Midwife vs. Ob-Gyn: How to Choose Your Pregnancy Care Provider

Here’s a closer look at both kinds of care to help you as you make your birthing decisions.

What Is an Obstetrician (Ob-Gyn)?

Ob-gyn is short for obstetrician-gynecologist. An obstetrician is a doctor that cares for women before birth, throughout pregnancy, during childbirth, and in the first few weeks postpartum.

These doctors are also gynecologists, which means they provide reproductive healthcare. They can diagnose and treat diseases of the female reproductive system.

What Does an Obstetrician Do?

Obstetricians provide routine prenatal care and diagnose and treat pregnancy complications. Obstetricians may work in a clinic, hospital, medical office, or university, and some have private practices.

If you choose an ob-gyn for your pregnancy and birthing care, you can expect them to:

• Perform exams, lab tests, and prenatal screening
• Measure your baby’s size, growth, and position in the uterus
• Monitor your pregnancy using blood tests, ultrasounds, and urinalysis
• Detect any complications and work with specialists, such as maternal-fetal medicine providers, as needed
• Treat conditions that affect your pregnancy or baby
• Handle labor and delivery, including induction, medications, and emergencies
• Perform a cesarean section if needed
• Provide postpartum care

Delivering a Baby With an Ob-Gyn

If you have an obstetrician, you'll plan to deliver your baby at a hospital or hospital-based birth center.

"As a physician, we typically have several patients [in labor at the same time]," says Hector O. Chapa, M.D., a board-certified ob-gyn at Texas A&M College of Medicine. "This may limit our bedside contact."

Fortunately, labor and delivery nurses are there to help and are the first line for patient care in between visits from the ob-gyn, Chapa says.

"This is why medicine and nursing function as one team. Nurses are considered our partners in care,” he says.

What Is a Midwife?

A midwife is a trained pregnancy healthcare provider. They provide care during pregnancy, birth, and postpartum. They also help provide newborn care.

Midwives tend to see pregnancy and birth as a natural process. They may be more open to labor and delivery practices that aren’t medical in nature. These may include the use of herbs, tinctures, homeopathy, and traditional Chinese medicine, Rector says.

What Does a Midwife Do?

A midwife does many of the same things as an ob-gyn—providing gynecological care, plus prenatal and obstetric care—but is typically only recommended for low-risk births and gynecology.

“Midwives are the gold standard for low-risk pregnancies around the world,” says Jeni Rector, a certified professional midwife and owner of the Village Midwife and Birth Center, in Newport News, Virginia.

If you’re considering working with a midwife for your low-risk pregnancy, the care you can expect to receive includes:

• Ordering labs, ultrasounds, and consultations
• Treating common discomforts of pregnancy
• Educating pregnant people on nutrition, lactation, and future family planning
• Providing postpartum care for you and your baby

Delivering a Baby With a Midwife

Midwives and nurse-midwives who are certified can practice at hospitals, clinics, birth centers, or in homes and offer a variety of services.

Midwives tend to be less strapped for time than ob-gyns and may be able to spend more time with their patients during labor, but it does vary. "I've spent two days, and I've spent three hours with patients," Rector says. She says she recently spent 12 hours with a mom in labor at her birth center.

"Midwives really try their best to be with the laboring woman," says Melinda Hurst, a certified nurse-midwife who works at an urban hospital in the South Bay area of California."But labor can take a long time."

You may also find that a midwife tends to provide care with a personalized approach. “Midwifery care is led by the pregnant person,” Rector says. “They tell the midwife what they want, and we help come up with a plan to get there.” That may include avoiding pain medication, if that’s what you want. (Note that you can still use an ob-gyn if you want a medication-free birth.)

If you’re considering a midwife, look for a midwife who’s certified, which means they’re legally licensed to practice. There are a few different types:

• A Certified Nurse-Midwife (CNM) has completed nursing school and has a graduate degree in midwifery. CNMs can work in hospitals, homes, and birth centers. They work in all 50 states.
• A Certified Midwife (CM) hasn’t completed nursing school. But they have a master’s degree in midwifery. They passed a certification exam from the American Midwifery Certification Board. They’re only licensed to practice in a few states, but they can prescribe medications.
• A Certified Professional Midwife (CPM) may work at a birth center or homes. They’ve completed coursework and are certified by the North American Registry of Midwives. They’re only licensed to practice in some states and can’t prescribe medications.

Midwife vs. Ob-Gyn: Which Is Right for You?

When making the choice between an ob-gyn or a midwife for pregnancy, the most important thing to remember is that midwives are best reserved for low-risk pregnancies.

“[Midwives] can deliver a baby,” says Cheruba Prabakar, M.D., a board certified ob-gyn who practices in Oakland, California. “But they’re not surgeons. If there is a complication, a midwife cannot handle that.” So, if you need a C-section, or you need assistance from a vacuum to help deliver the baby, an obstetrician will be called on, she says.

You may also be referred to an ob-gyn during your pregnancy if it becomes high risk—for example, if you’re diagnosed with preeclampsia or gestational diabetes. A pregnancy will likely also be considered high risk from the beginning if you have been managing diabetes or high blood pressure before you became pregnant, or if you’re pregnant with twins.

Choose a Pregnancy Care Provider for Your Needs

If your pregnancy is considered low risk and you’re exploring both doctors and midwives, do your research before choosing a provider.

It’s a good idea to meet with both an ob-gyn and a midwife to see which pregnancy healthcare provider is best for you. Ask them about their respective practices. Consider what kind of birth you might want.

Ideally, you should select a healthcare provider whose ideas about birth align with your own. Here are some things to ask yourself while establishing your pregnancy care provider:

• Are you comfortable seeing a provider who specializes in low-risk pregnancy? Or would you prefer someone who has high-risk training as well?
• Which caregiver makes you feel most comfortable?
• Which caregiver is right for your individual needs?
• Which caregiver will respect your wishes?
• Do you want your caregiver by your side during your labor, not just delivery?
• Do you want more of a holistic approach to care? Or are you open to a variety of medical interventions?
• Do you know which setting you want to give birth in? If so, where?

Midwife vs. Ob-Gyn Cost Comparison

Cost may be a factor too. Seeing a midwife for routine prenatal care is often cheaper than the cost of an ob-gyn’s care.

“People look at the cost [of a midwife] and think it’s a lot,” says Rector. “But what they don’t consider is the doctor is a fee, hospital is a fee, anesthesia is a fee, and there’s more. Midwifery care is just one price (usually) for everything. “

However, many health insurance plans will help pay for the cost of either a midwife or an ob-gyn, so either could be in your price range.

Also, factor in where you’ll give birth. While your insurance will cover a hospital, delivering at a birth center may not be completely covered and a home birth may not be covered at all.

Check with your health insurance company to find out for sure. Choosing a specific provider who’s in-network for your plan may help you save significantly.

Ask your health insurance company any specific questions around what your policy covers and what you’ll be expected to pay out of pocket for prenatal and postpartum care.

Safety Is Paramount

A pregnancy health care provider (midwife or doctor) is a good choice so long as you feel confident about the safety of you and your baby during pregnancy and delivery. If you go with a midwife, be sure they have a physician on call in case of an emergency.

“Nothing is really normal about delivery,” Prabakar says. “In a split second, things can happen. That’s why your midwife must have a backup plan.”

The goal for any doctor or midwife should be the safety of the birthing parent and baby, Rector says. “Sometimes, the plan has to change for it to remain safe, and that’s when collaboration with a doctor or hospital is helpful,” she continues. “When doctors and midwives work together, the process of getting to that goal can be more natural and holistic.”

You May Also Like:

• 8 Things to Consider When Choosing a Pregnancy Doctor
• 6 Tips for Easier Prenatal Care Visits
• What Happens at the First Prenatal Visit