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.
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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.
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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?
A nurse.
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.
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!
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My midwife didn’t attend my delivery, because it was a public holiday. Labour Day. Go figure.The women’s clinic I go to only has 2 midwives, both of which were apparently on holiday… So I had a doctor who did a similar thing to yours- just randomly, she would grab my perineum with two fingers and yank it as hard and as wide as she could. She wasn’t even watching me or the contraction monitor to see if I was ready to push! So I’d be in between contractions, trying to recover slightly and gather strength for the next one and she’d just yank and take away my breath and any focus I had! SO painful and a bit rough, really!
Ultimately, yes, I have a healthy baby, but my recovery is kinda painful, as the doc seemed unnecessarily rough and dispassionate toward me as anything other than a job to be done.
Am tempted to have my next baby in the UK or Australia, so that if my midwife is on holiday, there’ll be more than one possible replacement before getting a doctor!!
I am sorry for your experience with that. I flat out told the Dr. to stop!!! I have no idea why they think that’s helpful when you can feel it? It only lasted a second but that was surely enough. Thanks for your opinion on the matter, though! I guess it all depends on the doctors and midwives we have and what our goal is. But I have to say…. I’m a midwife all the way girl right now :)
I have only delivered once, with a doctor at a hospital. I did so naturally, and will probably do so again and with a doctor, because midwives are rare where I live. I would love a hospital delivery with a midwife if I could! My hospital is an hour away, so it makes me nervous to deliver at home, because if something did go wrong, we would be too far away to get the problem addressed quickly. Anyways, I also had a doctor that pulled on my perineum. It hurt a ton! Almost just as badly as actually pushing out my baby. He was still a resident, and I was literally the first natural delivery he had ever seen. Crazy! Even though he pulled quite a bit and it hurt a lot, I also think it helped me not to tear, so I’m thankful that he did it.
Erin, I read this comment as though I wrote it. EXACTLY. I was an hour away natural with a doc in the hospital and no midwives in the area really. And I had a pull on the perineum and it hurt like hades. Ha ;)
I LOVE my midwife. Love love love her but sadly she hasn’t delivered either of my babies :( My first one she was on vacation when I went into labor and my second one she was on maternity leave! I have already discussed with her my plans for baby #3 to make sure we aren’t pregnant together again haha! I agree with this post although i haven’t been as blessed as you have been with as personalized care, I do have my fav midwives phone number and have hung out with her outside of the office but it was out of friendship more than the patient/midwife relationship (she actually just recently bought my old tv from me haha welcome to small town life right?). Even though I didn’t get MY midwife to deliver, both of my deliveries were with other midwives and I was overall please with the experience. Where I live drugs aren’t just an option…they are pretty much forced on you. I have to literally FIGHT to have natural birth. Insane right?!?! They have a limit of only 3 hours once you start pushing then they will take you back for c-section :( The only experience I have had with a dr during delivery was when one peaked in to check on me since I was reaching the 3 hour marker in pushing with my first baby. Thankfully she okayed me to keep going past the “c-section hour” b/c I practically BEGGED! I have only seen a couple drs for appointments and had horrible experiences with them…I felt they were very much herding me like cattle! The experience with a midwife, for me, is exactly like you said where I feel like they truly care and talk WITH me not just TO me! Great post, as usual :) And I could write a BOOK about my feelings on this haha ;)
Love it! Can you believe there is a time limit on it? As though you will expire. Ha. But yes, as an informed person I appreciate it when they (be it a doctor or a midwife) talk with me and not to me, skipping important details, as though I had no clue what was going on! I even had one nurse tell me her license was on the line so it was out of her hands…geez.
In general, the above is true–but check out your midwife to make sure she is the typical midwife as described above! I chose a (hospital) midwife assuming that she would fit the mold you describe above simply because she was a midwife. I couldn’t have been more wrong. She was just like a doctor, swept my membranes without my permission, wanted to induce me 1 week overdue, and didn’t explain anything to me unless I specifically asked… I just wish I hadn’t assumed that she would be a typical midwife just because she bore that title.
Janice, thanks for writing this! This is a good addition to the comments and so true. I always hate when any medical professional never tell me anything unless I specifically ask and then give me answers that show they don’t believe I can actually understand them! I’m sorry for your bad experience too. It is particularly sad when such a joyous event is preceded by annoyance and negative experiences!
Rachel, thank you for this post! I’m a huge proponent of natural birth, midwives, and home births. I was delivered at home and had my two children at home. My midwife for my second son was actually the same midwife who delivered me twenty-six years earlier! Thank God she came to me knowing that I was in need of midwifery care. I was currently under the care of a doctor, and had similar experiences as you. I enjoyed her care and would recommend that clinic for someone seeking a doctor’s care, but I was so blessed to receive my midwife’s care. Nothing less of a miracle! I feel, unless it is a high risk pregnancy or there is some reason a home birth is not possible, then having your baby in the hospital just isn’t necessary. A birthing center is a good alternative, too, because it’s similar to a home birth with that amount of attention and connection.
On a side note: I ordered a birthing kit for my second son from a company called In His Hands. I couldn’t agree more!
So awesome hearing your story! I nearly had a home birth once, but didn’t. I will say the midwife vs. doctor experience is really very very different!
Fun update: We’re expecting twins in December or January! Because it’s twins a hospital birth is what I am more comfortable with. I am seeing my first midwife as my prenatal caregiver, since the doctor who will do the delivery will be whoever is on-duty/call and I won’t meet him/her until the delivery, anyway. I have more concerns with this delivery and the thought of doing it at home is extremely stressful. I’m actually looking forward to a hospital birth as a new experience in something I feel quite versed in. With a twin birth, for me, it is not worth any risk for anyone to be twenty minutes away from the hospital. Just knowing that I will be right there in the hospital in the event I need a c-section makes things easier. I know some hardcore home birth proponents have had successful twin home births, but I won’t one of them.
Holley, how exciting and congratulations :)
So very interesting the differences between Australia and USA. I didn’t realise that the USA was sooo medical with doctors. I’ve had both too, but my births were both a bit tricky so I needed them.
I’m from a rural area, but the only midwife with a birthing center was impossible to get into. I mean she was so booked out!
I appreciate you sharing your experience. As a doctor who works in the UK I am sure things are different between our two countries. But I think stereotyping doctors as cold and impersonal , and midwives as warm and friendly , is untrue. Those sound like personality traits. There are probably as many friendly doctors as there are aloof midwives . Plus what makes someone friendly to you might be overbearing or insensitive to another person since we’re all different. It’s not really fair to label those as professional qualities and values. Example, lots of my obstetrician colleagues know that the ideal thing to do is to have as few interventions as possible – I’ve sat in on consultations with obstetricians who are extremely reluctant to perform surgeries because they think a natural birth is best, and only agreed anyway because it was what the mum wanted and she was anxious about a natural birth . At the end of the day it’s up to the individual woman to make a personal decision about her birth plan, bearing in mind all the evidence & her gut feelings .
And I should also say that the decision might also be different if a woman’s pregnancy is high risk in any way.
You are very right, Ada. In fact, my most recent obstetrician was EXTREMELY friendly more so than quite a few midwives I saw! Thanks for your thoughts here, Ada.
Thank you for this Ada. I am honestly sick and tired of the dead old narrative that doctors are impersonal and blah blah blah. I mean, really? You just happened to meet a terrible person. Don’t make that about physicians. It’s unfair to physicians who have literally given up their entire life to serve people only to be deemed cold and what not. In the end, a trash human is a trash human, be that a nurse, midwife or doctor. Also, you are comparing healthcare in two different countries and systems. This is not a parallel or fair comparison.
I wonder if you doctor experience is country-specific or you just had a bad experience. I’m in Canada and being looked after by our family doctor who is also an OBGYN. I have never seen anyone but her when I go in for appointments, she is so kind and caring, and she takes care of me as a person, not just my baby. My care is personable and she is part of a collective of maternity doctors who are always available for questions and concerns at all hours. If you call the number, you will speak to a doctor, not a nurse, and they will talk to you (kindly) until you feel comfortable hanging up the call. No offense to midwives, but I never thought one second with trusting anyone other than my wonderful doctor with the health of my baby.
Thanks so much for sharing your perspective :)