OB or Midwife? — The Bump
March 2013 Moms

OB or Midwife?

I'm currently seeing an OBGYN, but after learning about c-section rates, I'm starting to think that a midwife might be a better option if I want to preserve the chances of having a natural (medicated or not) birth experience. Anyone have any input?
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Re: OB or Midwife?

  • I have no experience with midwives but I think she would be more caring and supportive. My OB wasn't on-call when I gave birth to DD and honestly after 20 hours of labor and an hour of pushing I kind of gave up and I heard the OB tell the nurses if she can't do it....c-section. No one was encouraging me or guiding me or anything. My aunt who luckily came the last few hours was yelling at me to man-up and PUSH! I thank her for that till this day. Otherwise, I think I would have given up.
  • I don't have an experience with an OB mine sent the midwife instead but after five hours of pushing I would have happily taken the c section.
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  • Each OB and practice is different. If you like your OB, there's no harm in discussing what exactly will happen with your L&D. There are many OB's out there who are not c-section happy. Also, if you are curious about midwives, look up local reviews and call. In the end, it's what makes you feel comfortable.
  • anc5anc5 member

    I really feel that this is a personal chose. My husband and I decided to have a midwife. Really you have to look at who makes you comfortable and wants what you want. Not someone who will make you do what they want. If you want more information on midwives I recommend the documentary ?The Business of Being Born.? Also ask your OBGYN what their rate of C-sections is and discus your birth plan. I wish you luck and hope that you chose who is best for you.    

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  • If you are like me and want to have as natural a birth as possible, go with a midwife.  I did watch "The Business of Being Born" and I definitely recommend it!  Midwives are more likely to be attuned to your needs during labor and help you work through the pain and fatigue without encouraging the use of pain meditations, or pitocin to speed things along. 
  • With my DD I pushed for 2 hours and 45 minutes. Thr limit for pushing is 3 hours, thrn it's considered failure to progress and csection is standard. The last 10 minuted I was starting to crack and thankfully my OB was awesome... she essentially told me I had come this far and I was not allowed to crack then, that I could do it anf I did. She was awesome and I loved her for that.
  • This is not necessarily a choice between an OB and a MW.  General OB rates are going to be different that your OBs individual rate.  I go to a collaborative OB/MW practice, and the OBs there have a very low c-section rate.  They're open to suggestions from the MWs, the preferences of the patient, and are all just generally supportive practitioners.  But they also have the training and experience to know when to draw the line.  The MWs also know when it's time to call in the OB.

    Don't let generalizations make your choice for you, talk to your OB about how they handle labor and delivery, what their policies are, etc.  If they're not in line with what you're comfortable, by all means look into other options, but don't limit yourself to looking at one or the other.

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  • I had REALLY hoped to have a midwife and hadn't considered anything else but was very disapointed when I called the midwife (the day I found out I was pregnant) that they were full for March. So I am now with an OB.  He seems fine but not the experience I had hoped for.  I also really wanted a midwife because of their 6 week follow up after birth. 
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  • A midwife would be perfect given what you posted. :) I am on my 6th pregnancy and I have always seen a midwife. (The same one for every pregnancy, I LOVE her!) I wouldn't have it any other way! If you're not high risk, and you're looking for a vaginal birth with little to no intervention, a midwife is a great option!
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  • Talk to a midwife. and get all of your questions answered.

    In my OB's office they have 8 doctors and 4 midwives. I chose the Midwife route because they spend more time with you in the hospitals and are more-so advocates of letting things naturally progress.

    The doctor's tend to be more transactional - come in break your water - push pitocin - Do an epidural - check how dialated you are - push for c-section - complete birth - c ya later (from what I gather from my SIL who has gone the Dr. route with 3 pregnancies and my sister who went thru mid-wife route with 2).

    I will say, my SIL went midwife route on pg#1 and Dr on Pg#2,3,4 because things didn't go as she planned with her DS#1 and she just wanted the plan to be laid out in stone for the rest (scheduled C-sections).

    I want to try to do things natural with no drugs - so I'd prefer to have a mid-wife who will support and respect my decision. She says if we want drugs - she'll get the drugs, if we want the jacuzzi - she'll run the water.

    Good luck with your decision!

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  • Sorry - duplicate post - Edited to avoid.

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  • Are these c-section rates specific to your OBGYN or the hospital you'll be delivering at?

    Really, it comes down to personal preference and where and with whom you feel most comfortable. Before you just switch to a MW because you think it will be "better" than an OB do your research about the Midwifery Model of Care which is the philosophy that most MWs ascribe to. Also get information about the hospital you plan to birth in and your OB's birth philosophy. If your hospital has the WHO's Baby Friendly designation. You are more likely to get a natural birth as well as to have rooming-in, skin to skin after birth, and support for breastfeeding at one of these hospitals. Also birthing with MW at  hospital will likely be a different experience than birthing with MW in an out of hospital birth.

    We've chosen to plan our birth at a free standing birth center staffed by Certified Nurse Midwives--basically we're planning an out of hospital birth. After a lot of research and interviewing different practitioners, we've decided that the Midwife Model of Care with out of hospital birth, is the best choice for us. These choices and the philosophy of the birth center and the midwives align with our other lifestyles values and ideals. We feel confident that planning our birth with MWs at the birth center will be the best was for us to achieve our desired birth outcomes.

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  • I love my OB, I see a group but my favorite one was on call when I went into labor and thankfully was the one to deliver DD. she helped me through everything and even massaged me down there during pushing so I didn't tear. There is a midwife at my practice who I see sometimes and she's a little cold and I personally like the doctors better. So I guess it all depends on the individual I don't think you can say all midwives are like X and all OBs are like Y.
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  • I'm currently seeing an OB but am open to switching to a midwife if the doc thinks my plans for natural (leaning towards water birth) birth is too crunchy for her liking.  I will meet her for the first time at my next appointment and I'm coming armed with questions and can re-evaluate after I meet with her.  
  • I love my OB, she's amazing and she's been through a lot with us trying to help us get pregnant.  My SIL is a nurse who specializes in LD/post-natal mommy and baby home checkups.  She planned a very natural water birth with 2 midwives, however she had to be induced and had blood pressure issues resulting in a hospital birth.  After hours of labor she also opted for an epidural, something she was set against.   I think whatever we choose, we have to be open minded that it might not go our way.  The most important thing is that a healthy baby comes at the end.  Smile
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  • I am the biggest cheerleader for midwives. I went to an OB/MW practice with my DD and fully intended to get the epidural throughout my entire pregnancy and when I started laboring. The midwife was on call and she talked me out of the epi and I was SO GLAD SHE DID. She empowered me throughout the entire birth. The OB's in the practice kept telling me that my baby was getting too big and wouldn't fit out the birth canal - the entire time I was pushing she was massaging with mineral oil saying, "There's plenty of room!!!" lol.... My DD was 9 lbs and I pushed for an hour without an epi. It was awesome and I can't wait to do it again.

     That said, we have moved since my DD's birth so I found a new midwifery group in my new town. We had some difficulty getting pregnant this time and when I had my u/s and saw a heartbeat, the entire staff was hugging and clapping for me. Midwife groups feel like a big family to me.

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  • Lots of good stuff in this thread.  There is another documentary called Pregnant in America.  It's on Netflix watch now (so is Business of Being Born).  I just re-watched PiA a few weeks ago.  It's really informative.  I'm reading "Gentle Birth Choices" by Barbara Harper right now, and thay may have some information you'd be interested in too.  I definitely think it's possible to have a fantastic safe and healthy birth experience with an OB, BUT even if you choose a great OB who is natural friendly and won't jump to augment your labor with pitocin "just because" or follow the typical "cascade of interventions" doesn't mean you'll actually end up with that OB in labor.  Which sucks.  If I were to pick an OB for that reason, I'd want to make sure his/her practice all followed the same ideals because I'd probably have the luck to end up with the OB who had a golf appt and wanted to be done for the day when I went into labor.
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  • I love your birthing story. I want your midwife!!!
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  • It's a very personal choice. I will be going with my OB again since I'll have a RCS. If I wasn't going that route and if they were available, I'd much rather go with a midwife. Do some research as to what is available in your area!

  • DH and I opted for a midwife practice that operates out of a hospital.  A childhood friend of mine who's currently in a Certified Nurse Midwife program really recommended this concept, and we are so thrilled we listened.  We are loving the midwife experience - so far, they are all really wonderful.  And we also love the gorgeous facility and the knowledge that there are OBs and high-risk OBs on hand if anything were to go wrong.
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