OB or Midwife: Finding the Birth Provider that Works for You

OB or Midwife: Finding the Birth Provider that Works for You

homebirth midwife checkup

Written by Erin Odom, Contributing Writer

If you’re expecting a baby (or hope to sometime in the future)–especially for the first time–your mind is probably spinning with questions. What supplements should you take? Should you exercise while pregnant? What’s the best pregnancy diet? And, of utmost importance, who should oversee your prenatal care and ultimately deliver your baby? Should you see an OB or midwife? And how do you find a birth provider that works for you?

These are questions no one should take lightly. But the last question I didn’t even think about during my first pregnancy. Even though it was 2008, I didn’t even know I had a choice besides using an obstetrician for my prenatal care and delivery. Since then, I’ve learned about Certified Nurse Midwives (CNMs) and Certified Professional Midwives (CPMs).*

Not all may be options in your state of residence (Obstetricians and CNMs are the only ones legally able to practice where I currently reside–North Carolina), but it’s wise to be aware of all your options before making a final decision.

OB or Midwife: Finding the Birth Provider that Works for You

Image by koadmunkee

Obstetricians (OBs)

Obstetricians are doctors. They have completed medical school, where they were trained to provide care for women during pregnancy, labor and post-labor. Most obstetricians are also trained to be gynecologists, with many possible areas of expertise, such as reproductive cancers or infertility. They are also trained as surgeons and are the only care providers who can perform C-sections (source).

Reasons to use an OB

  • You are a high-risk pregnancy. High risk does not necessarily include such conditions as gestational diabetes (I had it during my second pregnancy and used a CNM.), multiple babies or some other minor complications. High risk includes chronic, serious illnesses on the part of the mother or baby.
  • You feel most comfortable in a hospital setting. (That I know of, there are no OBs who practice in homes.)
  • You will require a C-section. 
  • It’s your only option. Even though I had no idea midwives still practiced when I had my first baby, I have since learned that, for where we were living at the time, an OB may have been my only option anyway. There are some areas where midwives are not available.

OB or Midwife: Finding the Birth Provider that Works for You

Certified Nurse Midwives (CNMs)

CNMs are essentially registered nurses who have received extra training to equip them to perform all of the same tasks as an obstetrician, except C-sections (source). I have used a CNM for both my second and current pregnancies. A CNM often practices in the same office as an obstetrician, and if an emergency arises (during pregnancy or labor/delivery), the obstetrician can back up the CNM and take over care if needed.

Where I receive my prenatal care, there are a handful of OBs and three midwives. I primarily see one midwife (who delivered my second baby), but any of the three could potentially deliver my baby–depending on who is on call at the hospital on that day.

The biggest difference I have seen is that CNMs are oftentimes more naturally-minded. They are accustomed to their clients preferring no or minimal interventions.

CNMs also spend more time getting to know their clients. My midwife feels like a friend. Instead of 5 or 10 minutes per prenatal visit (like I experienced when I used an OB during my first pregnancy), my midwife spends an average of 30-45 minutes with me per visit. Not only does she check my measurements and inquire about any difficulties, but we simply talk about life and get to know each other. This helps facilitate a mutual respect during labor. Also, my OB only entered the room when it was time for me to push during my first labor, but my midwife was there for the entirety of my time at the hospital (although she didn’t hover–and gave me privacy if I needed it!).

Reasons to use a CNM

  • You are a low-risk pregnancy but still want to deliver in a hospital (although some CNMs also deliver in birthing centers or even in homes).
  • You desire a natural birth.
  • You desire to get to know your birthing professional. You prefer to be a name instead of a number.

CPM check up

Image by eyeliam

Certified Professional Midwives (CPMs)

CPMs are skilled birthing professionals who are certified by the North American Registry of Midwives (source). They are able to perform all the same care as CNMs, but only practice in birthing centers or in homes. They are not required to obtain nursing degrees, although some CPMs do obtain both CPM and CNM status.

Many women who choose homebirth prefer the care of CPMs because their training includes an extensive amount of time attending home births. In fact, in order to become certified, they must attend a minimum of 20 births–10 of which must be in an out-of-hospital setting (source). Although CNMs can legally (in some states) deliver in homes, their training does not require the extensive out-of-hospital experiences.

Reason to Use a CPM:

  • You are a low-risk pregnancy.
  • You desire a homebirth or birthing center birth. 
  • You desire a natural birth.
  • You desire to get to know your birthing professional on a more personal level. 

OB or Midwife: Finding the Birth Provider that Works for You

Image by eyeliam

A Word about Doulas

I had never even heard of a doula until after my first child was born! A doula cannot deliver a baby or give prenatal care, but she is still a birth professional. The word “doula” literally means “a woman who serves.” A doula can serve as both an emotional and physical support to a woman before, during and after labor. Read more about doulas at DONA International.

*There are many different types of midwives beyond just CNMs and CPMs. This post is meant to give you a snapshot of some of the more common North American birthing professionals. For more information on midwives, visit the Midwives Alliance of North America.

What type of birthing professional do you prefer–OBs or midwives? 

Top image by eyeliam

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  1. I’ve used OBs and midwives, in hospitals and birthing centers, and I think a lot depends on the provider and not just their titles as well.

    With my first pregnancy, I was planning a homebirth and had interviewed a midwife. Then, when I miscarried four weeks later, she was so completely unkind and caring when I called her that I never considered using her with my second and third pregnancies.

    I saw an OB the second time around, and she didn’t have much of a bedside manner either, but a different OB attended our oldest daughter’s birth, and he was amazing.

    We moved between pregnancies and my second daughter was born in a birth center. I loved every midwife at that practice, which closed before my next pregnancy.

    I saw a midwife at a shared practice during my third daughter’s pregnancy, and I loved her…until she never even bothered to stop by after my emergency c-section to check on my daughter and I, even though I knew she was at the hospital and she knew what was going on.

    With my fourth daughter, I saw the OB who had performed my c-section for #3. She strongly encouraged me to have a VBAC, was incredibly supportive, hung out with us throughout my entire labor and was unbelievably kind and gentle throughout her birth.

    Needless to say, at the end of the day, that OB was my favorite, and I’d go back to her in a heartbeat, probably even over the birthing center midwives!

    1. Thanks for sharing all your experiences, Mandi! It is so disheartening to hear how unkind your first midwife was when you miscarried! I?m so sorry for your loss.

      I think it?s so important to be comfortable with your care provider. I really liked my OB with my first, but even though she was on call, I ended up having another OB during delivery, who was also on call (It was a very busy delivery day!). I really prefer my CNM out of the 3 that can potentially deliver this next baby (our 3rd girl!), so I pray she?s on call again! (She delivered my second!)

      It?s so good to hear the different experiences, and it?s great to hear you would go back to your OB in a heartbeat. That speaks a lot for her! I hope the ladies reading this will realize their options are wide open?and that the comments will help them see they don?t have to necessarily go with a midwife for the labor they desire.

      Thanks again for sharing. I love reading Life?Your Way! 🙂

      1. I’m sorry to hear about the reaction from the midwife. I lost our first to miscarriage and the dr was flabbergasted that I would cry since I was only 7 weeks along, he assured me I could have more. Is it any surprise why I didn’t go back for my next pregnancy.

        1. Wow, Sarah – I’m sorry that we share that experience. As if you need someone questioning your sadness on top of the loss!

      2. Thanks, Erin! Reading back through my comment, I’m afraid it sounded more argumentative than I intended. I was really just sharing our experiences (the old “start talking about pregnancy and everyone chimes in with their story”), and I thought your post listed a ton of great considerations as well!

  2. I had an OB for my first two pregnancies and a midwife for my third. The OB spent very little time with me during appts. and I ended up having different OB at the birth since my reg. one wasn’t on call that day. The midwife was fantastic and I learned so much with them along. Before and after care was fantastic. The only problem in Southern Ontario is getting in with a midwife! So many want one and there aren’t enough to go around. So it’s not really up to the mother to choose anymore – you are lucky if you get one. Thank you for giving women more info but remind them that sometimes you just don’t get what you want – no matter how bad you want it. In the end with an OB, it’s the NURSES who will be your greatest help during the birth!

    1. There is a huge lack of midwives here (in NC) as well! A lot of the hospitals around here (I live near Charlotte) don’t even give midwives (CNMs–CPMs are illegal to practice in the whole state) privileges. So, really, in the entire Charlotte metro area, there are less than a handful of hospitals where midwives are even an option.

      I barely even saw the OB with my first delivery–until the last 2 hours when I was pushing! However, since I had a midwife and doula with my second, I barely even saw my nurse! She was there but was very much in the background.

      Thanks so much for sharing your experiences, Heather!

  3. I think it also depends on the personality. I had a midwife with my first and I felt really connected to her, but the birth didn’t go well. When I had to switch to a doctor for the rest of my pregnancies, I searched and searched. I had seen some CNMs, but they really just seemed like doctors to me (wasn’t impressed), but without any power to make ultimate decisions (all overseen by doctors). Then I found my ob (at around 34 weeks pregnant with #2!) and I felt so at peace with him. He listens, he asks questions, he takes time for appts. and asks about things at home and whatnot. he’s like my birthing friend! haha. He is way more naturally minded as well. I have to have c-sections (previous severe shoulder dystocia and babies keep getting bigger) and he has preformed all 3 of them and I’m so comforted that he is doing them. He lets me have music in the OR to calm me and he said for my next baby we can try for the kangaroo care c-sections (where I’d get to actually hold baby during the rest of my c/s). His big thing is about women weighing risks vs. benefits for themselves. So anyway, I feel very blessed to have found such a great ob (we do have to travel to get to him, but so worth it)!

    1. Thanks for sharing your experiences! I totally agree about personality. I started out with an OB practice with my second pregnancy b/c I had a friend who actually had a semi-bad experience with her pregnancy at my current practice (she really desires a homebirth). However, I did not like the bedside manner of one of the OBs at all. When he scoffed (actually, literally laughed out loud) at me when I refused the extra screenings and 3D ultrasound they required (I get the 2D one), I was very upset. (He also told me that he knew I wouldn’t abort but that if the child has “something wrong” with it, he would know not to fight “quite so hard” to save it.) I ended up changing to my CNM after my 12-week appointment.

      It’s so wonderful that you’ve found such a naturally-minded OB who really care for you! Sounds well worth the drive!

  4. I agree that it completely depends on the provider. With my first pregnancy I saw a midwife, and she was wonderful! She was on vacation when one of my prenatal visits was scheduled, so I saw an OB in the office. She had great bedside manner and took the time to get know my husband and I before we got started with the actual appointment. During my delivery I switched from midwife care to OB, and I can honestly say I had a great experience with both.

    My next two pregnancies I miscarried, one with an OB who was so thoughtful, generous and compassionate with me and my husband as we greived. The second with a midwife who was anything but that. I’m now under the care of a third midwife, and she is wonderful! I’m at the same hospital as my first pregnancy, so if I have to switch to OB care, I already know that I will be in good hands there too.

    1. Thanks for sharing your experiences, Sara! I agree that a lot depends on personality. I really liked the personality of my first OB, but another OB ended up delivery (that wasn’t quite so gentle or kind–it wasn’t a “horrible” experience, though). I primarily see one CNM at my practice because our personalities really mesh well, but, really, any of the 3 could potentially deliver. (I’m just praying my favorite is on call, like she was last time!) It’s so great to have options. I am so sorry to hear about the unsympathetic midwife. That is really sad!

  5. I used a CNN with my last pregnancy, hoping to have a VBAC. Ultimately, I needed another c section, but my midwife came in while I got my spinal and stayed for most of the surgery. She came back in at the end and helped me hold the baby skin to skin while the ob finished the surgery. She also helped me breastfeed right away in recovery. It was a much better experience than my first c section!

    1. Sounds like you had a great midwife to stay with you the whole time and make things as comfortable for you as possible!! Thanks for sharing your story, Stacy!

    2. After my first c-section, once I was stabilized, I received a visit from each midwife on call for the rest of my hospital stay (they have 13 in their group practice) even though I was transferred to high risk OB care for my recovery. It made such a difference for me that they didn’t “abandon” me once I was transferred out of their care!

  6. I want to note that even if CPMs cannot legally practice in your area, there may be a way around it. In my state it is currently neither legal nor illegal for CPMs to practice. So they do. You just have to know where to ask. I had CPMs for my last two births and they were wonderful (at home).

    No matter what you do, ALWAYS interview potential care providers and if something about them doesn’t “jive” for you — get someone else! We had originally considered a practice of CNMs and OBs for my second pregnancy and I brought a big list of questions to my initial appointment. I was glad I did because I would have been okay continuing to see them, although I much preferred my CPMs and home birth. I learned after the first time, the very hard way, that you MUST be comfortable with your provider.

    1. Thanks for the info., Kate! Yes, it seems like in most states they are neither “legal or illegal.” Unfortunately, they are completely illegal in NC. 🙁 However, many women still have homebirths. There is a whole “underground” homebirth movement here. (We’re hoping it changes, so it doesn’t have to be “hidden”!)

      Interviewing is a great idea! I started out with an OB with my second pregnancy, but I had a terrible visit with him during my 12-week appointment. When he scoffed (actually, literally laughed out loud) at me when I refused the extra screenings and 3D ultrasound they required (I get the 2D one), I was very upset. (He also told me that he knew I wouldn?t abort but that if the child has ?something wrong? with it, he would know not to fight ?quite so hard? to save it.)

      I was so happy to find my CNM after that!

  7. To me a hospital is somewhere you go for emergency care such as extreme illness or accident – something serious. A birth is a natural healthy occurrence. I had my baby at home with a midwife. I would DEFINITELY do it again! The fact that everything was natural and no one took my baby away from me during those first bonding moments, was priceless. I got to sleep in my own bed, eat my own food…

    1. Thanks for sharing your experience, Jedonne! A lot of people would agree with you! I actually feel really comfortable in the hospital–especially during recovery. I like the fact that I can rest without having to tend to my household chores. Once I come home, I’m back to being “mom.”

  8. I have had both and definately prefer a midwife. My OB always pushed tests on me that I didn’t want or need. My midwife gives the info and lets me decide. For instance, she doesn’t require me to do the glucose test. The orange drink makes me very sick and I always have to take the 3 hour fasting test. So my midwife lets me do daily monitoring and had me keep a food log. She also doesn’t do any internal exams unless I desire them – I don’t! The OB gave me a hard time about that also. As for hospital vs home, home is where I want to be. I’d much rather cuddle in my bed with the new baby than have nurses come in at odd times in the night and not get any sleep. We will be having our 2nd home birth in about 9 weeks.

    1. Congrats on your impending birth, Sheri!! In my experience it does seem like OBs are more apt to push tests, but some of the other ladies in the comments actually had better experiences with OBs than with midwives!

  9. I don’t have the option for a midwife unless I want to get one almost two hours away….so, it’s an OB for me. BUT, I love my ob. 🙂
    I am having a doula this time around and I know it’s going to make things a lot easier for me. I know I can rely on her to keep a cool head when I start to lose mine. LOL
    Great article once again Erin!

    1. Stacey, there is a CNM in the area that does home births! She has delivered over a thousand babies in the hospital and home births. We are considering her for when we have another. We had an awful experience in the hospital with an OB with our first and we really don’t want a repeat. Let me know if you want her info!

  10. My first pregnancy was with a practice of two midwives and I had a great experience. But one midwife only does home births now and the other is part of a large OB practice. I opted to follow the midwife who delivered my daughter to the large OB practice because they seemed midwife friendly and were planning to add more midwives. While they did have as many as four, unfortunately at the moment they only have two. But I also know several of the OB’s have very midwife like/midwife friendly practices and are totally supportive of my choice to have a doula attend this birth as well. I would love to deliver with a midwife in a birth center, but in our area there aren’t any less than an hour away and I’m not totally comfortable with a home birth. The only downside of the large practice is that I only get whoever is on call, if there is a midwife on call and I want her, I can get her, but otherwise I get whoever the OB is on call. I’m a little nervous but I’m hoping for the best. (My due date is tomorrow).

  11. I enjoyed this article – I had my first daughter via c-section at the urging of a CNM. The midwife came recommended but as I neared the end of my pregnancy an u/s showed my DD would be 10lbs or more and the CNM told me I couldn’t birth a big baby (this was my first live birth) when I told her I still wanted a natural birth she went and got her overseeing OB who again tried to coerce me when I still held out the OB told my husband if I didn’t consent “something bad could happen to me or the baby” so DH told me to go ahead and consent. When I went in for the section (2 weeks early) the dr was commenting how they had to pull my DD out of the birth canal and had said oh I guess you would have gone into labor!!!!! It was a horrible experience and took months of counseling to forgive myself, my husband and even my baby and the dr/midwife team. With my next pregnancy I found another group of CNM to do a VBAC and was told that they weren’t allowed to do VBAC’s per their overseeing dr and I was likely to end up with another section. I left hurriedly and my friend told me about another OB who did allow VBAC’s and I’ve been with him ever since. I love him – he respects my decision to VBAC (although his partner does not), he also manages my diabetes since the high risk peri advised me to abort my 3rd baby, he doesn’t get on me because I turn down prenatal testing or non stress tests (my babies don’t move hardly at all). I do blame the section for messing up my body as for going into labor – I’ve never gone into labor with my last two babies and I was induced at 42 weeks with my 2nd and at 39 weeks for my 3rd – with being GD and now Type 2 things can get a bit hairy. I also have severe back labor which is due to very mild scoliosis and a titled uterus so I do get an epidural at the very last minute. I walk as much as I can (I hate birthing balls LOL) and stay out of bed. My labors are long and hard but if this is my ‘natural’ labor I’ll take it with an OB because it means I’ve avoided another section. That being said I know there are some great midwives out there but the ones near me I wouldn’t want them near me with a 10 foot pole but I have no idea what will happen if the Lord blesses my womb again and my OB retires as his partner has told me he won’t allow me to VBAC and he’ll take me straight in to a surgery.

    1. Once you have had a successful VBAC, no OB can deny letting you at least attempt. Fight to find one and demand they keep up with ACOG at a minimum. Good for you for not loosing your fight after your first terrible experience!

  12. Praise God I was blessed to learn all these options during my first pregnancies and both my babies were born in a birth center with a fantastic midwife whom I adored so much I wanted to put her in my pocket and take her home with me! 🙂 Thank you for sharing. Keep sharing the info because not enough moms are hearing it in time to avoid an unneccesarean or a tramatic experience.

    1. I agree Bek word needs to get out! I am a researcher by nature and was fortunate to find midwife care from my first pregnancy on. Everyone I knew from family to friends to co-workers had no idea what a midwife was or why someone would choose not to have an OB for their birth. Most people I know still prefer an OB, but they all know about the options of midwives now!

  13. I’ve had my three in hospitals with OB’s and am preparing for my fourth in a couple of weeks. Due to some complications with each pregnancy, that has been my only option. My first was with a large practice and I whoever was on call delivered. The doctor who delivered my daughter was the one I got along with the least, but when the nurses were encouraging me to consent to a C-section, she was the only one in the room who said I could do it and let me continue to try. Two pushes later, she was born.
    The second and third were born with a different OB who is the only one in the practice. His personality is a little more distant than others that I’ve seen, but he is extremely calm and wonderful during delivery that I can put up it during prenatal visits. He also makes a point of coming in after the baby is born, pulling up a chair and just talking with me and my husband, kind of like a wrap-up and a chance just to get to know you as a family unit. It’s because of this that he will be delivering my fourth in a couple of weeks. I also have to say that the nursing staff at the hospital is very supportive of any birth plan you come in with, and try to facilitate any thing you might want/need. I have been very blessed.

  14. I am lucky to live in an area that not only allows midwives to practice, but it is also very socially accepted and encouraged. I went to an OB office with both of my pregnancies that also has two CNMs. They have a policy that even if you are seeing the CNMs primarily, that you have to at least have one appointment with each of the OBs to meet them. That turned out to be a good thing because my first was a last-minute c-section due to breech, and my second was a planned c-section due to a high-risk issue late in the pregnancy. I LOVED my midwife, but I was very glad that I was able to at least meet with the OB that ended up doing my c-sections. It put me at ease.
    If anyone is trying to decide between an OB and a midwife, I would say that there are pluses and minuses to both, but in my experience, midwives typically take more time with you during each appointment and have a better relationship with their clients. OBs tend to be a little busier and not as personal. And midwives tend to put a greater emphasis/encourage natural birth (even VBACs if the hospital/birth center allows it).

    1. I might also mention that even though she couldn’t be there for my c-section, my midwife came to the hospital to see me and the baby both times. She really was wonderful!

  15. i am pregnant with my 5th – due in 5 weeks – and have a cnm and deliver at a hospital that has a birthing tub (which i used in my last labor and loved!). i had a great experience with a woman ob who was a believer with my 1st 3 kids, who let me decide the direction of my labors and who was extremely supportive and relational. i know not all people have this experience with obs. she moved out of state, so i decided to go with this particular cnm who delivered at a hospital that does water births (the hospital where i delivered my 1st 3 didn’t have that option). i have really enjoyed my experience with my midwife as well. i think no matter who you pick, you need to feel safe and comfortable with the provider, since birth is such a huge thing in life and it is important to have someone you think will listen to your wants and needs.

  16. I absolutely loved my midwife and the care she gave me the whole time I was pregnant as well as the care I got from her afterwards. Though I ended up needing to be transferred from the birth center to the hospital during my labor and my daughter delivered via C-section, I totally trusted my midwife. She made sure, in the crazy confusion at the hospital, that my wishes were still made known and achieved. She brought me my daughter as soon as possible after the surgery and made sure I got to do skin-on-skin and nurse her. She visited us at home, counseled me when my daughter had trouble latching on during the first few weeks, and gave us the best care.
    I’m planning on using her again when my husband and I have more children, because she believes I should be able to deliver the next ones naturally.

  17. I required c-sections for the births of my children so I was unable to work with anyone other than an OB but I wanted to share a great experience another friend had with an OB. She was high-risk, experiencing early labor at 28 weeks and on bed rest, but she desperately wanted to avoid a c-section if at all possible. She expressed this to the doctor in as many ways as possible. When she finally went into full labor at 41 weeks (ha!), her OB was not available but had informed all the other OBs in her group of her patient’s request to avoid a c-section if at all possible. The nurses and attending OB assisted her through 4 hours of pushing and finally helped her through a difficult delivery with the help of a manual rotation of the baby (a true miracle because she couldn’t have physically delivered her son the way he was turned), a vacuum, and a last second episiotomy to get his head fully out. If her OB had not been so open to her strongly held beliefs, I think she would have been pushed toward an unwanted c-section. My take away from her experience: your best bet is to work with a health care professional who understands, supports, and respects your wishes from beginning to end.

  18. I gave birh at a free-standing birth center with a midwife for my first. I had hired a doula and the whole experience was a good one. Hospitals scare me, so this was a great option for me (I was low risk, obviously.) I’m due to deliver in 8 weeks with my second at home with a CNM/CPM (I’m in NC, too, so I know all about the homebirth underground movement.) I’ve hired a doula this time too, because it’s so nice for my husband to have else to help. In the event of a transfer, my doula would also come to the hospital with me. I can honestly say that I’m excited for this birth!

  19. I saw an OB (rather, several at one practice) for my first two pregnancies, and wasn’t crazy about it. The care just seemed cold, formal, and too prone to interventions/tests. I agree with a previous commenter that the nurses at the hospital have more to do with the actual labor and birthing process than the doctor does.

    For the third time around, I was leaning toward a home birth, but my husband wasn’t crazy about it, our state (KY) doesn’t license CPMs, and our insurance (another major factor) does not cover midwives. I did a ton of research, and finally found the only family practice in the area that also offers maternity care. A family doctor sees pregnancy as part of your whole life, whereas the OB is only looking out for your reproductive system. My third pregnancy ended in a miscarriage at 12 weeks, but I was so blessed by my decision to choose a family practice over the OB. I had doctors and nurses crying with me, and hugging me, and telling me to call anytime with any question. And they said they’d be there for me with my next pregnancy. I couldn’t get past the crabby receptionist at my old OB’s office! I will definitely stick with the family practice, and would recommend that as another option somewhere on the spectrum between OB and midwife.

  20. Wonderful breakdown of provider options! 😀 My only wish is that Birth Arts International would start being listed alongside DONA as a respected place to research the Doula.

  21. Where I live the choice was until a year or so ago, only an OB you had to travel to (a few hours) or a family doctor (GP). Now we also have one midwife. I used my own family doctor (GP) for my 2nd baby and the midwife for my 3rd baby (just recently). For my first I lived somewhere else and used a midwife.

    I don’t have experience with OBs but just GP and midwife. I loved having a midwife so much more, especially because with this last baby I had the opportunity for homebirth.

    I found that it was much nicer to have a woman for my care, and someone I felt I could bond with and really take the time for me. Also, I prefer having the midwife there for the labour whereas the doctor just shows up at the end.

  22. I had home births with a midwife and it was amazing. I would highly recommend it. We interviewed her first to make sure and she gave us first rate service.

  23. Baby #1 – OB, big-city hospital
    Baby #2 – GP, small-town hospital

    Currently pregnant with baby #3 – Driving an hour and a half away to see a midwife. I will have to drive the same distance to deliver as well, since the midwives don’t travel this far out of their city. I’m almost 27 weeks – just entering my third trimester, and so far, it’s been worth every single second. I will also be incurring a fair bit of extra cost. Since I live in Canada and have free health-care, I could have delivered in our small-town hospital with a GP with pretty much zero cost. But now I have to pay extra gas money for appointments, plus the cost of a B&B that I’m planning to birth in, because I want to avoid the hospital.

    The difference between the doctor mentality (assuming that birth is a medical event) vs. midwives (assuming that birth is a natural event) is astounding and has such far-reaching effects that affect the entire birthing experience.

    My opinion so far? Worth every penny, and I’ll have midwives from now on if I can at all help it.

  24. Birth Arts International http://www.birtharts.com trains doulas and have amazing support for thier doulas, posptartum doulas and other programs, so you will know your doula is well educated and part of a team approach.
    This is a wonderful article and I appreciate you having it up. I am going to pass it around my facebook.

  25. Hi, this is a wonderful article! There are so many great organizations right now that certify doulas! There is Birth Arts International which is enrolling massive amounts of students nationally, Childbirth International, CAPPA, MotherWit and more! For everyone woman seeking a doula there is an organization out there and a point of view to support her needs! Keep up the great work on writing such wonderful articles!

    Much Love,
    Bai Doula

  26. Great article! I have had an OB for my first birth, LM(licensed midwife) for my second birth, CNM in a hospital for my 3rd birth, and CNM in a free standing birth center for my 4th birth.

    My first experience with the OB was terrible! I saw one OB for all my prenatals, but when I delivered it was an OB I had never met, and he had horrible bedside manner. All of the students around didn’t make it any better!! It was just a overwhelmingly bad experience, so it made me research more for my next birth.

    My second I researched and found a home birth midwife who would be willing to travel the hour to see me!(she was the closest one) It was amazing, and she almost missed the birth because my daughter came so fast!! That labor was 3 hours from start to delivery! She came right as I was in transition and she was almost crowning. It was so so great. She came to my house for every appointment, came for the delivery, and came a few days after the birth to follow up. I learned soooo much about labor and delivery with her too because she actually taught me things so much better than a child birth class at an OB clinic could.

    My 3rd birth we couldn’t afford to pay for the midwife, so we had to go with what was paid for on our insurance. At the hospital they had CNM’s who did prenatal care, but they only delivered your baby if they were on call when you went into labor. The care was so so. Not too bad/ not too great. The CNM’s were much more medically and rigidly minded than my previous LM was. IN the end, neither the CNM nor the OB delivered her though because she came so fast that the OB on call never made it to the room in time!! The nurse had to deliver her!

    With my 4th I wanted a home birth again, but again couldn’t afford it. I found a birth center in my area that took our insurance, so that is what we did! The CNM’s at the center were amazing! So much better than the ones at the hospital! They let me do what felt right in my body, and they let my body do what it needed to do to get the baby out. It was hands off, and just all around fabulous. This was actually my favorite birth of all of them because I was able to birth the way I needed and wanted to, but I didn’t have to worry about the house, making a mess, the kids: I was just a woman in labor instead of wife and mother in labor!

    As for doulas! I didn’t have one for any of my births. With the first I had no clue what they were, with the second we couldn’t afford it and there weren’t any in my area, and with the other two I was sure that my labors would be too short to even benefit from it. I however have decided to become one now that I am finished having children. I am passionate about childbirth and childbirth choice awareness, so since I am no longer having children of my own, I am expressing my love for childbirth by helping other women to achieve the birth of their dreams! 🙂
    I am certifying through Birth Arts International though rather than DONA because it better suits my holistic, spiritual, woman centered view of childbirth. The BAI website is http://www.birtharts.com. ☮

  27. All four delivered by an OB:
    Baby #1 – both baby and I needed to be on oxygen
    Baby #2 – healthy, normal delivery
    Baby #3 – 6 weeks premature, NICU for 2 weeks
    Baby #4 – 4 weeks premature, otherwise healthy

    My OB allows the mom a lot more freedom than what I’ve heard about other OBs. The problem I had was more with the nurses – seemingly wanting to finish with me before their shifts were up. Several nurses were wonderful, especially the NICU nurses.

    I absolutely loved not having to worry about what my house looked like; the nice, clean hospital room with someone else doing the laundry; the nursery with caring nurses who would care for my babies while I grabbed a few hours of sleep; visiting hours when I had a houseful of extended family; knowing that if there was a medical emergency a doctor and ER were right there; and the few days of cable TV! 🙂

  28. Your experience delivering with midwives describes my own exactly! I switched from an O.B. to a midwife in the third trimester of my first pregnancy. I am so happy I chose to deliver with midwives. I have had all 3 good hospital birth experiences and my most recent birth left me feeling empowered and changed in a big way. My babies were all between 9 to 12 pounds at birth and I am fairly confident that I would have ended up with 3 c-sections if I hadn’t chosen a midwife. My first baby was delivered by the O.B. who practices at my midwives’ office. He was also the one who broke my water at the beginning of my labor with my second and third babies. The care of a midwife along with the support of an O.B. gave me the confidence I needed to approach birth without fear.

    I considered hiring a doula as well, but both my husband and I were confident that he could support me and communicate my wishes to hospital staff. I wouldn’t change a thing about my birth experiences!

  29. I started with an OB, then transitioned to a CNM who delivered in a hospital, and finally to a midwife in a freestanding birth center. I definitely loved the more personable feel with the midwife–sitting on her couch and chatting for 45 minutes instead of being perched on an exam table. I’ll be looking to do another water birth with a midwife for baby #2!

  30. I had a CNM… or rather, a whole group of them! There are 7-8 CNMs in my OB group, and I see them exclusively, including for routine gynecological care. I wanted a doula for my last delivery, but it didn’t work out.

  31. Erin, awesome post. Very informative for moms-to-be. I gave birth in a hospital both times. I felt more comfortable with that. But I did have negative experiences with breastfeeding…right off the bat. So I know an alternative birthing center would have likely been more supportive.

  32. hey there, this is my first pregnancy and we are using a CNM. My husband and I are strongly leaning torwards a doula also, any words of widsom on doulas?

    1. research the doulas in your area. Check out many different organizations. Find a doula or a group who supports your needs and goals. Look at how different doulas and organizations approach birth. Try to find a doula you really click with.

      Warm Wishes,
      Trina Baggett, Birth Arts International Doula , C.D. (Matrona)

  33. I felt like your article was VERY biased. The pictures you present for each category show your bias very clearly. In your photos, the women with the home experiences are shown as happy and comfortable, while the women with the hospital experiences have medical professionals who look distraught. This is not always the norm. I feel you picked and chose your pictures very intentionally. You are passive-aggressive in your comparisons between hospital births and nurse/midwife births. Through your article , you seem to be making a judgement call towards women who chose the hospital route. Who are you to judge or project a righteous attitude? I enjoy your blog, however I feel very disenchanted by reading this article. Your readers are smart enough to identify your false attempts at neutral journalism. I would respect you more if your were honest in your beliefs on this blog; don’t try and be neutral when you are obviously not.

    1. Sadie, for some reason, this comment just came through. I am very sorry you feel that way. I am curious why you think I am “making a judgement call towards women who chose the hospital route” when I am about to have my 3rd hospital birth? Obviously, hospitals are where I feel most comfortable. As I stated in the article, I have used both an OB and a CNM.

      I did not choose my pictures based on whether or not the people looked “happy and comfortable” in the home or the medical professionals “looked distraught” in the hospital. To be honest, I am a very busy work-at-home mom, and I choose the quickest pictures I can find that come up with a quick FlickR Creative Commons search. I am surprised you found those in the second hospital picture–especially–anything but “happy and comfortable” because the mother in the picture is me. Perhaps I didn’t look like it, but I felt very happy and comfortable in the hospital where I had just birthed my second baby when the picture was taken. 🙂 From the outside looking in, the first picture shows extreme concentration on the parts of the doctors and medical professionals. I know I for one want those who deliver my babies to be nothing by concentrated.

      Again, I am sorry you feel this way, but I was not in any way trying to deceive mine or Stephanie’s readers. The purpose of the post was education. I had no idea anyone but OBs existed when I had my first birth, and I think women should know of all their options. If you will read in the comments, many women had wonderful experience in hospitals with OBs. That truly is the best choice for some. And although I personally prefer hospital births (which I am assuming you do as well), I fully support and advocate for women who chose home birth, as my extensive research has shown it to be safe. I believe the safest place for any woman is where she feels more comfortable. And I feel most comfortable in a hospital. 🙂

  34. I had your typical ob/hospital birth for my first 2 babies (2nd was an unnecessary induction). For our 3rd baby I used a midwife at a freestanding birthing center with a doula. She stopped catching babies so we drove over an hour to another freestanding birthing center with another midwife for our 4th baby.

    My midwives were FAR BETTER EXPERIENCES, not just emotionally but I felt safer physically. My midwives focused on nutrition/health/exercise to help me be at my best physical condition for pregnancy/birth. They wanted to AVOID problems/complications. They educated us and loved questions. My first OB, couldn’t give a rats behind about my symptoms of a complication and didn’t do a darned thing. My OB hated questions and rarely spent more than 2 mins with me and left us with unanswered questions. THe hospital didn’t want me out of bed, poked me, starved me and wouldn’t even let me drink, HAD to check me constantly, the bed was highly uncomfortable. It was a torture chamber literally.

    Hands down, our midwife/birthing center births totally rocked! It was so nice to NOT have to fill out pages of paperwork and answer tons of questions when we arrived (our midwives already had that information and knew us). It was wonderful not having strangers coming in and out (and leaving the door open exposing me). The birthing center wasn’t quite as comfortable as a home, but it was far more comfortable than a hospital. It was really nice to be supported in our decisions at the birthing center. Yes, we were happier and healthier with our midwives births.

  35. There is also the option of a family practicioner (and I did not read all the comments to see if someone else mentioned this). We used our family practicioner for both of our kids- I labored and delivered in the hospital completely naturally for both (no meds at all) and did not feel pressure in the least to have drugs or a c-section. It wouldn’t be very cost effective for us to have highered a certified nurse midwife at the hospital becuase we would have just been paying extra people based on how the system works and I lovvvveee my doctor. I just thought I would throw that out there.

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