortable with?
If you have a good relationship with a gynecologist who practices obstetrics (delivers babies), you may want to stay right where you are. This is especially true if you feel your doctor cares about you, knows your history, and makes time to answer your questions. But if you have any doubts about your doctor or you're curious about other options, this is the time to look around for another doctor or consider switching to a midwife.
How important to you is a more individual, less routine approach?
If you're looking for a practitioner who will have more time to answer all your questions, see your pregnancy as a unique event, and treat you as an active participant in your own care, you may prefer a midwife. A midwife will encourage you to learn about the physical and emotional changes you're experiencing throughout pregnancy and to think carefully about all tests and interventions, so you can choose what's right for you. Whatever you choose, she will support you in your decision. For example, a midwife will help you have a non-medicated labor if that's what you choose, but an epidural will still be an option during labor if you're giving birth in a hospital. All CNMs have obstetricians available for consultation and backup if needed.
What kind of setting do you want to give birth in?
If you have your heart set on a natural birth in a comfortable setting (possibly even your home) with family and friends around, you'll want to find a midwife to attend the birth. Many certified nurse-midwives work out of childbirth centers that specialize in family-centered care. Birthing centers are known for natural births with no routine interventions and for welcoming family, friends, and even siblings in the birth room. If you want to give birth at home, you can choose either a certified nurse-midwife or a direct-entry midwife to attend you. On the other hand, if you want medicated pain relief, or you're very anxious about something going wrong during delivery, you may be best off in a hospital, where complications can be dealt with quickly. If you want a hospital birth, you can choose either an obstetrician or a certified nurse-midwife to be your primary caregiver.
Is it safer to choose an ob-gyn over a midwife?
Several studies in the United States have shown that healthy women with normal pregnancies who choose certified nurse-midwives are just as likely as those who choose ob-gyns to have excellent outcomes. Certified nurse-midwives recognize when problems develop during pregnancy, labor, and birth and are trained to manage emergencies. All CNMs have arrangements with obstetricians they can consult with or call in if a complication develops during pregnancy or labor. (If you choose a direct-entry midwife, make sure that she has this kind of back-up arrangement.) What's more, women who choose midwives tend to endure fewer medical interventions (including continuous electronic fetal monitoring, epidurals, and episiotomies) and have a lower rate of cesarean section.
What do most women choose?
Obstetricians are by far the most common choice, although certified nurse-midwives are becoming more popular: In 1999, CNMs delivered about 8 percent of the babies born in the United States. Some women choose practices that have both obstetricians and midwives. And some women have their family physician deliver their babies. The most important thing is to choose someone with whom you feel completely comfortable and who practices in the right setting for you.
• How can I decide what kind of practitioner should deliver my baby?
• Is it safer to choose an ob-gyn over a midwife?
• What do most women choose?
• See also
--------------------------------------------------------------------------------
How can I decide what kind of practitioner should deliver my baby?
As soon as you decide you want to start trying to conceive, you should start looking for the practitioner you want to care for you during your pregnancy. Whether you choose an obstetrician-gynecologist (ob-gyn), a certified nurse-midwife (CNM), or a direct-entry midwife will depend on what kind of a birth experience you want to have, where you want it to take place, and whether your pregnancy is normal or high-risk.
Here are the primary considerations:
Do you have a serious chronic medical condition?
If you have a medical condition such as high blood pressure, epilepsy, heart disease, or diabetes, or certain prior complications, your pregnancy will most likely be considered high-risk, and you'll need to see an obstetrician or, if possible, a perinatologist (a physician who specializes in high-risk pregnancies). Once you're pregnant, if you're having twins or multiples or certain problems develop, you'll also be put in this category and will need to have your care transferred to an ob practice, if you're not with one already.
Do you have an ob-gyn whom you trust and feel comfortable with?
If you have a good relationship with a gynecologist who practices obstetrics (delivers babies), you may want to stay right where you are. This is especially true if you feel your doctor cares about you, knows your history, and makes time to answer your questions. But if you have any doubts about your doctor or you're curious about other options, this is the time to look around for another doctor or consider switching to a midwife.
How important to you is a more individual, less routine approach?
If you're looking for a practitioner who will have more time to answer all your questions, see your pregnancy as a unique event, and treat you as an active participant in your own care, you may prefer a midwife. A midwife will encourage you to learn about the physical and emotional changes you're experiencing throughout pregnancy and to think carefully about all tests and interventions, so you can choose what's right for you. Whatever you choose, she will support you in your decision. For example, a midwife will help you have a non-medicated labor if that's what you choose, but an epidural will still be an option during labor if you're giving birth in a hospital. All CNMs have obstetricians available for consultation and backup if needed.
What kind of setting do you want to give birth in?
If you have your heart set on a natural birth in a comfortable setting (possibly even your home) with family and friends around, you'll want to find a midwife to attend the birth. Many certified nurse-midwives work out of childbirth centers that specialize in family-centered care. Birthing centers are known for natural births with no routine interventions and for welcoming family, friends, and even siblings in the birth room. If you want to give birth at home, you can choose either a certified nurse-midwife or a direct-entry midwife to attend you. On the other hand, if you want medicated pain relief, or you're very anxious about something going wrong during delivery, you may be best off in a hospital, where complications can be dealt with quickly. If you want a hospital birth, you can choose either an obstetrician or a certified nurse-midwife to be your primary caregiver.
Is it safer to choose an ob-gyn over a midwife?
Several studies in the United States have shown that healthy women with normal pregnancies who choose certified nurse-midwives are just as likely as those who choose ob-gyns to have excellent outcomes. Certified nurse-midwives recognize when problems develop during pregnancy, labor, and birth and are trained to manage emergencies. All CNMs have arrangements with obstetricians they can consult with or call in if a complication develops during pregnancy or labor. (If you choose a direct-entry midwife, make sure that she has this kind of back-up arrangement.) What's more, women who choose midwives tend to endure fewer medical interventions (including continuous electronic fetal monitoring, epidurals, and episiotomies) and have a lower rate of cesarean section.
What do most women choose?
Obstetricians are by far the most common choice, although certified nurse-midwives are becoming more popular: In 1999, CNMs delivered about 8 percent of the babies born in the United States. Some women choose practices that have both obstetricians and midwives. And some women have their family physician deliver their babies. The most important thing is to choose someone with whom you feel completely comfortable and who practices in the right setting for you.
