Midwife or OBGYN? Both can be great and this decision is largely one of personal choice. Meet with and ask questions of some midwives and some OBs. The differences in their approach to care combined with each provider's unique personality will likely leave you with the sense that a certain provider is just the right fit for you. You will not get this intuitive knowledge without taking the time to meet with several providers. It is worth your time to know that you have made an informed decision about who will provide care for you and your baby. Take a tour of a birth center and a hospital and ask lots of questions in both settings. Defining and creating your birth experience is an essential act of parenting—be an active participant in this decision making process.
A few area hospitals have groups of Certified Nurse Midwives that have privileges to deliver in the hospital (Group Health, Highline, Evergreen, UW and Swedish Ballard). These midwives work in groups similar to the OBs but they have more experience with unmedicated births. A midwife who practices out of hospital will likely provide you with a more personalized experience and continuity of care but be sure to ask if the midwife you are interviewing will be at your birth or if she works with partners. Be sure to meet all partners so that you can be sure the practice is a good fit for you.
We have some of the best birthing centers in the country right here in our county. A birth center is a free- standing clinic with rooms appointed for birthing. They are beautiful, warm, and lovely places to deliver your baby. They are located within minutes of the hospital for safe and fast transfers in the event that it is required. Even if you do not imagine yourself birthing outside of the hospital, it is worth a tour and a talk with a midwife so that you can make a truly informed decision. Generally speaking, birth is a very normal, low risk event. It is a natural part of what women do in their lives. Typically, parents will pay a fee for use of the birth center.
Unlike open heart surgery, which is high risk and highly specialized, for which we would not choose someone who “loves to work with hearts and appreciates the inner working of this life source”, birth is so innate to the body that were a woman alone in a room by herself, she could deliver her own child.
Midwives are trained to recognize high risk pregnancy and at no time will they compromise the mother’s or the baby’s health. If your pregnancy requires specialized care, they will help transfer your care to an Obstetrician. If all is healthy, the midwife will help you work with your body to birth your baby. She will stay with you from the time you meet her at the birth center until several hours after you deliver your baby. They are trained to provide prenatal care as well as labor, delivery, and postpartum care.
There are several differences between a midwife and an OB in the areas of patient education, participation in your labor, and leadership style in the pregnancy and delivery. The OB provides patient education through explaining to you what your body and baby are up to at each visit as you go along. Generally, at around 38 weeks you will present her or him with a birth plan you have created and they will discuss it with you, and let you know how your experience delivering in the hospital will likely compare to what you want. If you use an OB you will labor in the hospital at the direction of hospital staff and protocols. An OB is also trained to help manage high risk pregnancies and provide surgical services if needed.
The midwife follows the Midwifery Model of Care which is based on parents being active, educated leaders in their pregnancy and labor. She will provide you with resources and services to help you create the birth experience you want to have using knowledge you have acquired over the course of your pregnancy. She will likely be present for most of your active labor and delivery and will flex her skills to meet your preferences during labor.
There is a place for both models and each woman will find herself with a different set of health issues, desiring a different type of birth experience, requiring a different type of provider and birth setting.
You may also choose your home as your place of birth. Women across all walks of life are choosing homebirth. From professional lawyers to young women having their family before they embark on a career, women find homebirth offers them options to connect with their innate potential, their body, their baby, their partner, and intuition in a way that can only occur in the home. Women who birth at home cite feelings of freedom and autonomy, experience less pain due to the uncompromised and uninterrupted flow of oxytocin a woman who feels safe experiences, and enjoyment of the experience of intimacy and control she has over her birth.
A healthy, speedy birth really boils down to where you find yourself most able to relax and release your body to the process of birthing. This requires trust and comfort in your environment and providers.