You’ve gone through all the test sticks in the box, and those little lines keep staring back at you. It’s confirmed: you’re pregnant! First come a mix of emotions ranging from completely thrilled to terrified. Then come the questions:
“How will I tell my family and friends?”
“Am I having a boy or a girl?”
“What do I do next?”
“You want a trusted, reliable partner who can help you navigate your pregnancy with care and compassion,” says Dr. Katie Krumwiede, medical director for HealthPartners’ OB-GYN. “This is a very personal decision to make. It’s important to know your options.”
To help you learn more about your options, let’s dive into the similarities and differences between midwives and OB-GYNs, where doulas and family medicine doctors factor in, and what you should consider when choosing who to trust with your care.
The differences between a midwife and an OB-GYN
OB-GYNs and midwives both provide great pregnancy care and safely deliver babies. But there are some fundamental differences between the two.
OB-GYNs and midwives have different credentials and educational backgrounds
While OB-GYNs and midwives are part of the same specialty area, the training, education requirements and credentials they hold are different.
What is a midwife? A trained and experienced health professional
You may know that an OB-GYN is a doctor, but you may be wondering: what is a midwife? Well, like OB-GYNs, many midwives can provide a broad range of women’s health services. A midwife may do everything from annual checkups and birth control all the way to menopause care. But pregnancy, birth and postpartum care are what they’re most widely known for.
They work closely with the rest of your health care team (e.g. OB-GYN or family doctor) to meet your needs during your pregnancy. Many women continue to use their midwives for care after their delivery, too.
There are three levels of midwifery credentials:
- Certified nurse-midwife (CNM) – Certified nurse midwives are registered nurses (RNs) who have master’s or doctorate degrees in nursing. They have also received their American Midwifery Certification Board certification.
- Certified midwife (CM) – Certified midwives are non-nurses who have earned a post-graduate degree in midwifery, and have also been certified by the American Midwifery Certification Board.
- Certified professional midwife (CPM) – Certified professional midwives are specialists who have demonstrated their knowledge and skills in providing midwifery services, and have been certified by the North American Registry of Midwives.
In the United States, the vast majority of midwives have completed graduate degrees. At HealthPartners, all of our midwives are CNMs.
What is an OB-GYN? A specialized medical doctor
An OB-GYN, meaning an obstetrician-gynecologist, is a medical doctor who specializes in women’s reproductive health, as well as pregnancy care and delivering babies. They’re also surgically trained and can perform Cesarean sections (C-sections) when necessary. You may already visit an OB-GYN for your annual well-woman’s visit.
When it comes to training and education, OB-GYNs complete four years of medical school, a four-year residency program and a three-year fellowship.
Board-eligible vs. Board-certified OB-GYNs
OB-GYNs – like other medical doctors – can also pursue certification from the American Board of Obstetrics and Gynecology (ABOG) after they’ve completed their residency and gotten their license to practice. Board-certification is optional but a mark of distinction, implying that a doctor has gone above and beyond the minimum standard of education in their field.
The path to certification requires passing a qualifying exam, preparing an extensive case list demonstrating expertise in multiple categories, and then passing a certification exam. At HealthPartners, all our OB-GYNs are board-certified.
OB-GYNs and midwives have different birthing specialties
Birthing specialties are one of the most important differences between midwives and OB-GYNs. Why? Depending on your needs, certain specialized care may be required for you and your baby’s health and safety. And depending on your preferences, you may be looking for someone who has specific experience. Here are a few examples:
- High-risk vs. low-risk pregnancies – OB-GYNs can manage high-risk or complicated pregnancies such as women who are expecting twins or have preexisting medical conditions. Midwives, on the other hand, can manage low-risk pregnancies and births, but can coordinate care with other specialists like OB-GYNs if necessary.
- Water births – While water births (or tub births) are becoming increasingly common in hospital settings where OB-GYNs are the primary care provider, they are very common within the midwifery specialty. So, if you are leaning toward a midwife, chances are high that water births are among their top specialties.
- C-sections – Midwives can’t perform C-sections, whether they’re planned in advance or become needed to safely deliver your baby. OB-GYNs have the surgical training to perform scheduled, unplanned and emergency C-sections, which is one of the reasons they can handle high-risk or complicated pregnancies.
Midwives sometimes deliver babies outside a hospital setting
OB-GYNs almost always deliver babies inside a hospital-based birth center. But midwives can deliver babies in a few different ways:
- Home births – When women with low-risk pregnancies plan home births, midwives are the professionals who support the labor and delivery process.
- Freestanding birth centers – Freestanding birth centers are not part of a hospital and they’re designed to provide a home-like, non-medical environment for birth. While some freestanding birth centers may have OB-GYNs on their care team, midwives are usually the main care providers.
- Hospital-based birth center – Midwives, like our certified nurse-midwives, can also be part of a larger care team at a hospital. A hospital setting is the safest place for giving birth. There, midwives can offer more pain management options and connect you with other specialized care if needed. All our midwives deliver at hospital-based birth centers.
The similarities between midwives and OB-GYNs
Both an OB-GYN and a midwife can deliver babies, but they also have a lot more in common.
Midwives and OB-GYNs are both highly trained and certified
Midwives and OB-GYNs are experts in women's health and pregnancy care who have extensive specialty training and experience in their field. In addition, each has received a relevant certification, which means they have demonstrated knowledge and skill within their area of expertise.
Midwives and OB-GYNs are both committed to your safety and comfort
Midwives and OB-GYNs are extremely passionate about what they do. And they want to make sure you and your baby are happy, healthy and safe throughout your pregnancy experience. So, they’ll work with you to honor your pregnancy goals and birth plan, while also offering their expertise and information on all your care options as your pregnancy progresses, including pain management during labor and delivery.
Midwives and OB-GYNs both strive to give you the best experience
You probably have a vision or plan for how you want your prenatal care, and labor and delivery to go. However, you might think you need to trade experience for expertise (or vice versa) depending on the type of care provider you choose. But that’s not true.
At HealthPartners, our OB-GYNs, midwives and pregnancy care teams strive to deliver your baby, your way. That means we all want to help you have the care and child birthing experience you’re hoping for, regardless of who you choose as your primary specialist.
Midwife vs. OB-GYN: A side-by-side comparison
Want to see the differences between a certified nurse-midwife and an OB-GYN at a glance? Here’s a quick overview of OB-GYNs versus midwives:
Doula vs. midwife: Another part of the pregnancy care equation
As you’re considering your options, midwives and doulas may come up in your research and conversations with friends. And it’s important to know what sets them apart.
So, what is a doula?
Doulas are trained professionals who provide physical, emotional and informational support throughout the pregnancy, birth and postpartum experience.
How doulas are different from midwives
While doulas are trained professionals, they’re not trained health professionals like midwives. Doulas do not deliver babies, rather they provide support through the process. Midwives (and OB-GYNs) deliver babies and are responsible for the health and well-being of their patients. At HealthPartners, we can help connect expectant mothers with doulas and welcome them in our hospitals.
What about family doctors? Can they provide pregnancy care?
Yes. Family medicine doctors can provide care during pregnancy, delivery and postpartum. But not all family doctors practice pregnancy care. And for those that do, not all have trained to perform C-sections.
So, if you already have a family doctor and think you may want to continue to see them, check with them to see if they can provide you the right care.
Choosing an OB-GYN or midwife for pregnancy care: What to consider
Choosing who to trust with your pregnancy care and child’s birth is a very personal decision. Your goals, preferences, and health and safety should all be top of mind. Here are some things to consider as you weigh your options.
Is your pregnancy considered high risk?
If your pregnancy is deemed high risk or complicated, you’ll work with an OB-GYN who may also coordinate care with a maternal-fetal medicine doctor, who specialize in high-risk pregnancies. Remember, midwives focus only on low-risk pregnancies and births.
What is a high-risk pregnancy? If you have a preexisting medical condition like diabetes or high blood pressure, you may be considered high risk. If you’re expecting twins, triplets or other multiples, your pregnancy may be considered both high risk and complicated.
Where do you want to deliver your baby?
If you’re low risk and are considering a home birth or a freestanding birth center, a midwife is likely at the top of your list of potential care providers.
But the vast majority of births happen at hospitals or their attached birth centers, where both OB-GYNs and midwives can deliver babies. Hospitals are always the safest place to deliver your baby.
However, most OB-GYNs and midwives only deliver at one or two select hospitals. So, when you’re choosing between a midwife and OB-GYN, you may also be choosing a hospital to give birth at.
How do you want to deliver your baby?
If you’re low risk and leaning toward a water birth or hypnobirthing, an experienced midwife is who you’ll want to look into. But regardless of risk, if you think you’d be more comfortable with a medical doctor providing your care, then an OB-GYN might be the best fit.
If you want a wide range of birthing and pain management options so you can have flexibility when birth day arrives, finding a midwife or an OB-GYN who delivers at a hospital is key.
How do you want to manage pain during labor and delivery?
Whether you’re planning on an unmedicated birth or an epidural, both midwives and OB-GYNs can provide you with a range of options.
Midwives often specialize in “natural” or little-to-no pain medication births. However, it’s a myth that midwives don’t have or aren’t willing to provide a range of options.
If you’re giving birth at a hospital birth center, you can stay in control of your care and still use an epidural or another anesthesia option (like nitrous oxide) – no matter the type of care provider you chose. However, if you choose to work with a midwife for a home birth or at a freestanding birth center, your pain management options will likely be more limited. So if there’s any chance that you may want more options or you just want some peace of mind, make sure you choose a hospital or hospital-based birth center to deliver.
What kind of team do they work with?
The person you choose will likely be part of a larger team. Some teams are multi-disciplinary, meaning they work alongside a lot of different specialists. Other teams may be more focused within their specialty area.
It’s important to understand what kind of team your midwife or OB-GYN works with for a few reasons:
- If you choose a midwife for care, you’ll want to make sure they have the ability to coordinate care with an OB-GYN and other specialists if complications arise.
- Depending on the appointment type, you may not see your OB-GYN or midwife for every prenatal appointment. So, it’s good to find out who you may be getting care from on a regular basis.
- The midwife or OB-GYN you choose for prenatal care may or may not be the one to deliver your baby. Every clinic is different but OB-GYNs and midwives usually share hospital on-call duties with a group of others in their field. That means “your” doctor may not be on-call when baby decides to make their entrance. So, for peace of mind, it’s good to know who’s on their team.
What kind of ongoing care do you want?
OB-GYNs and midwives can provide ongoing care for your reproductive health. So, as you’re looking at your options, think about whether you want someone you can see for years (and maybe even pregnancies) to come. Think about the qualities and areas of expertise that are important to you, from preventive care to fertility.
What kind of coverage does your insurance plan offer?
Many women wonder if there is a cost difference for an OB-GYN versus a midwife. But the cost of delivering a baby primarily varies based on where you deliver and what type of delivery you have, not who delivers your baby.
It all depends on your health insurance plan. The one exception here may be home births. Home births are usually not covered by most insurance plans.
Also, it’s quite possible that not every hospital or birthing center is included in your specific insurance plan. Likewise, there are different insurance coverage levels associated with C-sections and vaginal deliveries.
So, before you make any appointments, it’s best to check with your health plan to understand your coverage. There’s no such thing as a silly question. Member services representatives are there to answer exactly these types of calls.
If you have HealthPartners insurance, you can log into your HealthPartners online account. Or, call Member Services at the number on the back of your member ID card.
Ready to find your pregnancy person? We can help.
We try to make it as simple as possible for you to find the right specialist for your pregnancy care.
Through our doctor match tool, you’ll answer a few simple questions and we'll match you with doctors and certified nurse midwives who fit your preferences. From there you can make an appointment with the person of your choice, or you can explore their individual profiles and reviews to help you choose.
Another way we make it easy for you to get great care is by offering a range of appointment options, which includes in-person and video visits for prenatal care.