What is the Difference between a Midwife and an OBGYN?

When it was first recommended to me that I consider using a Midwife I’ll be honest I had NO CLUE what that meant… I kinda figured they were in addition to my doctor but that the doctor would have all sorts of control over the relationship. However, having delivered one baby with a Midwife and being about to deliver my second with one as well I have a new perspective on what exactly a midwife is and how they differ from an OBGYN.

I believe that many people don’t fully understand what it is a Midwife actually does. And to be fair it can (to some extent) vary from location to location which confuses the matter even further. But if you are NOT familiar with the practice of Midwifery and follow our mainstream advice chances are you are working with a GP or General Practitioner (aka Family Doctor), or an OBGYN.

And to be upfront there is nothing wrong with working with either of these, they both have some great benefits. But so do Midwives, and when you are looking for the right care provider for your pregnancy they are worth looking into.

In this post you’re going to find things grouped by various topics and I will include the similarities (cause there are some great ones) and some differences after that. You may want to check with your Care Provider directly on all of these topics since there can be some variation based on location or the licensing of your particular professional. And it is a great way to get to know your Care Provider better.

So let’s get right into it 😀

Licensed Medical Professionals

Yes, to be a Midwife or an OBGYN you have to be licensed! That means some serious schooling/education in the medical field. Both professions go through YEARS of intense training and are required to “apprentice” so to speak to someone in the field with more experience.

OBGYN’s will call it an internship, Midwives typically reference apprenticeship or mentorship.

The difference here will be that an OBGYN has to study to be a GP (General Practitioner) BEFORE they get into the specialty of OBGYN. So they have a longer route to get licensed and may have information about other general health issues that could affect your pregnancy then a Midwife may have experience with.

An OBGYN also will have specific training around performing surgeries like C-Sections where a Midwife won’t. And OBGYN’s train on how to use many of the machines and techy options for monitoring and evaluating situations during pregnancy and childbirth.

An OBGYN, however, will be restricted in their licensing to delivering Babies in a hospital. This is the realm they know, study and understand so if you are looking to deliver at home or in a Birth Centre they can’t help with that.

Midwives do have a pretty intensive education as well and must be highly qualified to get their license. The difference is that their focus within the education realm is more focused on what is considered “normal” during pregnancy and childbirth.

Midwives study how to spot issues well in advance without many of the technical tools some doctors employ. They also learn a lot about the natural ways to do things during pregnancy and childbirth and can support you in decisions around how that can affect your situation.

Also if there is something that a Midwife thinks puts you or baby in a risky spot they can and will refer you to an OBGYN for anything that is outside of their scope of practice.

Both professions are required to stay current and up-to-date on the standard recommendations for during pregnancy, labour, delivery and postpartum.

Many Midwives can also have a “Nurse Midwife” designation, which means they are Registered Nurses as well as a Midwife though this option is not available in all areas.

Midwives & OBGYN’s can both work in Hospitals

Yup, a licensed Midwife can deliver babies in a hospital just like an OBGYN. You don’t have to have a home or birth center birth to work with a Midwife.

Just make sure that you check with your Care provider that they can deliver in the location you want to use (this goes for OBGYN’s as well) not all Medical Professionals will work in all hospital locations either due to affiliation or licensing reasons.

Midwives can work outside a hospital

This is a licensing thing usually. Many Midwives work directly in a birth center but can also deliver babies at home if that’s what you would like to do.

OBGYN’s typically are not licensed to deliver babies in Birth Centres OR Home Births. Though I doubt any medical professional who got caught in a situation where the baby was coming at any location would deny a woman help.

OBGYN’s are just not licensed to PLAN these kinds of deliveries. And NO you should not try and trick one into being around when you go into labor that’s mean.

Pre-Natal Care

YES, they both work with you throughout your pregnancy to ensure your and baby’s health! They can handle all aspects of your Pre-natal Care from the initial “WOO HOO we are pregnant!” to delivery. Things like:

  • Ordering Blood Work
  • Scheduling Ultrasounds
  • Checking Blood Pressure
  • Listening to Baby with a Dopler
  • Answering Questions
  • Letting you know what’s normal
  • Giving you the heads up on what to expect
  • Discussing delivery options

And so much more, both positions are highly knowledgeable.

Appointment Times

The big difference I’ve noticed here is that the appointment time available for each profession varies. OBGYN’s typically will try to provide you with what you need in about 15 minutes or less. Which makes it a challenge to build rapport with them.

Whereas a midwife will usually book a meeting for about an hour.

The appointment frequency throughout your pregnancy is around the same, but with an hour to ask questions and even just “chat” it’s a bit easier to get to know your midwife.

They work in teams

Both OBGYN’s and Midwives work in teams (usually though not always). This means someone is always on call and they can still have lives outside of their practice.

The difference is that with Midwives you will get to meet the whole team throughout your pregnancy so you know the person delivering your baby before you go into labour.

OBGYN’s will often accommodate your request to meet the rest of the team, but not always. They don’t default to a method of introducing you to everyone who could be on call when you deliver.

I personally had an issue with this when I was working with a doctor in my area for our first pregnancy.

Working with Other Support Personel

Both Midwives and OBGYN’s will commonly work with other support personnel throughout your pregnancy. If you need something like physiotherapy, massage, or chiropractic assistance they can and will give you referral information and share information from your file as needed.

However, when it comes to working with a doula not all OBGYN offices will be as helpful. Some have even recently started making statements in their office that they are banning Doulas from working with their patients. I’m sure there is a good reason (to their way of thinking).

I have yet to meet a Midwife who doesn’t love the idea of working with a Doula… my Midwife and Doula have met repeatedly and I often hear great things about one or the other from them both. It’s reassuring and helps me to know I’ve chosen the right one for us.

Your Care provider during Labour & Delivery

Yup, both a Midwife and an OBGYN can deliver babies for the women in their care.

The difference here is in the details.

During Labour…

During labour your OBGYN may not be anywhere NEAR you, chances are you will be dealing with the nurses in the hospital. Many of whom are AMAZING men and women with tones of info on how to help and support you.

And chances are whichever doctor is on call will show up in time to “catch” baby and take all the glory from the hard-working nurses.

Midwives on the other hand function as your Nurse as well as your doctor.

If you are birthing at a birth center they will be the one greeting you at the door, helping you get to your room, and walking you through all the stages of labour.

Dealing with Complications and Interventions

OBGYN’s have a reputation for recommending more pain killers, and other interventions during labour. I’m not going to get into if these are nescessary or not because every situation is different and there is just too much info to go through for one post.

But chances are higher if you are working with an OBGYN that someone will recomend some kind of intervention during labour.

Also when working with hospital trained staff often times they have policies and procedures that happen “automatically”. All the nurses and doctors are expected to follow these so that everyone is on the same page and the birthing person is not always given the option to consider their choices.

With a Midwife, you are less likely to have pain options recommended that require medication. They tend to work with you on things like positioning, or breathing methods that could help. In my area, Midwives are also able to administer “laughing gas” (not sure the medical name of it) if you want it.

If you want an epidural you will need to be in the hospital and have an Anesthesiologist administer that.

Midwives tend to be less procedure-oriented and more “are we in the normal parameters?”. This goes for labour and delivery as well. Because they are with you all the way through labour they also have more experience of what is common or normal in labour and childbirth and may be less inclined to call for interventions.

However, Midwives are well trained in spotting any potential concerns or complications and will give you advanced notice that there MIGHT, MAYBE be something to think about.

Working with Other Support Personel

Mostly I’m talking about Doula’s here, Midwives tend to love seeing you walk in with a doula. OBGYN’s who are used to it will also love seeing them (along with your nurses), and some OBGYN’s may have NO CLUE what a doula is or even be against them as mentioned above.

Outside of that both Midwives and OBGYN’s will work with support personnel like Nurses and other Doctors depending on the location (ie are you in a hospital?) and who is available to help as you labour.

Delivering Your Baby

So again, both a Midwife and an OBGYN can deliver your baby. (Depending on the location and their licensing as mentioned above)

However, if you need an emergency C-section (or elective one) your only option will be an OBGYN. While Midwives are highly trained they are not licensed or trained to perform a major surgery such as a C-scetion.

Midwives can and will often spot any potential issues well before a C-Section becomes necessary and get your care transferred to an OBGYN if you need one.

Some Midwives and OBGYN’s are also comfortable delivering babies that are in unique positions on their way out. Or in using methods to shift baby without needing to use devices like forceps or vacumes or even resorting to a c-section.

Though this is fairly rare in the care provider realm (to my understanding) so if it is something you are concerned with ASK YOUR CARE PROVIDER what their stance is.

Tools used during delivery

As discussed above, Forceps or vacumes can be used during delivery. However, these are ONLY used by OBGYN’s. Midwives typically do NOT have access to these tools even if they are in a hospital.

Delivery Positions

More and more OBGYN’s are getting comfortable with women delivering babies in “alternate” positions. Meaning something other then the traditional flat on your back feet in the stirups pushing and straining to fight that baby out.

However, you will want to discuss this in advance with your OBGYN as there is still a way to go in getting them all on board with the whole Mamma’s Choice for delivery positioning.

Midwives tend to recommend positions that make delivery simpler for Mom. They will even talk about them during your pregnancy to help you think about what options you may want to consider.

Water Birth…

Water Birth can be a great thing for Moms, I know for me it was key in My Painless Birth. But I have yet to meet a doctor or OBGYN that would advocate for one… Midwives will give you information on it and let you chose.

If you want a Water Birth I highly recommend talking to a Midwife.

Postpartum Support

Ok, this is another big difference, usually after you have baby in a hospital your OBGYN will see you once maybe twice before you get discharged (length of stay depends on where you are but can vary from 24 hours to much longer if you have a c-section or any other complicating factors).

Midwives (even ones that deliver babies in a hospital) can discharge you as early as 4 hours after birth… think about that. You could be home recovering in your own bed 4 hours after birth if you had an uncomplicated pregnancy and delivery!

But the support for BOTH professions doesn’t stop there, while you are in their care they will assist you (as best they can) with breastfeeding, show you things like how to put on a diaper etc.

Though with the OBGYN you will likely be dealing with Nurses and maybe a lactation consultant instead of the doctor themselves.

Midwives will be right there with you lending you all the knowledge they have.

There are also follow up appointments to see how you are doing. OBGYN’s typically want to see you within 6 weeks of delivery for a follow-up. And you’ll likely get 1 15 minute appointment to discuss anything you are concerned with or have questions on.

Of course, if you have any complications you will need to go in for more appointments. But the onus is on you to make that call.

Midwives tend to see you more often, I don’t remember the exact number of appointments I had after delivering our first, but I know I saw her 24 hours after the baby was born, 48 hours, 72 hours and then they started spacing them out more after that.

The last 2 appointments were in the Birth Centre my Midwives worked out of, and the rest were in my HOME where I could rest and be lying around effectively naked if I wanted (we were breastfeeding on demand and I hated taking off my shirt and putting it back on OK?).

Talk about a more relaxed laid back experience, and the Midwives took whatever time was needed to make sure I was ok, and Baby was ok.

I was even told to ask MORE questions because being a new Mother can be overwhelming and it’s better to ask than not.

The one test we opted for after birth was done right in our home, and other than that we mostly chatted about how I was feeling and what was going on.

Postpartum Mental Health

With the rise in awareness around Mental Health in general and specifically Postpartum Mental Health, both professions are watching more for any signs or concerns that their patients are in need of additional support.

You can count on them to help you to the best of their abilities if you do need some help in this area! And it is important to speak up and NOT suffer in silence when there are so many options out there to help with anything you are dealing with, PLEASE reach out if you think you might need it.

Which one should you choose?

Well, this one is all on you, I can’t make a recommendation one way or another. Both professions are AMAZING at what they do, both have some great benefits and some restrictions. So it really is something of a personal choice for the birthing Mamma.

The biggest thing I can say and advocate for is that you need to trust the people in the delivery room with you, if your gut tells you that the care provider you picked isn’t right for you then listen to that!

Interview a bunch of them (if you can) and pick one that you feel will listen to you and work with you in the way you want to handle your pregnancy and birth. Not only will this person see you semi-naked, but your life and the life of your baby will be entrusted to them and that can be a scary thing especially when you are in a situation that can be very vulnerable.

We Mamma’s need to start standing up and advocating for ourselves more and more, and if we all do this together then maybe, just maybe there will be a shift in our birthing culture that sees women as powerful and worthy of the respect we already know we deserve during this amazing stage in our life.

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