Kinda a dumb question... Midwife Vs Regular Dr - which is better? Differences?

[gummibears]

I know this is probably a sensitive subject, but it's one I've been thinking about lately. What's the difference between a midwife and a plain ole doctor?

With DS I went to a clinic and saw whoever (I was young, I hadn't a clue there were any differences and whatnot) I had a perfect pregnancy and birth at the local hospital.

Now that we are moving and I'm older, I've been wondering which is better. I know nothing about the doctors in these towns, so word of mouth isn't really possible. I see there's a midwife listed 20 miles away in another town (not the one we were considering getting my care at) and the other town has just the hospital, like I had for DS.

When looking for a care provider, what are your important criteria? Midwife or Dr and why? (you can keep this as short as you want, I'm just trying to get an idea) Up until now my only criteria was female. LOL (Yeah, I know...)

[WifeofAnt]

Better depends on your situation (and if by regular doctor you mean OBGYN).

OBGYN
'High Risk' pregnancies inc. higher order multiples
Mother is more comfortable at hospital (some midwives do hospital)
Birth Defects suspected

Midwife
Most everyone else (low risk mothers)
May be better if culture/religion strongly prefers female care providers
Women who want homebirth
More personalized care

Either way, find a care provider you are comfortable with who shares your views. If you're more natural-minded it is more likely this may be a midwife than an OBGYN but its not guaranteed.

[Aleka333]

this is my first, so I don't have that much experience. But I knew from the start I wanted a midwife. Where I live, the doctors I've seen in the past were pretty ignorant about veganism (even vegetarianism - they thought I should eat fish). I didn't want to have to deal with the doctors' lack of knowledge on nutrition, etc.

I also knew I wanted a homebirth, maybe in water, and I didn't want to be strapped to a bed with monitors and things. I want to be able to eat, drink, and move around as I feel like. So, all these criteria kind of made seeing an OB inappropriate for me.

The last Dr. I went to for a regular checkup had censored her own posters of the reproductive system - she'd actually taped construction paper over the 'dirty parts' -- I was looking at that while my feet were up in stirrups. LOL Granted, I live in a backasswards part of CA.

So far, my midwife has been excellent. She sees me for 45 minutes once a month - no waiting, no rushing around. She's trained not only in childbirth & emergency response, but also nutrition. It's all been pretty laidback so far - which I need so I don't freak out as a first-timer!

[weliveintheforest]

I would recommend midwives to anyone. There are good doctors out there, but for the majority of women, you will get much more personal and holistic care from a midwife. I think it depends a lot on your region what your actual options are.

My criteria would include low intervention rates, and a reputation for respecting women and babies.

[gummibears]

Ah, I see. I've been trying to figure which offers the closest care, too as hubby works 20 miles away, then there's another 20 to doctor (he has only vehicle in house) as well.

I see there's both nearby, so really it kinda comes down to hospital or home birth preferences. (Or at least in a nutshell it is)

Both imo seem to have their perks, too bad one couldn't mix them up into one :P

I like the more personal care of the midwife, but in the event that it's needed having the hospital there is also relieving. (DS was sleeping at the time and I had some issues delivering him on hands and knees - severe back labor, too, yikes!) Other than that, it was a pretty normal delivery aside from him having some jaundice that went away a couple days later.

I'm going to have to give this a bit more thought, I suppose, and I never had an obgyn (ever), just a reg doctor at the clinic that was qualified to do prenatal care and births.

[gummibears]

Originally Posted by weliveintheforest

I would recommend midwives to anyone. There are good doctors out there, but for the majority of women, you will get much more personal and holistic care from a midwife. I think it depends a lot on your region what your actual options are.

My criteria would include low intervention rates, and a reputation for respecting women and babies.

DH is big on holistic. Really big. That does factor in without a doubt for me, personally.

[Ola_]

It's my first also so I don't have a comparison. But I got a midwife because I wanted to have more options in my care. It's one of my favourite things about my midwife: each test and procedure is presented as a choice and she explains why we may want to do it or skip it. There's no mandatory "now you're going to do this". And here midwives can deliver either at home or in the hospital.

Plus, every appointment starts on time, lasts around 45 minutes and there's lots of time to ask questions and discuss things. They have a lending library of books and videos in their office, and I have a 24 hour pager number for my midwife and her backup. I heart my midwife.

[MegBoz]

The "midwifery model of care" I'd define as:

• treating the whole woman/woman centered / individualized/ they remember your name & your wishes & don't have to consult a chart for everything
• viewing pregnancy & birth as normal physiological processes/ a part of a healthy life
• less interventive (more likely to "wait & see" & only intervene when a problem arises)
• lower tech (i.e. using positioning to help a baby descend instead of going to CS, using movement, eating, emotional support, nipple stimulation, to help labor keep moving & progressing instead of pitocin or CS)

The "Medical Model of care":

• The opposite - viewing pregnancy & birth as fraught with problems, more testing, etc.
• Less individualized (For example, EVERYONE gets continuous electronic monitoring, EVERYONE gets AROM by 8 cm, etc.)
• more likely to intervene then let nature take it's course
• higher tech (& see above examples - and the tech methods have a LOT more risky side effects than the low tech examples I listed)

Now, what's crucial is that some OBs do practice a more 'midwifery model' while some MWs practice more medically...such creatures exist, but on the whole OBs = medical, MWs = woman-centered/midwifery model as a generalization.

Also generally OBs deliver only in hospital. I'm sure there are exceptions, but I believe it's VERY RARE for OBs to attend births at home or a FSBC (Free-standing birth center.) At least in the US. So MWs are your only choice for out-of-hospital birth.

For a healthy woman with a healthy pregnancy, outcomes are better with the midwifery model. Period. Outcomes for mama AND for baby are better with MWs. I wouldn't bother looking for an OB if I were healthy - especially in the US.

If you want more data on the whole 'medical model' issue, check out the fantastic book, "The Thinking Woman's Guide to a Better Birth" by Henci Goer (shows, VERY CLEARLY, how intervening without need makes things worse!) & the movie "Business of Being Born."

Read through your tribal area for recommendations, attend an LLL meeting, search for reviews on www.thebirthsurvey.com, etc. You'll find out REAL FAST who is NCB-friendly & who is not. For example, there's a great deal of consensus here in Baltimore about which hospitals to birth in if you don't want FSBC or HB, and which I'd personally rather squat all alone in the woods than step into to birth.

[thebigfam]

I had a hospital MW with DD (that went ok but not like I wanted it to) and I really wanted a HB MW this time (I didn't want to babysit the hospital again). The state I live in is very anti midwife so the only HB mw cant practice untill after my delivery. My Family doctor is very natural minded and she respects my wishes as to the kind of birth I want. I am also hiring a doula...so she can babysit the hospital for me. I am comfortable with this decision but I still yearn for the homebirth I have been wanting!

Big Momma

[ILoveMyBabyBird]

I know for me I really liked my dr. with ds, she was easy going and we had a developed relationship, so much so that when I was in labor dh asked her to stay to deliver me even though she wasn't on call and she did. The thing with obgyn's, is you could have a really great dr. have a great relationship and then go to deliver and they aren't the ones that will even be there, it could be anyone in the practice, that may not be in sync with your birthing wishes.

Now with this pregnancy, as long as nothing high risk develops, I will be delivered by one of 3 midwifes, and I have seen 2 of the 3 already and the 3rd ones online bio is actually the best sounding as far as natural birth.

Another thing to look at is not just the dr. or midwife, but if planning a hospital birth, the nursing staff. With ds I had a great night nurse, who helped me to the whirlpool, encouraged the birthing ball, but once the morning nurse came in it was all about getting the baby out as fast as possible. Overall the nurses were pretty good, but that one rubbed me the wrong way and made dh upset and therefore made me upset and then i ended up with pitocin and epidural. If you have a hospital birth, you will be spending most of the time with the nurses, not the dr. or midwife and anyway, so check the hospital practices, and nurses too.

[CherryBomb]

It depends on what you want. It also depends on the individual doctor and midwife. I see a lot of insinuation in the natural birth community that doctors are always mean, cold, and intervention happy, while midwives are always hands off, loving, and supportive. The real world is rarely that that black and white. There are good doctors and bad midwives, there are bad doctors and good midwives. The person is more important than the title, imo.

A big factor is going to be if you want to birth in a hospital, birthing center, or at home. Obviously if you want to be at home or in a freestanding birth center, you're going to be looking at a midwife of some kind. If you want to be in the hospital, some have attached birth centers and CNMs.

[CherryBomb]

Originally Posted by ILoveMyBabyBird

The thing with obgyn's, is you could have a really great dr. have a great relationship and then go to deliver and they aren't the ones that will even be there, it could be anyone in the practice, that may not be in sync with your birthing wishes.

This is the only downside to my OB. She attended my last birth (vba2c) and she's really wonderful, I love her (very hands off, respectful, supportive of natural birth, etc). But she has like 6 or 7 other OBs in her practice! Thankfully I wound up delivering shortly after business hours last time so I had her, but idk what will happen this time. At her practice they have your OB sign your birth plan and then put an electronic copy in your file so that if you do get the on call doctor they're supposed to honor your birth plan. I hope it actually works out that way if I don't end up with her at my birth

[MyFullHouse]

I've delivered twice with OBGYNs and twice with midwives. The two biggest differences in my experience were length of appointments (I've never left a midwife appt. without having all of my questions or concerns addressed, and I've never been rushed) and presence during labor (mw never left the hospital during my 6 and 16 hour labors, and was in the room with me, encouraging me, for the majority of the time, rather than just showing up to catch.)

My OBs never saw me as a person, never knew my dh's name, and had to refer to my chart or re-ask me everything. My midwives know and remember nearly everything about me (after all, they see me for more than 3 minutes every month).

And that's not even taking into account that my mws try to be as natural-minded as possible.

I will say that I would happily transfer to their back-up OB if needed though. He's their biggest advocate, so I know he supports their methods. Through my few visits with him for other health needs, I have no reason to suspect he'd ask me to do anything that wasn't needed.

[Honey693]

Keep in mind if you decide to go the doctor route there is a difference between OB-GYNs and family practitioners. A family practitioner is a nice compromise between midwife and doctor (usually) if there's no midwives in your area you like.

[clutterbug]

Originally Posted by gummibears

I see there's both nearby, so really it kinda comes down to hospital or home birth preferences. (Or at least in a nutshell it is)

It depends on how midwifery works where you live. Here, midwives have hospital privileges. You can have a midwife-attended hospital birth, if you so desire.

To me, it's about so much more than place of birth. I have had a family doctor-attended hospital birth and a midwife-attended home birth. I am hoping that even if I end up with a hospital birth this time (for whatever medical reason), my care is still with a midwife. My first birth was fine, the doctor was not a jerk or anything like that, but the difference in midwifery care was evident from the first time I walked through the door to their office. The care is much more personalized, I didn't feel like I was being put through an assembly line of wait, pee, weigh, wait some more. My midwife appointments were 45 minutes to an hour each - we got to know each other, my son was welcome to play with toys in their office, they got to know my husband. By comparison, doctor appointments were 5 minutes with a med student/1st year resident, then more waiting for the doc to come in, then 5 minutes with the doctor and I was out of there. Usually an hour and a half of sitting around to spend 10 minutes or less actually receiving care.

Just my experience. Good luck making a decision!

[AZgirl2207]

There are lots of wonderful posts with great info. For me (one OB hospital birth and one MW home birth), I feel get higher quality care from my midwife. My MW wants to know about my diet, exercise, mental health, body image, family dynamics, EVERYTHING! I feel like my MW actually thinks about me and cares about me and my family. She offers me options for everything--there is always something else to try.

With the OB, it was a struggle to get her to answer basic questions. She certainly wasn't concerned with my anxiety level, what vitamins I was taking, or even if I knew anything about birth. It was pretty much assembly-line medical care, no choices unless you wanted to fall off the conveyor belt. (looking back, I should have jumped!)

There are certainly wonderful, natural-minded, supportive OBs out there, I just wouldn't count on finding one. My OB/hospital experience wasn't terrible--thanks to a wonderful hubby and awesome doula.

[gummibears]

Originally Posted by Honey693

Keep in mind if you decide to go the doctor route there is a difference between OB-GYNs and family practitioners. A family practitioner is a nice compromise between midwife and doctor (usually) if there's no midwives in your area you like.

That's what I did with DS at the clinic. It went pretty well, but often I felt rushed after apts and I disliked that. But otherwise it was pretty good.

[crayfishgirl]

Originally Posted by CherryBomb

It depends on what you want. It also depends on the individual doctor and midwife. I see a lot of insinuation in the natural birth community that doctors are always mean, cold, and intervention happy, while midwives are always hands off, loving, and supportive. The real world is rarely that that black and white. There are good doctors and bad midwives, there are bad doctors and good midwives. The person is more important than the title, imo.

This is exactly true. I interviewed three midwives with my first, and they either didn't mesh with my personality or couldn't address (what I thought) were very basic questions (which made me question their abilities). I liked the OB I selected throughout my pregnancy as he was very supportive of minimal interventions and my plans for birth. However, he misrepresented himself and I ended up firing him in the delivery room when my water broke in absence of productive contractions and he gave me 6 hours to deliver before he would intervene. My new dr (who replaced him and delivered our daughter with minimal interventions 41 hours later) is wonderful! She is knowledgeable, respectful, and has unlimited time for me at my appointments. She delivers all her patient's babies whether she is on call or not (unless she is out of town), and endlessly supportive. Example: she gave me her cell phone number when I miscarried in the spring so I could call her if I needed her, and encouraged me to do so again with this pregnancy if I was having problems/feeling anxious. She walks on water in my mind.

That's a super long-winded way of saying that it depends on how you want your birth to be (i.e. hospital/home), but that not all drs are evil and medically/intervention-focussed.

[bella99]

If you're talking "in general" then yeah a midwife. But if you're talking about individuals, you'll only find the answer by meeting with specific providers and deciding who you are most interested in and comfortable with.

My last pregnancy was with an OB, who was fantastic, and I've heard him described as an OB/Midwife. My current pregnancy is with a midwife because he moved away. As much as I really like the midwife, if the OB returned to the area, I would jump ship and go back to him.

I actually hate discussions where OB=bad and midwife=good, because I've met great OB's and god-awful midwives (actually one who told me I had an eating disorder because I'm naturally thin without knowing anything else about me) and I think it does a disservice to providers who automatically get lumped in with the larger group. I think if you're willing to do some research in your local and meet with a couple of providers, you'll find the right fit, regardless of whether there an OB or a midwife.

[gummibears]

Originally Posted by bella99

If you're talking "in general" then yeah a midwife. But if you're talking about individuals, you'll only find the answer by meeting with specific providers and deciding who you are most interested in and comfortable with.

My last pregnancy was with an OB, who was fantastic, and I've heard him described as an OB/Midwife. My current pregnancy is with a midwife because he moved away. As much as I really like the midwife, if the OB returned to the area, I would jump ship and go back to him.

I actually hate discussions where OB=bad and midwife=good, because I've met great OB's and god-awful midwives (actually one who told me I had an eating disorder because I'm naturally thin without knowing anything else about me) and I think it does a disservice to providers who automatically get lumped in with the larger group. I think if you're willing to do some research in your local and meet with a couple of providers, you'll find the right fit, regardless of whether there an OB or a midwife.

I agree. I figured I'd just get better informed as to know who to include in the meeting session, so to speak. There's a couple towns both the same distance from home and from what I've seen online, they each offer either a midwife or obgyn, there's also family practitioners, which I did with DS and was going to just blindly do again this time, but something stopped me and made me want to really think this one out - which I think by and large is a good thing. Just makes things a bit more complicated in the beginning, but I think I and the baby will be better for it.

At this point, if I find a midwife that I connect with and that does hospital births, I'll likely go that route.