Is an OB/GYN or a Midwife the best choice for your prenatal care? How do the different options affect where you will give birth? There are many factors to consider when choosing your prenatal care provider and your birthing location. In addition to taking into account your personal health history, it also comes down to personal choice. What you feel is best for you and your family is most important. Learning the differences and determining the qualifications and skills that matter to you, can help you choose the right provider for you.
An OB/GYN is a doctor that has completed medical school, a residency, other advanced training and specializes in obstetrics and gynecology. Your doctor has the full range of medical skills to address any type of birth. This includes difficult complications, variations and cesarean sections when needed. They will care for all high-risk pregnancies and reproductive issues. Choosing an OB/GYN as your provider will mean that you will give birth in a hospital setting.
A midwife is a highly trained medical professional who is certified in midwifery. Midwives are trained to care for families that are having normal, uncomplicated, low-risk pregnancies. A midwife may use fewer medical interventions during childbirth. They are often chosen by families that are wanting to have an unmedicated birth experience. Midwives have the training to perform a range of medical exams, guide you through prenatal care, administer medications, monitor baby’s health, attend to the birth of your child and close tears and incisions.
There are different types of midwives. For the sake of this article we are going to discuss just a couple available in the Tampa Bay area:
Certified Nurse Midwife
A certified nurse midwife is a registered nurse (RN) that has earned a graduate-level degree in nurse midwifery, has a number of years of clinical experience, and has passed a national qualifying exam. CNMs work in hospitals, clinics and birth centers. Choosing a hospital based practice that has CNMs may give you a better chance at a low-intervention birth experience while still having the security of being in close proximity to emergency care in a hospital.
When you are under the care of a CNM at the hospital, the OB/GYNs are part of your care team. If complications arise, an OB/GYN will be there to help as needed. A large majority of births proceed without difficulty. And yet, this team approach can give you peace of mind, while still choosing the care of a midwife.
Certified Professional Midwife
A certified professional midwife usually works in a free-standing birth center or as a homebirth midwife. CPMs only care for low-risk families and identify those who need care from an obstetrician and give appropriate referrals. A CPM has met the requirements of the North American Registry of Midwives (NARM). They have graduated from a midwifery school, and/or have apprenticed with a qualified midwife and completed an entry-level evaluation process.
CPMs are committed to providing the Midwives Model of Care, including:
- Monitoring a woman’s complete (not just physical) well-being from pre-natal through post-natal
- Giving each mother individualized education, counseling, and prenatal care, assisting during labor and delivery, and supporting the mother and newborn after the birth
- Using as few technological interventions as possible
Your choice of prenatal care provider also ties into your choice of birthing location and facility.
Tampa Bay is home to many wonderful hospitals where the full range of prenatal, labor, and postpartum services are available. A hospital is a good choice for those who wish to have pain medication in labor, an epidural, high-risk patients and those who may need a c-section. If your baby has any potential complications consider a hospital with a neonatal care unit (NICU). NICUs range from Level I – IV with a Level IV NICU the highest level of neonatal care.
Hospitals have different cultures, styles of care and attitudes toward labor, delivery and postpartum. Some hospitals in Tampa Bay do not have any midwives, and strictly work with OB/GYNs as the care providers. Looking into hospital c-section rates can also give you a clue as to what their culture is regarding birth interventions.
Check out this blog post to learn more factors to consider: How Are You Choosing Your Hospital and Care Provider?
You can also head to this section of our blog to learn about some of our hospitals: Tampa Birth Facilities.
A freestanding birth center offers a home-like environment but with more support staff and a wider range of supplies readily available. Birth centers are staffed by midwives and are geared toward caring for low-risk women. You will have less restrictions than in a hospital, will be free to move around as you wish during labor, and are free to invite your family members and children to participate in the birth experience. Most birth centers offer tubs where you can labor and give birth in the water. This is one of the primary reasons some families choose birth centers.
Most local birth centers in Tampa have Certified Professional Midwives providing prenatal care, although some also have CNMs on staff. You will not have access to all pain medication while laboring at a birth center. However, some local birth centers do offer nitrous oxide, which can take the edge off of your pain experience during contractions.
For example, Sweet Child of Mine & Breath of Life Birth Center both offer nitrous oxide pain relief.
Midwives in a birth center can take care of some complications, administer certain medications and have an array of interventions available to them. But, if you need interventions beyond the resource of the birth center you will be transferred to the local hospital. Usually your midwife will come with you and sometimes will stay and be your support person while you are at the hospital.
Additionally, at a birth center you cannot request a meal from the cafeteria after giving birth, which you can usually do in a hospital setting. Like a home environment, you will bring your own food and snacks or order and pay for delivery from a nearby restaurant. Many birth centers have kitchens, and additional living space for other family members to occupy. Lastly, you will usually be discharged and sent home the same day, sometimes as soon as 4 hours after birth and you will return to the birth center within the next 24 – 48 hours for a postpartum visit and check-up.
Birth centers in the Tampa Bay area include:
And finally, another birth location choice is your own home. Yes, you can give birth right in the comfort of your own home. Women have been giving birth naturally for thousands of years and for a large part of history this took place at home surrounded by family and the support of other women. Scenes from “Call the Midwife” were considered totally normal and still happen to this day.
If you are healthy and low-risk you may seek the care of a midwife that practices in a home birth setting. A home birth midwife, usually a CPM, and sometimes a CNM, brings the care to you. Some home birth midwives come to your home for each of your prenatal visits. Others have an office that you will visit for your prenatal care. You can also include your partner, other family members and children in these visits. You will usually find these visits are longer and more personal than prenatal visits with a hospital based provider.
For labor and birth your midwife brings all of the equipment that she needs to your home: doppler, stethoscope, cord clamps, sterile gloves, oxygen, and much more.
This option may seem too uncertain for some families. Home birth is not for everyone. If you are interested in learning more about this option, the best way to do so is by speaking with a licensed home birth midwife. Interview her and find out what care she can and cannot provide. Seek recommendations from others that have succeeded in having a home birth to ensure you choose a trustworthy provider.
Like at a birth center, if there is a need for interventions your midwife cannot provide, you will be transferred to a hospital for higher-level care. It’s a good idea to tour your local hospital so you are prepared just in case.
Whether you choose to work with an OB/GYN or a Midwife, a hospital, birth-center or a home birth, we hope you feel empowered knowing you do have choices. It is important to feel comfortable, reassured and confident you have the best provider for you. Your provider should make you feel heard, understood and valued in the decision making process. Take your time and choose wisely!