The difference between a midwife and a doctor

Of my three births, the first two have been with midwives and the third with a doctor. I used a doctor the third time because there was no midwife available to do a birth in a hospital, but at the time I would have preferred to use a midwife. 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.

I will not malign neither the midwives nor my doctor and was generally happy with both. At the end of the day, I had three healthy babies which is the goal. However, if there is anyone out there considering using a midwife then this post is for you. Or, if you ever just wondered how the childbirth experience is different, then this is also for you. Midwives are not only for fruity, crunchy granola type moms.

While I do think I tend towards keeping things simple and naturally lately, I am no hippie. I like Diet Coke (apparently aspartame is bad…) and Reese’s (so is, apparently, processed sugar..) . Nor are midwives only for women who refuse drugs. My midwives in both places (Pickles was born in Scotland and Jiggy was born in Australia) offered the same drugs they do here in the good ole USA. However, the way in which they offer them and encourage their use did differ slightly.

These are, of course, based on my own experiences so this post is no way intended to be a blanket explanation. So without further ado, let’s get into it, everything you really wanted to know about using a midwife…

(1) Midwives are nurses, and they behave as such.  

You know how you go to the OB/GYN and the first person you see is a nurse? Then, after a bit, the doc comes in and out and you go home? Well, with a midwife, she (although I am sure there are some male midwives) does it all. With my first two births I never saw a doctor one single time. My doctor the third time didn’t make me feel rushed, per se, as doctors often do. The nurses do most of the work and the doctors come in and make sure it’s all how it should be and that’s it. It can, depending on the doctor, leave you feeling pushed through like cattle.

Also, doctors don’t always tend to be as personal or nurturing simply because of the volume of people they see. Again, this is my experience. Midwives (at least the 6-10 I’ve been seen by in my time) take on the roll of the expert and the nurturer. If you imagine nurses wiping patients foreheads with cloths and saying kind words, this is how midwives tend to be. Instead of a doctor speaking to you it feels as though they are speaking with you. Instead of them telling you how it is, you feel as though they’re training you.

(2) Midwives seem to focus foremost on you, your choices and your comfort 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. But it has always seemed to me that doctors act as though a healthy baby and mama are items to be checked, almost a tad impersonally. Midwives focus on you and your baby and you really feel as though they are in it with you, even a little 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.

Midwives are also more focused on your choices and preferences in the birthing process. Not that a doctor ignores your wishes, but it seems they go a little on autopilot and just do what they do. With all my midwives I sat down, discussed my options, asked lots and lots of questions, and wrote out a birth plan.

Get my free printable birth plan here. 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 (because I’d been in the hospital 4 hours…wow…) 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.

(3) 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 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. Mine 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. In my opinion they aren’t necessary since they don’t give you an indicator of when the baby will come since you can go from 0-10cm in a few hours or sit at 4cm for a day anyway.

(4) Midwives don’t do things without asking

As I mentioned here, my doctor in my most recent delivery (a month ago) did a membrane sweep at 38 weeks while doing a routine internal exam. I am telling you, 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, this is still shocking. A midwife’s mentality is less “let’s get this baby into the world” and more “things happen in their own time and way, no need to push it.”

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. Now, that doesn’t make her a bad doctor of course, but it was unnecessary and I surely didn’t ask for it.

(5) 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, 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!

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