Hi! I’m Kayle, a client and friend of Amanda’s, and she asked me to talk a bit about the differences between an OB/GYN and a midwife. I’m the mother to a 2 year old boy and a 1 month old girl and I had different healthcare providers, different hospitals, and vastly different birth experiences for each. With my son I had a standard OB/GYN and then for my daughter I switched to a different practice and their team of midwives. As a result, I think I’m the perfect person to speak on the difference between the two!

An Obstetrician Gynecologist (AKA an OB/GYN) goes through 4 years of medical school (after getting their undergraduate degree), 4 years of residency, and 3 years of specialization. They deal with all aspects of women’s health (including menopause care) and hospital births and can assist with surgical procedures, such as C-sections. They’re also able to prescribe medications and contraception. Pretty much-they can handle any complications that may arise during childbirth. They tend to spend less time in the room with you and are more, unsurprisingly, clinical. In my experience with my son all of my prenatal appointments were very quick in and out. The doctor came in, said everything looked good, and left. And then came labor. I had an exceptionally long and difficult labor (60+ hours of back labor, fun!) and did not end up feeling like my doctor (or most of the nurses at that particular hospital) really cared about what was going on with me individually. It was like there was a checklist or a script on how things were supposed to proceed and it didn’t allow for the various nuances of labor (like that my contractions were absolutely never regular) or the fact that I wanted to have a natural birth with no interventions. Everyone was perfectly nice and it all worked out (although I did end up being pressured into pitocin and an epidural towards the end) but I truly believe things could have gone smoother or faster if anyone had really listened to me or cared about my individual needs. It was just a very one-size-fits-all approach and for me, personally, it wasn’t my ideal situation.

There are two different kinds of midwives: Direct Entry and Certified Nurse Midwives. Direct Entry midwives’ training is an apprenticeship under another midwife and they are not certified or able to prescribe medication. These types of midwives are almost exclusively used for home births and are not what I have experience with. Certified Nurse Midwives are Registered Nurses (so they have a Master’s of Science in Nursing) and are certified through the American Midwifery Certification Board. They are able to assist with home birth, in birthing centers, and in hospitals (they also deal with women’s health in general, not exclusively pertaining to prenatal, childbirth, and postpartum) and are able to prescribe medication and contraception. Midwives are not able to perform surgical procedures or deal with certain other complications so there are some circumstances and some medical cases where they are unable to be the healthcare provider for your pregnancy/birth. Midwives usually focus more on the relationship with their patients and are more likely to talk things over with you in depth and really care about what you’re wanting. They view childbirth as a natural process and tend to be much more supportive and helpful with allowing labor to progress naturally and avoiding unnecessary interventions. That said, you absolutely can still use pain management (or be induced, etc.) while using a midwife: they are there to help support you and the birth experience you want. I saw an immediate difference when I switched to midwives before the birth of my daughter. Every midwife I saw would sit and talk with me during my appointments. They were still relatively quick but I felt like a person, I felt seen and heard. And then for my entire labor process I was listened to. My midwife sent me to the hospital after an appointment because I’d had 2 weeks in a row of borderline high blood pressure, but I was also already in active labor. She signed off for me to be induced but when I expressed the desire to avoid pitocin she changed the order to have my waters be broken. Then, after I was checked into the hospital and met with the midwife on call (and spent at least a half hour talking with her and discussing what we wanted, how our past experience had gone, etc.) she decided to hold off on breaking the water and see how I progressed on my own. Every step of my labor I was checked in with and my desires and circumstances were taken into consideration. As soon as my water broke (on its own!) my midwife did not leave my side until I was taken into recovery after the birth of my daughter. She talked me through transition and just told me to push when I felt that I needed to (a vast difference from the timed and directed pushing I had been told to do for my son). And, even though water births are not technically supposed to happen at the hospital I was at, when the time came and I was still laboring in the tub she just let my body do what it naturally wanted to do (and helped me breathe and vocalize in a productive way) and then she helped me guide my sweet little girl into this world. My midwife was an angel. She helped me have exactly the birth I wanted and was so kind and considerate and the entire experience was so redemptive to me. 

I realize I seem very biased, but this is based on how I felt and the experience I wanted to have! Every person is different and what we all need for childbirth is different. Some of us may be more suited to an OB/GYN or need one for medical reasons and others, like me, may find midwives to be a better fit. No matter what you choose you will end up with a perfect baby, and that’s the best part.