Midwife vs Doctor:
Pros and Cons
As most of you know I have 3 amazing kids. It has been quite a journey, not only raising them but preparing for their arrivals and their births. To date the most important lesson I have learned is that nothing ever goes as planned. Throughout this nerve racking and exciting time in our lives its important to remember that plans change and THAT IS OK! Many people consider the idea of having their babies with a midwife as opposed to an obgyn. So the question was what were the pros and cons to a midwife vs doctor.
Since in the U.S. 98.5% of births are at hospitals, it’s only natural to wonder about the differences. Midwifery in the U.S. is unusual, it’s not the norm, as opposed to the rest of the world and even in the U.S. historically. Only 8.1% of births in the U.S. are attended by midwives. When I first got pregnant with my first son, I immediately knew that I did not want to have a hospital birth. There were a few reasons.
First, I am deathly afraid of needles. I could not imagine a world where I could survive a spinal tap or an epidural. I know how silly that sounds next to pain of labor. BUT how could I possibly have pushed out a baby if I was passed out? lol I know I’m being a little exaggerated, but still. I started doing tons of research on birth centers and midwives, as well. I soon started to learn about how the rates of c-sections and complications during birth as well as the length of times of births grew exponentially in hospitals. This really drew me further from an obgyn and closer to a midwife.
When I was pregnant a friend of mine had her baby and had an EMERGENCY c-section because her baby was “too big”. No other reason, literally the doctor told he wouldn’t fit through her birth canal. That was the last straw for me. I was officially decided on having my son with a midwife after that. So I went to a tour at the birth center closest to my house, which was half an hour away. My second, I had in the hospital because I went into early labor at 35 weeks minus a day, and my third was also with a midwife. With a hospital birth and 2 births at a birth center I am able to compare the 2 different experiences for those of you still caught between the 2 still unable to decide I hope my experience helps.
I started out at an ObGyn, since I hadn’t decided what I was going to do and I still hadn’t found a birth center near by. First of all it took me forever to find an ObGyn that was covered by my insurance cause I anted my doctor to be a woman. When finally found one, and I arrived I had to wait like half an hour for the nurse to call me in. She weighed me, took my blood pressure, and took a blood sample. She had me wait for the doctor and that was it.
When the doctor came in almost 20 minutes later, she explained the schedule of appointment and how many sonograms I would have. She also told me about different birth options what would happen if I need a c-sections and some information about the hospital that they used. She explained to be how she and the other 5 (male)doctors go on a rotation schedule for on call deliveries. So my chances of actually having her at my birth were very few.There was never
On my very first appointment not only did my midwife go over what ti expect throughout the pregnancy but also labor and post party. She sat with me an my husband for an entire hour. She signed us up for a laboring class, a hypno-birthing class, a breast feeding class. They set every appointments for half an hour each. There were 4 midwives and they worked on-call bi-weekly. So 2 would work on call for labors the first half of the month and the other 2 would work the end of the month. They would schedule my appointments with the midwives that would be on call while I was due.
I was also able to take my other kids to the appointments and sonograms and not only was it allowed but it was welcomed. They really took the time to get to know me and what I was looking for. So I was able to really get to know them before the actual labor.
Midwife for the WIN! Of the 2 I would definitely say that I was able to establish a much better relationship with the midwife than I was with the ObGyn. I felt like I was just a number on the schedule for the ObGyn and with the midwife they genuinely cared about me and what I wanted. I know some people may say that well it was the specific midwife I was with and that an experience with a different midwife would be different. But not really, because I had my first with a midwife at an entirely different end of the state.
Everyone’s biggest concern with choosing a birth outside a hospital is “How safe is it”. I totally get this and this very question is what kept me from going down the midwife route off the bat. I was concern about an emergency situation. What if the cord was wrapped around the babies neck? or what if he had swallowed meconium? Or what if, god forbid he was born without a pulse? What could a midwife possibly do to help? All of these questions would go through my mind as I was considering whether or not I wanted to stay with my ObGyn or not. There was also the issue that I didn’t want to have drugs in my system when I breast fed and I didn’t want the baby to feel the effects.
Now obviously an ObGyn would have full access to all medical equipment in a hospital for an emergency. Ifi needed a c-section or if the baby needed the NICU it would be simple. That being said this is just what I concluded based on my own research. 32% of ALL births in the U.S. are via c-section. 25.8% of all c-sections where of low-risk pregnancies. Those are HUGE numbers! I am not saying it’s wrong, every mom does what she thinks is best for her and her baby. A mom’s best is THE best. But I just couldn’t chose a c-section without some kind of emergency.
These number appalled me, and I started to look into what that meant for out of hospital births. At my first appointment my doctor was already telling me the different ways to go about a scheduled c-section. After a certain amount of hours in labor they HAD to do a c-section I was dumb struck. I don’t remember how many hours but still. This ended up not being a problem for me at all as my birth were so incredible quick.
Well first of all, obviously you can’t have a c-section if you’re not in a hospital, so that was out of the question. Phew! That was a huge thing for me. I really did not want to feel pressured into a c-section. But my first thought after that was well what if I NEED a c-section. Like really need one because the baby is having a complication of some sort. Both birth centers that I went to were within 2-4 miles from a hospital that had excellent NICUs. That really comforted me.
They also had a system where the hospital would already know when they had a birth just incase. That way they could notify the hospital which was already on call and they would be at the door in a matter of minutes. My midwife had been attending births since the early 60’s and she told be that she only ever called the ambulance once. The birth went on naturally at the hospital, the only issue was that the labor had gone on for more than 24 hours and mom requested it. This was the only reason I chose to give birth in the birth center as opposed to at my home.
I lived a half an hour away from the hospital both times and didn’t want to risk it. The nest biggest factor for me was the screening. This may be different based on the state in which you live. In Florida, in order for a midwife to handle your prenatal care and attend your birth you must first pass a screening. Basically the way this worked is you filled out a form and checked off the boxes that applied to you. If you scored more than a certain number you could HAD to use an ObGyn. If you had a low enough score your pregnancy was low-risk and you most likely wouldn’t have any complications. This was exactly what I needed to hear to settle my fears.
Something I did not know was that a Certified Nurse Midwife is trained to handle situation that arise with the baby. The could give the baby their vitamin K and handle resuscitation, and the cord around the neck. All of those things as a pregnant mom you never want to consider. Literally the only thing they couldn’t do was stuff like surgery and incubation. They had IVs on hand if we needed them and all kinds of medical training that I was surprised and glad to know. Also many midwives actually attend hospital births, so always ask your hospital and or midwife if that is an option for you.
All that being said, I will call this one a TIE. Because of the fact that there is the option that a midwife can do a birth in the hospital. 😉 And also because there is such a lower rate of c-sections with midwives.
This is such a HUGE concern. When I tell people I had a natural birth, and even a water birth the first thing they want to know is how I bared the PAIN. Well I won’t it was painful. Very painful in fact. But my midwife throughout my prenatal care really taught me so much about my own body and what I could do to prepare for labor. She had me doing exercises and taking supplements to facilitate labor. All of which TOTALLY paid off. All of my labors where 3 hours or less, from my first contraction to the birth.
My body was so ready to give birth after everything I had been doing to prepare that I literally would arrive at the birth center just to push. My midwife taught me natural ways to manage my pain and honestly, if I hadn’t been able to feel the contractions I think that I would have torn. I tried to labor on a bed with my first and it was awfully painful. I ended up having a water birth. Barely gave the Midwife enough time to fill the tub, but the warm water made such a huge difference. Not only did it sooth my contractions (a little) but it was also such a relief down under.
Pain management options are a spinal tap and an epidural. Both of which can have long lasting effects cause be complications. I am not saying this happens to everyone but it is a possibility to consider.
I will also give this one a TIE. Because while an epidural is more effective in pain management it also has more risks, and while natural pain management is less effective it runs no risks and helps speed up the labor processes without risking unnecessary tears.
This is simple number so there isn’t much to say other than: Doctors get paid way more for a secession than a labour. My friend had a c-section and her pre-insurance bill was $25,000, give or take. The hospital stay alone was almost at $10,000, so a regular labor at the hospital would have been at least that much. My pre-insurance bill for my labors were $2,400, give or take. Her copay was $2,000 and mine was $800.
Dr.s tend to follow standard practice to avoid liability issues. Because of this they listen to you less, and just follow procedures. My ObGyn wasn’t even present at my daughter’s birth. When I started having contractions I was alread
y 6 cm and I told the doctor not to leave because I would dilate super fast. She said that those things take time and she would return to “check in” on me in an hour. I had my daughter half an hour later. They also REALLY wanted me to have an epidural the anesthesiologist came in 3 times to ask me to sign the release to put in my epidural. That was so frustrating. Was hooked up to an IV, which I felt I did not need and a band around my stomach, which was so uncomfortable, and I HAD to birth on the bed.
The environment is so much more tranquil at the birth center. I was free to walk about and the midwife gave me myspace. She would only come into the room every so often to see if I needed anything and to check the babies heat beat. She asked me if I wanted her near by of if I anted to labor on my own. They lowered the lights for me and I was allowed to have my kids there(not that I did it was the middle of the night). But there was no running around or nervousness.
I was discharged 2 hours after the birth. I was home before my kids even knew I had left. Since I birthed over nigh, they just woke up with a new baby brother at home. The whole process was just peaceful and relaxed. And as woman when all is said and done you feel amazing that you were able to do it on your own. It’s so empowering! A huge downer for me was midwives cannot not do preterm births. With my second I went into labor at 35 weeks due to a stressful situation So naturally I had my daughter in the hospital.
All of the statistical information mentioned above was obtained from the CDC’s website.