Ever wondered what the difference is between a midwife and a doctor as it relates to pregnancy, labor, delivery, and after care? Here are some things to consider if you are deciding between using a midwife or doula or a doctor.
Of my five births, the first two have been with midwives and the last three with doctors.
For my first birth I was in Scotland, and midwives are the norm.
For my second birth I was in Australia, and midwives are also very common.
For my third, fourth, and fifth births, I was in a rural area in the US and midwives were fewer and further between.
I decided it would be a good study to see the differences in care, expertise and experience between the two and – as it turns out – in my experience there was a huge difference.
Before we get into the nitty gritty, let’s remember these things…
- Midwives are not only for fruity, crunchy granola type moms.
- Midwives are also not only for the women who want a drug free childbirth.
- Generally, mothers who want a more natural birth will prefer midwives, but that doesn’t mean no pain management.
- Geography will often determine which you end up going with due to availability of the midwives and the proximity to the hospital, which is a deciding factor for some.
The Differences Between Using A Midwife Or A Doctor
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Midwives are nurses, and they behave as such
When you go to the OBGYN, who is the first person you see?
Then, after a bit, the doctor comes in for a minutes or two then leaves and you’re done. When you use a midwife, she does it all.
With my first two births I never saw a doctor one single time.
I loved the doctors I had with my last three births, but nurses took on support roles during these births, so it was more like a larger team.
With a midwife, you have a one stop shop.
- Doctors don’t tend to be as personal or nurturing simply because of the volume of people they see and their role as the ultimate authority.
- Midwives (at least the 6-10 I’ve been seen by in my time) take on the roll of the authority and the nurturer.
- If you imagine nurses wiping patients foreheads with cloths and saying kind words, this is how midwives tend to be.
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Midwives seem to focus on you whereas a doctor is more solely focused on the goal
Obviously the doctor’s goal is for a healthy mother and baby, and I am in no way disputing that.
In my experience, it’s been like doctors aim for a healthy baby and mom, but in a more impersonal way.
Midwives focus on you and your baby and you really feel as though they are in it with you, even emotionally speaking. Not that a midwife befriends every patient, but it is has felt for me that the dynamic is one of a type of temporary partnership as opposed to a medical professional/patient.
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For both of my first two births, we went with the birth plan fully. For my second delivery, when the doctor kept circling outside trying to give me some pitocin to speed things up my midwife ran interference and kept him at bay since she knew I didn’t want drugs.
I didn’t even find out about this until later, she was protecting my plan and me at the same time.
Midwives think naturally if possible, intervention if strictly necessary
I think generally speaking epidurals are the norm.
At least they were with the OB/GYN group I was with. I don’t mind them one bit because, as I’ve said before, I’m not against drugs on principle.
➡️ However, I am against drugs if they are pushed on me or if anyone assumes I will take them, or be pressured to take them, simply because they are the norm.
Chicken is also the norm and guess what people, I can’t eat it!
With both of the midwife groups I’ve been with natural is very common and it is not the norm to induce childbirth unless necessary.
- In both Scotland and Australia (during the time I lived there) they won’t induce until you’re at least 10 days overdue and even then they will try natural methods first, such as a membrane sweep.
- In the US, my doctor did a membrane sweep at 38 weeks without asking which induced labor. My son was born two weeks early.
- My midwives didn’t encourage drugs to speed up labor, and I felt that just generally had more of a “people deliver babies all the time, women in China come off the rice patty, deliver, stick the baby in a sling, and go back to work” mentality.
- In fact, with both midwife pregnancies, I never had an internal check to see if I was dilated or effaced until I went in for delivery.
Midwives don’t do things without asking
As I mentioned here, my doctor in my most recent delivery did a membrane sweep at 38 weeks while doing a routine internal exam.
She said “whoa the baby’s head is very low” and did a membrane sweep.
This is actually a natural form of induction.
And, in fact, I had the baby the next day. While I can’t say I wanted to go another two weeks being pregnant because I felt like I’d been pregnant forever, this is still shocking.
Additionally, during delivery after a pushing contraction was finishing and I was leaning back to relax, my doctor did some kind of “helpful” maneuver where she attempted to widen the opening a bit so the next push could be more effective.
It hurt like hades and I said (more meanly than I normally would in a non-labor situation) “what did you just do?” She was genuinely shocked that I even noticed or felt it since she’s used to patients who can’t feel anything.
She apologized and didn’t do it again, but I’d never had that happen before.
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Midwives can come to you
This will depend on where you are, but in both Scotland and Australia my midwives visited me at my home.
In Scotland I went in to the office once a month and then at the end, once every two weeks.
After the birth, they came to the house every few days for a couple of weeks and then again upon request for a few months.
Can you imagine the level of comfort and security this brings to a first time mom?
In Australia my midwife came to my house throughout my pregnancy for the routine checks and I only went in to the hospital for ultrasounds (two), the glucose test, and to deliver.
Now, if you’re having a home birth you would go in even less. Afterwards the midwives came to the house to check me and the baby. I have to say this is an amazing thing. Here in Florida where I delivered my last baby I had to drive an hour for every appointment, which is once a week near the end, and there are definitely no visits. Visits aren’t mandatory, but they are so convenient.
I mean really, who wants to leave the house with a newborn to drive an hour for a five-minute appointment?
So to recap…
So, this isn’t a technical list nor will it mirror everyone’s experiences, but I have to say that I prefer midwife delivery. I liked my doctor and would recommend her to others seeking a doctor, but if you are at all keen to try a midwife then I’d suggest you go for it.
Midwives help you feel in control of the situation and less dependent. After all, you are doing the work.
- Midwives give you a confidence that you are doing it all and in control and they are simply there to catch the baby.
- I am a proponent of natural birth – though I have nothing against drugs – and I have found that midwives are more confident and used to delivering babies without drugs so they don’t naturally push things on you.
- With a doctor I almost felt that I had to justify my preferences.
So, as you may have guessed without having to read this whole post, going with a midwife felt more natural and having a doctor felt more medical.
But either way at the end of the day, a healthy baby is – in fact – the goal!