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Midwife? Family Doctor? OB/GYN?

elizabeth b. September 5, 2012

When I was pregnant with my first child, I didn’t know that I had options for my maternity care. Once I had my pregnancy confirmed by my family doctor, I was promptly given my instructions: “Refer to Obstetrics.”

After asking for referrals, I made my first appointment with a highly recommended OB/GYN.

One of the perks of being her patient was a copy of What to Expect When You’re Expecting.  While perusing the pages, I read of different caregivers—OB/GYN, Family Doctor, and Midwife. My first reaction was that this book needed to be revised because what responsible parent-to-be saw a midwife for a pregnancy? And seeing a family doctor for pregnancy was something that went out of style with my parent’s generation, so obviously another outdated practice!

Since I was “with the times,” I continued seeing my OB/GYN, trusting that I was doing the absolute best for my baby and myself.

I soon learned there were tests, interventions, and monitoring — sometimes without medical reason or necessity. When it came time for the birth, interventions upon interventions fell like dominoes in a chain reaction. Every hour or so, there was talk of a c-section.

Needless to say, I no longer blindly accepted what others deemed to be right. I also learned that my experience wasn’t atypical as most of my friends, except the ones who rejected it, were given Pitocin or other measures to start or augment labor.

How had we become a society in which women were no longer considered able to give birth without the help of medicines, machines, and excessive monitoring? Were women suddenly broken? Or was there something else going on?

While I continued to use an OB/GYN for my next two births, I also hired a birth doula, which made a positive difference and helped me feel more empowered.

Then I decided to step out! I had my fourth baby with a family doctor and my fifth baby at home, with the assistance of Midwives.

Since I have experienced the different modalities of care, friends and acquaintances have asked my opinion on these different providers.

Image by istockphoto.com/gchutka

Pros and Cons of Different Care Providers

OB/GYN

Most women see an OB/GYN during their pregnancies. While mine was personable, the office was very “medical,” with many tests and monitoring. Long waits and an emphasis on labs and results led me to feel as though I was being put through a system, especially when it came time for the birth.

I quickly understood why a woman might want to shout, “Oh, is the machine having the baby?” whenever a doctor or nurse tells her she’s not experiencing a painful contraction because it’s not registering on the monitor. As someone who strives for natural pregnancy and births, I felt as though my desires were more or less tolerated, rather than supported. On the other hand, if there was a need for emergency intervention, the doctor was equipped.

Family Doctor

A family doctor is able to see the whole family but has extra training in obstetrics. If I needed tests or other interventions, he had access; but he was genuinely supportive of doing things as naturally as possible. While I loved that he was able to see the whole family, I think this contributed to the busyness of his office. In some ways, he was busier than my former OB/GYN.

Midwife

When I told my parents I was seeing a midwife for my fifth pregnancy, they had the idea that I was seeing a “Granny Nurse” from times past. Today’s midwives are highly trained in prenatal care, birth, and newborn care. State requirements vary, so you will need to check the laws in yours as you interview providers.

As for appointments, I enjoyed an hour speaking with the midwife and her apprentices and assistants. Not only did she check the routine things — blood pressure, protein, etc. — but she also asked about nutrition and my emotional well-being. When “Birthing Day” arrived, these ladies felt more like friends and sisters, rather than care providers. I also had the confidence in knowing that if we needed interventions, they knew the appropriate time to transport and would even be able to communicate with the hospital staff.

Midwife? Family Doctor? OB_GYN?

Advice for Moms-to-Be

If I were a first-time mama-to-be and not quite ready for a homebirth, but wanted to have as natural of a pregnancy and birth as possible, a family doctor who practices obstetrics is a great way to begin.

Note, I have met a couple of great OB/GYN providers who were supportive of mother and baby friendly care.

Above all, read, research, talk to your friends about the details of their maternity care and birth experiences, and interview several care providers to find one with whom you feel comfortable. Another important aspect to talk about is the difference between prenatal care and birth support. Some women have experienced exceptional prenatal care but found the same provider used unnecessary interventions when they got to the big day.

A great site to find resources is Birth Network, where you can find local chapters, providers, and information for your state.

I’m still concerned about the high use of interventions. I’m not a doctor or a midwife, but common sense easily points to a problem in today’s current system. That said, I believe women should give birth where they feel most comfortable, so if that’s in a hospital setting, I highly recommend hiring a doula — a birth advocate who can help you understand your options and support you during your labor and birth. If you’re unable to locate one through a Birth Network, check out DONA or CAPPA.

What provider did you choose, and did you enjoy the experience?  Any advice to share?

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9 Comments

  1. I’ve been doing more research on care providers lately, and I’m realizing that achieving a natural birth may have even more to do with the birth location rather than the care provider. There are many nurse midwives who practice under an OBs watch or in a hospital that have been educated by the medical institution and may not be much more naturally inclined than an OB, as you mentioned in your other post. I know many people won’t agree with me, but I’m coming to the conclusion again that if you want a safe natural birth, stay as far away from a hospital (or a hospital based birth center) as possible. Given my research a home or birth center birth is a safer option with better outcomes for low risk pregnancies than giving birth in a hospital.

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  2. […] best for yourself and your baby, and that means choosing the right health care provider.  Are you comfortable with your care provider, or do you need a new […]

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  3. […] doctors will do a blood test at your initial appointment, usually around 8 weeks.  One of the things […]

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  4. […] are having problems with your pregnancy (preterm labor, struggling to gain weight, etc.) and/or are seeing a doctor who is not so naturally-minded, you may be in for a lot of extra visits and tests.  You might have […]

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  5. […] to understand that while many complications warrant some extra attention from your doctor (and switching to a doctor if you weren’t already seeing one), they aren’t extremely serious nor immediately […]

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  6. I like how you mentioned that OB/GYN are the ones to go to whenever there are emergency interventions in a woman’s pregnancy as they are well-equipped for the situation. That is great to learn as I would not know the left and right when it comes to pregnancy. Personally, among the three you mentioned, I’ll most probably go with the OB/GYN as they seem to know best what they are doing. Thanks!

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I’m Kate, mama to 5 and wife to Ben.  I love meeting new people and hearing their stories.  I’m also a big fan of “fancy” drinks (anything but plain water counts as ‘fancy’ in my world!) and I can’t stop myself from DIY-ing everything.  I sure hope you’ll stick around so I can get to know you better!

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