Midwife or Obstetrician?


As a doula in Utah I get a lot of question about doctors at birth, but many American woman don’t know that they can hire someone besides an OB for their pregnancy. Those who have heard of midwives often believe misconceptions that midwives are for hippies who want to birth naturally in a barn. The truth is most midwives are highly trained and certified and many even have the ability to attend hospital births and authorize the administration of any needed drugs

From the surface, a midwife and an OB are pretty similar. By definition they are healthcare providers who assist woman with pregnancy and birth. The obvious difference being that the Obstetrician is trained to preform a cesarean section when needed while the midwife has no surgical training.

So who then should you choose to deliver your baby? The answer lies in the type of birth you seek. (And other health considerations as well.)

Ask yourself how you view birth…

The way I see it, there are two ends of the spectrum. Some see birth as something that has been happening for thousands of years. They see it as a normal right of passage into motherhood. (Midwives tend to view birth more like this.) The other end of the spectrum is those whose see birth as something that is to be greatly feared and as truly a dangerous event. (This is closer to the Obstetrical view of birth)

Most of us fall somewhere in the middle of these two ends of the spectrum. (Healthcare providers included. Many OB’s are very aware of how normal birth can be and some midwives take a very techno-medical approach to their care.) Because of the media and the popularity in the US of telling birth horror stories, many American woman fall closer to the terrified out of their minds end of the spectrum.

To those who didn’t know they had an option outside of the usual OB attended birth let’s explore together the midwifery model of care and whether or not it is the right choice for you… (Keep in mind these are generalizations and may not be true of every healthcare provider.)

One of my favorite things about midwives is the fact that they attend the entire labor. They assist the laboring woman and watch for any complication the entire time. Most Obstetricians will only show up when you are ready to start pushing or if he/she is informed by nurses that something is not going as planned.

A midwife does not put such strict time limits on the speed at which labor progresses. There is not usually the feeling of “If this baby isn’t born in X hours we will force it out.” The midwife understands that each woman and each labor is different.

A midwife understands the mind-body connection and it’s role in labor. This might sound strange, but just like a person who finds it hard to continue using the restroom when someone disrupts them, so does the woman in labor find it hard to let go and progress with too many disruptions and strange things going on.

Most midwives try to protect the perineum. They will do anything they can to prevent tearing where possible. Most Midwives have a very low episiotomy rate especially when compared to that of most obstetricians.

Most midwife prenatal appointments are longer than that of OB prenatal appointments. They take time to answer questions and are even willing to explore your non pregnancy related fears and problems. They take the time to get to know you so that you feel comfortable in having them there for such an intimate life experience.


I personally have had both an OB and a midwife attend my births and preferred the care I was given by the midwife I chose but it is a personal decision each woman must make for herself. I would interview a couple OB’s and a couple midwives before making your final decision.

Good luck and please let me know if there is anything I can do that will help you find the care provider that is right for you!

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