All the Different Birth Providers Explained

More than 90% of women in the U.S. see an OB/GYN, but did you know that this isn't the case in other countries? In countries like the United Kingdom or New Zealand, the majority of women are seen by a midwife, with only women who need a higher level of care see an OB/GYN.

You may be confused about what specifically a midwife can & can't do. You may also wonder if an OB can support an unmedicated birth. This article will sort out all the confusion so you can choose the provider that's right for YOU and your birth wishes!

What is an OB/GYN?

An OBGYN is a doctor that specializes in both Gynecology (which serves women from puberty to menopause) and Obstetrics (which serves pregnant and postpartum women). They are able to perform surgeries, such as a C-section. They are specially trained to manage high-risk pregnancies & deliveries.

As with any other doctor, Obstetricians have different skill-sets - some are more adept at managing complex deliveries while others are more interested in physiological (& unmedicated) birth. In general, most Obstetricians are most comfortable with utilizing modern medicine during birth. This is why if you're high risk or have a complicated situation, an OB is usually the best choice.

What is a Midwife?

According to the Midwives Alliance of NA, "Midwives are the traditional care providers for mothers and infants. Midwives are trained professionals with expertise and skills in supporting women to maintain healthy pregnancies and have optimal births and recoveries during the postpartum period. " Midwives

Did you know there are different types of midwives?

Certified Nurse Midwife: An CNM is a medical professional who has completed accredited graduate-level programs in midwifery. CNMs can work in hospitals, birth centers, or homes. While a CNM cannot perform a c-section, she can prescribe medications such as Pitocin or an epidural. I highlighted this point because I think this is something that many moms don't realize - you don't need to have an unmedicated birth to use a midwife!

Certified Professional Midwife: A CPM is trained in midwifery without first getting a nursing license. They are certified through national programs that ensure certain training & qualifications have been met. They are highly skilled to manage low-risk pregnancies and births. Most practice inside of homes but some also work in birth centers. They usually aren't able to prescribe medications, with the exception of a few states.

Professional Midwife: (Also known as Traditional Midwife) This is a midwife that's not certified under the North American Registry of Midwives. According to mana.org, "They believe that they are ultimately accountable to the communities they serve; or that midwifery is a social contract between the midwife and client/patient, and should not be legislated at all; or that women have a right to choose qualified care providers regardless of their legal status."

What is a Maternal-Fetal Medicine Specialist?

"Maternal-Fetal Medicine (MFM) physicians are high-risk pregnancy experts, specializing in the un-routine. For moms-to-be with chronic health problems, we work with other specialists in an office or hospital setting to keep mom healthy as her body changes and her baby grows." (smfm.org)

You may be referred to see an MFM if you are diagnosed with Gestational Diabetes, Pre-eclampsia, or many other conditions. MFMs also consult with parents about genetic disorders and other issues with the baby.

What is a doula?

A doula is a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible.

Families hire doulas for home, birth center & hospital births. While most insurances do not cover doula expenses, some are beginning to see the cost-benefit of doulas. Doulas are research-proven to reduce interventions and c-section risk significantly. They also promote the well-being of mom and dad.

Doulas cannot perform medical procedures or prescribe medications. They are there for support.

Which is right for me?

You'll want to take into consideration your pregnancy, risk level, and birth wishes when making this decision. I recommend that most couples at least consider using a midwife if the mom is low-risk. The reason why is that the midwifery model of care is much more patient-centered. You'll typically have longer prenatal visits, you'll develop a relationship with your midwife, and you'll receive more personalized care. And, as I mentioned above, you don't need to plan to have an unmedicated birth if you use a CNM.

Midwives also do a better job with postpartum follow-up. Most will schedule a 2-week and 6-week check with you. I find that the 2-week check is especially helpful, as usually if there are any issues, such as postpartum depression or breastfeeding struggles, they're going to start really showing up around that 2-week mark.

I realize that not all places have access to midwifery care, so don't despair! There are many wonderful OBGYNs who are supportive of all your birth wishes. Ask around to get referrals to the best ones in your area. A good place to look is local Facebook groups. You can also hire a doula to help support you.

I'll also mention that in our Birth Class for Couples, we talk extensively about this! We even include a printable with the essential questions to ask your OB if you're planning an unmedicated birth (to see if they are really supportive). Click the link above to sign up.