Doctor or Midwife?

Finding the right obstetrical provider is stressful enough, but having to choose betwen the differnt types of provider just might put us over the edge. Here is a quick guide to the difference between the doctors and midwives.

Training
The fundamental difference between a medical doctor (MD) or a midwife (CNM/CM) is the training. Midwives are trainied specifically in the normal birth process. They are trained in how recognize and manage health birth, pregnancy and newborn care. Typically, they are taught to identify risk factors, and deviations from a healthy birth and pregnancy process and then co-manage a high-risk pregnancy or birth with a physician, or refer a client to a doctor for care.  Some midwives do receive additional training to perform surgeries and manage high-risk patient populations. These midwives may have the additional credentials after their name such as DNP, RNC, or PhD.

Physicians are trained in all medical fields from pediatrics to geriatrics in medical school. After usually 4 years of medical school, they are officially an MD, but may not practice as such until they complete some residency training. After medical school, they specialize by selecting a residency program. In OB/GYN, the residency is typically 4 years.  In these four years, they are trained in gynecology, obstetrics, gynecologic cancers, infertility, and gynecology surgery. Some physicians will go on to receive additional training in each of these specialties, called fellowship. Fellowship is only done by a handful of doctors, and it is a sub-speciality of an already chosen medical career path.  In the medical field of obstetrics, sub-specialized training is called maternal fetal medicine (MFM) or sometimes called a high-risk obstetrics.

Beyond the difference in training, each individual midwife and doctor will be unique. Women tend to choose physicians for their expertise and midwives for the personalized, unhurried care.  The model of care the worked in the US until the mid 1900's and still works in Europe today is to have the midwives care for the majority of clients unless they have a medical history or conditions that necessitates the use of a doctor.  Ideally, women would have access to both a midwife and a doctor and have the best of both worlds.