Midwife vs OB - WWYD?

Ceridwen21

I have a tough choice to make and would love your input.  Here's my pros and cons list based on the particular midwife and OB that I have met and will choose between.  We will be doing a hospital birth no matter what.

Midwife

Pros	Cons
Long appointments/ask anything	Must leave hospital after 3 hours
Natural birth	Epidural only if 100% desperate, and then transfer of care to hospital staff if I get one
Supportive atmosphere (other moms, group sessions, library, etc)	Too granola for us?
More experienced in normal births than a doctor	Not a doctor, chance would have to transfer care due to pregnancy or labour complication
Delivery by midwife or partner	Only 1% of their births occur at the hospital ? perhaps a little less comfortable in that surrounding.

 

OB

Pros	Cons
Doctor, no need to ever transfer care	Less experience in normal births
Can easily cave and get epidural	Can easily cave and get epidural
Pro natural birth (compared to the average OB)	Shorter appointments
Full-on admittance to hospital and more time to stay post-birth if wanted	Longer waiting times, postponed appointments due to deliveries
	Won?t be delivery doctor if labour on weekend
	At mercy of nurses (potential of bad ones)

iris427

I'd pick the midwife.  But I'm biased because I've already gone the OB in a hospital route and I have a nice cesarean scar to show for it.

MandyPandyBear

Just based on your pros and cons list it seems like you have more cons for the OB than pros.  Personally I'm going with midwives at a birthing center that's connected to a hospital. 

honkytonk_kid

I love your pros and cons list! I make these all the time

Unless you have some reason to believe you're likely to become high risk, I would definitely go with the midwife. My reasons: longer/higher quality prenatal appointments, more supportive environment, knowing who will deliver your baby, and less likely to "cave" and get an epidural.

FWIW, I had all my prenatal care with MWs then transferred to an OB at 37 weeks because LO was breech. If I had it to do over knowing how it would end, I would still have gone with the midwives without a second thought. Don't underestimate the importance of those prenatal appointments.

julyjennifer

I'd choose the midwife, personally.  You have a much higher potential for great "continuity of care," meaning you'll have the same person for prenatals as the one who attends your birth.  That's a big one for me. 

Even if you ended up having to transfer care late in pregnancy or transport to a hospital during the birth, you're really no worse off than the situation in which you've been seeing one OB all along for (short) prenatals and then you have a different one on call when you deliver.  Rather, you're probably better off for having under your belt the longer prenatals with a more attentive care provider who is knowledgeable in normal pg and birth.  So to me those "cons" on the midwive con list relating to potential for transferring care are less weighty than some of the cons on the OB list.

Mrs.Greeko

I wouldn't think of must leave hospital after three hours as a con.  I hated having to stay at the hospital with my first, I didn't get any rest and it wasn't comfortable, with my second I was home 5 hours after birth and it was so much better for me.  I stayed in bed resting mostly for a few days, and DH brought me food and stuff, but it was so much more comfortable and I was able to rest much better in my own bed. 

I've done both, hospital birth with an OB and birth center birth with a midwife.  Midwife wins hands down.  The con of being at the mercy of the nurses is a HUGE con, they can really make or break your entire stay at the hospital.  They made my entire stay miserable and I don't think it was on purpose, just that I didn't fit into their usual patient catergory of epidural, push baby out, send baby to nursery several times for things so they didn't know what to do with me and it made my stay miserable.

CaseBride

Mrs.Greeko:

I wouldn't think of must leave hospital after three hours as a con.  I hated having to stay at the hospital with my first, I didn't get any rest and it wasn't comfortable, with my second I was home 5 hours after birth and it was so much better for me.  I stayed in bed resting mostly for a few days, and DH brought me food and stuff, but it was so much more comfortable and I was able to rest much better in my own bed. 

I've done both, hospital birth with an OB and birth center birth with a midwife.  Midwife wins hands down.  The con of being at the mercy of the nurses is a HUGE con, they can really make or break your entire stay at the hospital.  They made my entire stay miserable and I don't think it was on purpose, just that I didn't fit into their usual patient catergory of epidural, push baby out, send baby to nursery several times for things so they didn't know what to do with me and it made my stay miserable.

Exactly this.

Leaving early was a definite pro for us! Even with the first one, we were so sick of all of the constant interruptions, taking of vitals, etc. and we just wanted to get home to our own comfortable bed.

I also agree about the nurses. I had a terrible nurse at first during my hospital birth and I truly believe that was why my labor "stalled" until shift change and we got a better one...

Manderlin923

I love making lists too

I would say it depends on how badly you want to go med-free. Also, I switched from an OB to a MW at 20 weeks and never regretted my decision. I loved my MW (though my OB was nice, don't get me wrong) and loved having long appointments. I got hugs after appointments and having my MWs know details about me, it was so personal and comfortable to me. That said, i did have to transfer to hospital after birth for some light bleeding and other issues. It really sucked having to transfer but I have to tell myself I was just an unlucky gal that day. The rate of transfer is less than 10% and I am sure we'll go back to the birth center for our next birth, even with that transfer in my history.

Hope that helps.

Ceridwen21

Thank you so so much everyone.  Your feedback is really valuable to me.

I forgot another big MW pro: In-home postpartum care.

How badly do I want to go med-free? That's the big question.  When I first got pregnant I assumed I would get an epi, cause that's really all I knew.  When I found out I got into the MW program (which is a miracle given the waiting lists in my area), it actually came as a surprise to me that they only did natural births.  Now that I'm educating myself about natural births it certainly seems like something I want to do, but am I 100% convinced I can do it? Not yet.

monkeyqueen

I don't know.   I wouldn't want to leave the hospital after only three hours, but I'm biased because Natalie's seizures didn't get diagnosed as seizures until the next day.     I sure as heck never recognized her movements as seizures.

eta:  I felt fine after delivery (for the last two) and would have been fine leaving the hospital for myself.

abell77

After my experience last time delivering in a hospital with a MW, and my prenatal care thus far with a MW, I would choose a MW every time.  I switched from an OB to MW practice at 30 weeks last time because I was so dissatisfied and I have never regretted my choice.

flyer23

monkeyqueen:

I don't know.   I wouldn't want to leave the hospital after only three hours, but I'm biased because Natalie's seizures didn't get diagnosed as seizures until the next day.     I sure as heck never recognized her movements as seizures.

eta:  I felt fine after delivery (for the last two) and would have been fine leaving the hospital for myself.

That is what in-home postpartum care is for It's not like the midwives cut you loose after 3 hours and never see your baby again...

I'd go with the midwives, personally, as long as you are committed to avoiding the epi!

monkeyqueen

flyer23:

monkeyqueen:

I don't know.   I wouldn't want to leave the hospital after only three hours, but I'm biased because Natalie's seizures didn't get diagnosed as seizures until the next day.     I sure as heck never recognized her movements as seizures.

eta:  I felt fine after delivery (for the last two) and would have been fine leaving the hospital for myself.

That is what in-home postpartum care is for It's not like the midwives cut you loose after 3 hours and never see your baby again...

I'd go with the midwives, personally, as long as you are committed to avoiding the epi!

Yeah, I thought of that.  But, I do wonder if a midwife would have been able to recognize seizures as seizures.   They were very odd and as it was it took a few doctors and nurses to diagnose.  She also did not have a recognizably traumatic birth either.  That situation is completely different, though.   With Dominic, I easily could have left the hospital without a care in world within a few hours:)

OP:  Do what you are comfortable with.    It entirely depends on these particular caregivers.    My dr.'s were very natural-friendly.   I don't think my experiences are typical.

cros8380

Ceridwen21:

Thank you so so much everyone.  Your feedback is really valuable to me.

I forgot another big MW pro: In-home postpartum care.

How badly do I want to go med-free? That's the big question.  When I first got pregnant I assumed I would get an epi, cause that's really all I knew.  When I found out I got into the MW program (which is a miracle given the waiting lists in my area), it actually came as a surprise to me that they only did natural births.  Now that I'm educating myself about natural births it certainly seems like something I want to do, but am I 100% convinced I can do it? Not yet.

I am going to go off on a tangent here...I see the twinkle of confidence in that statement and I wanted to say that I'm proud of you! So many women don't stop to wonder if they can do it, they just assume they can't (for whatever reason...society, family pressure, fear of pain). So, yay! Keep doing your research, asking tons of questions, considering your options...etc. I had a friend once say to me that she KNEW she could do it, it was a matter of whether or not she wanted to. But after all the reading and reserach she decided (and these were her words) that "a few hours of pain/discomfort that I've preppared for far outweigh the potential side effects of augmentation". GL!

Ceridwen21

cros8380:

Ceridwen21:

Thank you so so much everyone.  Your feedback is really valuable to me.

I forgot another big MW pro: In-home postpartum care.

How badly do I want to go med-free? That's the big question.  When I first got pregnant I assumed I would get an epi, cause that's really all I knew.  When I found out I got into the MW program (which is a miracle given the waiting lists in my area), it actually came as a surprise to me that they only did natural births.  Now that I'm educating myself about natural births it certainly seems like something I want to do, but am I 100% convinced I can do it? Not yet.

I am going to go off on a tangent here...I see the twinkle of confidence in that statement and I wanted to say that I'm proud of you! So many women don't stop to wonder if they can do it, they just assume they can't (for whatever reason...society, family pressure, fear of pain). So, yay! Keep doing your research, asking tons of questions, considering your options...etc. I had a friend once say to me that she KNEW she could do it, it was a matter of whether or not she wanted to. But after all the reading and reserach she decided (and these were her words) that "a few hours of pain/discomfort that I've preppared for far outweigh the potential side effects of augmentation". GL!

Thanks.  There is indeed a twinkle of confidence there.  Honestly, I'm a very confident woman and I'm always up for a challenge.  I had a friend say to me that if anyone she knows could do this, it's me.  That excites me! But there's such a great fear of the unknown.... I've lived a pretty charmed life and have never really experienced serious physical or emotional pain.  I know I could do it... I just don't know if I want to (like your friend said).

I am very much leaning towards the midwife option.  As great as the OB was, I just really love the idea of going to a midwife, and I think the pros outweigh the cons.  DH is supportive of either option, though he (and our parents, not that it matters cause it's our decision) would rather go the OB route.

Billy Boy

i'd pick a midwife for sure.  if we didn't have one, i can't say i would have had a natural birth! 

 

 

 

www.mommieswithoutmommies.com

Texas77again

::comes in chanting:: 

Midwife!  Midwife!  Midwife! 

AuburnTiger11

Midwife all the way...

 

We're planning a homebirth with a Certified Nurse Midwife. I am so excited!

Mrs.Handy

I pushed for 3 hours.

According to my doula, if we didn't have such an awesome midwife, I probably would have had a c-section or at least episiotomy. Thanks to her, I had neither!

I went to a practice where they had both midwifes and OBs. I disliked the one OB I met with for my prenatals. All the MWs were great.

KrisMomma

If you don't have any reason to believe this will be a high risk pregnancy, I'd go with the MW. You have more cons for the OB/GYN and based on your pros and cons I am guessing you'll be happier with the MW. Having a MW and a hospital birth is the middle ground here. Also, if you go with the OB and go into labor on the weekend, your new OB may not be as open to natural birth. Good luck with your decision!

KCKappa

I would go with the MW! I'm having a hospital birth with an OB who is supportive of my desire to go med-free... but if I go into labor over a weekend when she's not on call, I'm stuck with one of her partners, who aren't as supportive. That possibility has been a big source of stress these last couple of weeks, and I'd much rather avoid that if I had it to do over again!

MawrtyrB

Midwife all the way! I switched to a midwife for my section PG before I knew I was having twins. SHe had an in-house OB to back her up and I also saw a perinatologist to keep watch on the twins' health.

 If I didn't have a midwife, there was no way I'd have been able to avoid a C-section. (And I didn't need one).

I felt like a piece of cattle being herded in and out of my old OBs office.The hospital was not natural friendly in the least. The midwife and her staff plus the natural friendly hospital were just amazing. It was like night and day. I can't wait to go back.

Ceridwen21

Thanks, everyone.

It certainly is unanimous on this board! I just wish the OB we met would have been cold and mean, then my decision would be so much easier!