Obstetrician vs. midwife: How to choose a birthing partner

When you’re pregnant, there’s a lot to consider about your baby’s arrival. Will you find out the sex? What name will you choose? Which crib or car seat fits your needs? When it comes to your baby’s development and birth, there’s one big question: Who will provide the care you need and deliver your little one — an obstetrician or a midwife?

Choosing the right maternity care provider can set the tone for your pregnancy and impact the quality of care you receive. A provider who understands your wishes can personalize your care. They include you in decisions, offer more emotional support and boost your confidence.

Insights and guidance from Atlantic Health on how to choose an obstetrician or midwife can help you decide which provider is right for you.

Obstetricians and midwives

An obstetrician and midwife can both support a healthy pregnancy. But there are some differences.

• Obstetricians: These medical doctors have special training in prenatal, labor and delivery, and post-delivery care. As experts in caring for low-risk and high-risk pregnancies, these providers can perform procedures like C-sections or episiotomies, if needed. Many obstetricians also offer gynecological care.
• Midwives: These providers also offer prenatal, labor and delivery, and post-delivery care. But they are better suited for low-risk pregnancies. They create flexible birth plans that focus on your emotional, mental and physical needs. They stay by your side during labor, offering continuous support that may help you avoid some procedures.  

To be sure you’re choosing a compatible maternity care partner, ask your family, friends and coworkers for recommendations. Then see if the ones they’ve suggested practice at the hospital where you’ll deliver.

What to consider when choosing an obstetrician or midwife

There are many factors to keep in mind when making your birth partner selection. When choosing your obstetrician or midwife, keep these things in mind:

• Appointment wait times: Appointment delays are common. So, it’s important to know how long you may wait to see your provider. The average prenatal visit wait time for an obstetrician is roughly 30 minutes. Wait times for midwives can be longer if they get called to assist with a birth.
• Attention: Find out how much time providers spend with each patient. Do they stick to a strict 15-minute visit schedule? Or will they devote extra time to your appointment if you have questions or additional needs?
• Availability: Look for a birth partner who will be accessible. If you call or email, how quickly will they respond? Many midwives are available 24/7. Some obstetricians are, but many hospital-based doctors follow an on-call schedule. That means if you have a question or need help after hours, you may end up talking to a different obstetrician.
• Backup delivery coverage: For most women, labor is unpredictable. That means your obstetrician or midwife may be involved in another delivery when your baby decides to arrive. You’ll need to have a plan in place if your primary birth partner is unavailable. Typically, another obstetrician or midwife from the same practice will step in.
• Convenience: Keeping up with your prenatal visits is important to protect your health and your baby’s well-being. Consider the office location when choosing your obstetrician or midwife.
• Finances: If you can, it’s important to choose an obstetrician or midwife who accepts your health insurance. Discuss other fees and available payment options.
• Practice size and provider rotation: Smaller practices can lead to a stronger one-on-one relationship with your obstetrician or midwife. You may see the same provider for every visit. With larger practices, it’s common to see multiple providers throughout your pregnancy.

Questions to ask an obstetrician or midwife

Pregnancy can be an uncertain time. So, it’s important to know that you and your provider are on the same page about how to handle major parts of your care. Ask about these topics when you’re evaluating your maternity care provider selection:

• Birth environment affiliations: If you would like to deliver at a particular birthing center or hospital, look for an obstetrician or midwife that has an existing practice relationship with that facility.
• Birth plans: A birth plan is a document that spells out your labor and delivery choices. It should include your pain management preferences, where you’d like to deliver, your preferred delivery method and your requests for post-delivery care like breastfeeding assistance or placenta banking. Look for a provider who will help you create a birth plan that aligns with your wishes and values.
• Meeting your birth team: As the old saying goes, it takes a village to raise a child. It also takes a village to birth one. Several health care providers will work alongside your obstetrician or midwife during your delivery. Ask to meet them before you go into labor.
• Pain management during birth: How you manage the discomfort is up to you. Talk with your provider about your options. You may choose localized anesthesia like an epidural. If you prefer non-pharmaceutical pain management methods — like hydrotherapy or massage — make sure your provider will support that choice.

Consider your birthing preferences

All your prenatal care and planning leads up to your delivery. You may want a traditional birth in a hospital labor and delivery suite, or you may prefer a birthing center with a more homelike atmosphere. Whichever you choose, make sure your care provider and delivery environment can accommodate your birthing wishes.

Consider these factors when selecting your birthing location:

• Delivery options: Look for a hospital or birthing center that can support your chosen birthing position. You may want to squat while using a birthing ball for stability. Or you can ask if your facility offers birthing tubs.
• Pain management: Your pain management preferences may change during labor and delivery. Look for a facility that offers both medical and nonmedical pain management options in childbirth. Medical management can include epidurals that numb your lower body, IV opioids that affect your whole body or nitrous oxide (laughing gas). Nonmedical options include aromatherapy, deep breathing, hydrotherapy and massage.

Your maternity journey: The next steps

Knowing the difference between an obstetrician and a midwife is a strong start. It helps you plan the kind of support you want and shape a birth experience that feels right for you. As you move forward, there are a few more steps in your maternity care journey that can help you feel prepared and confident.

• Interview multiple providers: Interview between three and five obstetricians and midwives. Ask about their training, back-up provider protocols, experience, fees, on-call policies and pain management procedures.
• Take a hospital maternity center tour: Schedule a time to walk through the maternity area where you will welcome your little one. If you’re familiar with the facility, you’ll be less anxious and more at ease during delivery.
• Verify insurance coverage: Without insurance, an uncomplicated birth can cost between $10,000 and $15,000. If you need a C-section, the price tag can climb to more than $25,000. So, make sure the obstetrician or midwife you choose accepts your health insurance.

Finding the right provider

Choosing a birth partner that aligns with your wishes and values is an important part of a successful pregnancy. The right obstetrician or midwife can help you have a positive birth experience. Atlantic Health is here to help meet your needs.

Looking for an obstetrician or midwife? Find an Atlantic Health doctor or contact our maternity centers directly.