OB-GYN vs. Midwife: Which One Is Right For You?

Congratulations!  You’re having a baby!  What began with excitement may now be creating stress as you choose which option is best.  Here are a few questions to consider in deciding between an OBGYN and Midwife.

What’s the difference?
An OB-GYN, or obstetric-gynecologist, is a medical doctor that specialized in women’s health, specifically pregnancy and the female reproductive system.  OB-GYNs have completed extensive schooling, including medical school, internships, and residency in order to receive their credentials.  If considering a midwife, it’s important to choose someone that is a CNM, or Certified Nursing Midwife.  CNMs have a Bachelor’s in Nursing and must complete a master’s degree, in order to have a license to practice as both a Certified Midwife and Registered Nurse. 

Is my pregnancy normal or high-risk?
If you’re under 35, are carrying a single child, are not overweight, and don’t have any pre-existing medical conditions, a midwife might be a great option for you!  Pregnancies that are classified as “high-risk” include carrying multiples (twins, triplets, etc.), high blood pressure, previous C-section, gestational type 1 or type 2 diabetes, pre-existing or chronic health issues (cardiac, liver, kidney, gallbladder, etc.), or pregnancy complications (baby in breech position).  If your pregnancy is considered “high risk”, a Certified Midwife cannot delivery your baby, but can still provide emotional support throughout the labor process and provide care to you and baby after your pregnancy.

The health and safety of mother and baby come first.  Certified Midwives are trained to recognize problems and will call in an OB-GYN if necessary.  OB-GYNs are trained to manage high-risk pregnancies, perform surgeries (C-sections), and can use forceps or vacuums to facilitate delivery.

Do I want natural childbirth?
While most Certified Midwives encourage natural delivery and drug-free methods, it’s important to know that they can prescribe pain medication, if necessary.  One advantage to a “natural” delivery, is that you are allowed to labor on your own, without continuous monitoring.  Midwives use fetal heart monitors to check in on the well-being of the baby, but you have freedom to move during contractions and try alternative birthing positions.  An OB-GYN can prescribe an epidural which effectively blocks the pain, but requires that you be confined to bed during labor with a heartbeat monitor connected continuously.  It’s important to educate yourself and be realistic about whether “natural” is right for you. 

How much will it cost?
The cost for a vaginal delivery at a hospital ranges between $10,000-$15,000, which covers the obstetrician’s and anesthesiologist fees, as well as hospital fees.  Cesarean births can range between $20,000-$35,000. The cost for a midwife delivering at home or in a birthing center can range between $3,000-$5,000.  Home births are generally not covered by medical insurance, since they are considered “higher-risk”.  Some medical insurance plans don’t cover the cost of midwife services.  Most plans will cover hospital deliveries, but it’s important to check with your insurance company to know up-front what is covered and what will need to be paid out-of-pocket. 

The good news is that research has shown that outcomes for the mother and baby are equally good when comparing OB-GYNs and midwife births!  One is not better than the other.  You get to decide what will be best for you and your baby!

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