Is A Midwife Really All That Different?

When it came time to choose a care provider for my first pregnancy, I knew exactly where I would turn.

mom doctor

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A nurse-midwife, no doubt about it.

Working as a student nurse in the labor and delivery unit of a hospital near campus, I thought I had seen it all when it came to the difference between doctors and midwives. I had watched, with incredulity, as a doctor once tapped his watch and ordered, "Let's take her back — I have a dinner reservation at eight," referring to taking his patient in labor back to the C-section suite.

No way was I going to subject my body and my baby to that kind of callous doctoring, thought I. A nurse-midwife would provide me the kind of individualized, personalized care that would show respect to a woman going through labor and delivery. And she did. The nurse-midwife we chose plopped down on the floor near my tub at midnight when I finally went into labor and didn't leave my side unless I wanted her to.

It was just the experience I was looking for. But then, much to my surprise, when I had to choose a doctor for care during my third pregnancy, I found the same experience with her.

Turns out, it's not so much about the what in choosing a health care provider during pregnancy, but the who.

Traditionally, nurse-midwives have worked in treating women by viewing pregnancy as a normal life event that generally requires little intervention and having a basic respect for the woman to take the lead in her care. Today, however, more and more doctors who specialize in obstetrics are embracing the same philosophy and working to support patients looking to choose a more holistic approach to childbirth.

"The difference between physicians and midwives is not always as great as you would think," notes Michelle Bader, certified nurse-midwife and Central Michigan University OB-GYN faculty member. "Time restraints on physicians are their biggest obstacle to providing the care that a patient and family receives from a midwife."

As I experienced, a nurse-midwife (who often has a lower patient-to-provider ratio) can devote more time to supporting a woman in labor, but given the right relationship, the same can be said of working under a doctor's care. In fact, I think I actually saw more of my doctor during my fourth labor than I did under a different nurse-midwife with my second.

The bottom line is that when it comes to caring for pregnant women, doctors and midwives aren't pitted against each other — or you. You should choose someone you are comfortable with and someone who you know you can have a trusting and open relationship with. "My goal to educate and support a family during the most incredible time of their lives is the heart and soul of my practice," says Bader. "Women still have the right to make choices during their care and supporting those choices, within reason, enhances their birth experiences."

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Doctor or midwife: Which should you choose?
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