Choosing to use a Midwife over a doctor is a huge decision. There are several reasons why someone might choose a midwife over a doctor for their prenatal care, childbirth, and postpartum care. It’s important to note that both midwives and doctors play essential roles in providing healthcare during pregnancy and childbirth, and the choice between them depends on individual preferences, medical history, and the specific circumstances of the pregnancy.
Here are some common reasons:
- Personalized and Holistic Care: Midwives often provide a more personalized and holistic approach to care. They may spend more time with their patients, getting to know them on a deeper level and addressing the emotional and psychological aspects of pregnancy and childbirth.
- Less Medical Intervention: Midwives typically emphasize natural and low-intervention approaches to childbirth. They may be more likely to support options like water births, home births, or unmedicated births, depending on the individual’s preferences and health.
- Focus on Normal, Low-Risk Pregnancies: Midwives are often chosen for pregnancies that are considered low-risk. They are trained to manage uncomplicated pregnancies and may refer patients to obstetricians if complications arise.
- Support for Home Births: Midwives can provide care for women who prefer to give birth at home, which can be an appealing option for those who want a more intimate, homey birth experience.
- Continuity of Care: Midwives often offer continuous care throughout pregnancy, labor, and the postpartum period, providing a sense of familiarity and support during the entire journey.
- Empowerment and Informed Decision-Making: Midwives tend to place a strong emphasis on patient education and informed decision-making. They encourage individuals to be active participants in their healthcare choices.
- Cultural and Personal Preferences: Cultural, religious, or personal beliefs may lead someone to choose a midwife, as midwives can offer care that aligns with these preferences.
Midwives are often associated with a more natural and low-intervention approach to childbirth. If a person desires a home birth or a birthing center experience with minimal medical interventions, a midwife might be a preferred choice. Midwives generally have expertise in supporting natural childbirth processes. Generally, someone who works with a midwife throughout their pregnancy requires less medical intervention than those at a hospital. Doctors tend to have a more hands-on approach, medical intervention breeds more medical intervention.
If you have chosen to use a midwife instead of a doctor, you will have lots of questions. Here are a “few” I had when choosing a midwife.
What would disqualify me from your care?
The criteria for midwife care can vary based on the type of midwife, the legal and regulatory framework in your region, and the specific midwifery practice. Generally, midwives are trained to care for low-risk pregnancies and provide holistic care throughout the childbirth process. However, there are certain situations or medical conditions that might disqualify someone from receiving midwife care.
Basic situations such as high-risk medical conditions, multiple gestation (twins, triplets, etc.), previous cesarean, or complex surgical history would immediately disqualify you from their care. There are other complications that could occur during your pregnancy that may result in you having to switch to a medical doctor or hospital birth for further care. Conditions like placenta previa or placental disorders, certain genetic conditions or fetal abnormalities, breech presentation, or even high blood pressure.
Each midwife will have their own set of conditions as well as state laws they must follow. Your midwife should have options to assist you if such conditions occur.
If I tear, can you stitch me up?
Your midwife should be a licensed and trained professional. They will rarely perform an episiotomy but will be able to sew stitches either way. Be sure to ask about stitches or other forms of sealant.
The Mayo Clinic has more information on episiotomies, what they are, and why they are sometimes necessary.
What is your fetal monitoring procedure during labor?
Most hospitals will require constant fetal monitoring. This is where you have two bands strapped to your stomach, one that monitors the baby’s heartbeat, and one to monitor contractions. This will be strapped to you during the entire labor process to ensure that labor is progressing the correct way and to make sure the baby’s heartbeat doesn’t drop too drastically during labor. This is beneficial but can also be a hindrance. The monitoring process might limit mobility and comfort during labor.
Midwives generally do not perform consistent fetal monitoring. They will check the baby’s heartbeat using a Fetal Doppler intermittently during labor. This method also comes with its pros and cons. Intermittent fetal monitoring leaves room for errors or complications to slip through the cracks. However, intermittent fetal monitoring allows you more mobility during labor, which can result in a faster labor progression.
American Congress of Obstetricians and Gynecologists can tell you about the types of fetal monitoring and when they are necessary.
Fetal monitoring is a collaborative process between the birthing person, healthcare providers, and the birthing team. It’s important to discuss your preferences for monitoring with your healthcare provider and to understand the reasons behind the recommendations made. Ultimately, the goal of fetal monitoring is to ensure the safety and well-being of both the baby and the mother during the labor process.
What should I expect from you after the birth?
What type of postpartum care do you provide? How often will I have postpartum appointments? How do you support breastfeeding and postpartum recovery? If you give birth with a traditional OBGYN, you’ll be in the hospital for a couple of days, then you will have a 6-week postpartum checkup to make sure your stitches are healing, your uterus is returning to normal, have a pap, and to check in mentally. Breastfeeding support will most often be found with your child’s pediatrician.
A midwife often goes beyond this. My midwife was available through text, email, and phone calls for MONTHS after the birth of my daughter. We went home the same day, but she assisted with breastfeeding, we had a 2-week telephone appointment where she checked in on me mentally and assessed how I was feeling, and then also had a 6-week checkup to assess how I was healing physically. She even brought in a physical therapist at my 6-week appointment who gave me tips on how to build my muscle mass, make sex more comfortable, and help fix any other physical issues I had.
It is best to know ahead of time what appointments you have so that you can schedule in advance, but to also know that you can lean on your midwife during any distress during pregnancy, labor, or postpartum.
What is the game plan if I go over my due date?
A pregnancy that extends beyond 42 weeks is considered post-term. After this point, the risks of continuing the pregnancy may start to outweigh the benefits. The risk of stillbirth and other complications could increase, and monitoring the baby’s well-being becomes more crucial. If you go over your due date, your midwife will likely have to transfer you to a medical hospital. It is wise to know the plan ahead of time so that you can be prepared.
I went to 42 weeks before I went into labor, my daughter was born at 42+1. I was able to still have a home birth with 2 midwives and several nurses. The plan was to have an induction if I went any further without labor beginning. We were prepared for it to go in any direction, and you should be too.
Will I be allowed to eat or drink during labor?
If you are birthing in a hospital, most of the providers will only allow you to chew on ice or eat very light snacks. They will give you an IV regardless of labor progression. They do this for multiple reasons.
1. They will be able to give you IV fluids during your entire labor, which will keep you hydrated. 2. Having an IV already in your arm, will give easy access if a problem should occur 3. If a complication does happen, eating and drinking ahead of time would be a problem during surgery. You may vomit and asphyxiate, depriving oxygen to your brain.
Most midwives will not automatically give you an IV. They encourage you to eat small, protein-filled snacks, and to drink as much water as you can. Discuss this ahead of time and you can add snacks and electrolyte water to your labor bags.
How do we acquire a birth certificate?
Your hospital or midwife will file for the birth certificate and fill out all of the necessary paperwork. If on the off chance, your midwife does not do this, or if you cannot make it to your hospital/birthing center and labor on your own, you should go to the nearest hospital and tell the circumstances of the birth. They will either still fill out the forms or will assist you on ways to have it done.
How many people will be allowed to attend the birth?
Having people attend a birth can provide various forms of support and assistance to the birthing person and their family. The decision to have individuals present during childbirth is deeply personal and varies from person to person. If you are in labor, you might want certain people to attend a birth to offer emotional support, physical support, advocacy, or even to document the experience.
Many birthing persons choose to have other children there so that they can watch their younger sibling be born. I chose to have only my husband and older child in the room. Knowing how many people will be allowed to attend the birth will allow you time to decide on which friend or family member will be by your side during such a strange and exciting time.
Are you able to write prescriptions if necessary?
The ability of midwives to write prescriptions can vary depending on the country or state/province, as well as the specific regulations and licensing requirements in place. In many places, midwives are licensed healthcare professionals who provide care to pregnant individuals before, during, and after childbirth. They may be authorized to prescribe certain medications and treatments within their scope of practice, especially when it pertains to pregnancy and childbirth.
However, the extent of prescription-writing authority for midwives can vary. In some regions, midwives may have limited prescribing privileges, while in others, they may have broader authority. It’s important to check the specific regulations and licensing requirements in your area to determine what a midwife can and cannot prescribe.
In many cases, midwives work in collaboration with other healthcare providers, such as obstetricians and primary care physicians, and may consult with them or refer patients for prescriptions and medical care outside their scope of practice when necessary.
Would you be comfortable with my husband or me “catching” the baby?
If you have your child in a hospital with a traditional OBGYN, nurses will be surrounding you constantly. Your doctor will only come in as the baby is on its way out, they will be the only ones allowed to deliver your baby. The only way a birthing person will not deliver with their doctor is if they specifically tell them that they do not want to be touched, then they will catch their own baby.
A midwife is very much different, per usual. My husband delivered our daughter with guidance and supervision from our midwives. I had never thought about anyone besides our doctor/midwife delivering our baby, but when the option arose, I knew I wanted my husband to be as much a part of the experience as he could be. Knowing that he was the one to deliver our daughter, makes the experience so much more magical to me.
You may be entirely uncomfortable with this option, and that is perfectly okay, but you also have the ability to consider the alternatives. I have met several women who squatted during the final bits of labor, caught their own children, and were able to have immediate skin-to-skin contact. Whatever your ideal way to give birth is, is the way you should choose, regardless of other’s opinions. It is important to find a provider that takes all of your wishes and choices into account and tries to make your labor as beautiful of an experience as possible.
Are you able to give an IV if necessary?
The scope of practice for midwives and their ability to administer IVs can depend on their level of training, certification, and the legal regulations in the area where they work. Midwives are a little more holistic and recommend that you stay hydrated and energized through electrolyte water and high-protein snacks. If you are unable to eat or drink for any reason, they very easily and quickly can put an IV in your arm.
How long do you allow for spontaneous delivery of the placenta?
After the birth of a baby, the placenta is typically delivered within a relatively short period of time. The third stage of labor involves the delivery of the placenta and the completion of the birthing process. The time frame for the spontaneous delivery of the placenta can vary, but it generally occurs within 5 to 30 minutes after the birth of the baby.
When you birth a baby in a hospital, they give you a shot of oxytocin/pitocin to help the placenta deliver faster, they will also pull on it to encourage it to separate from the uterine wall. Midwives generally allow for a more natural approach, which can end in less bleeding and fewer complications.
How do you measure and weigh the baby after birth?
After a baby is born, midwives and healthcare providers use various methods to assess the baby’s overall health and measure certain important parameters. These assessments help ensure that the baby is transitioning well to life outside the womb and is in good condition.
The midwife will give your baby an APGAR score, measure length and head circumference with a tape measure, and weigh the baby with either a hand-held swaddle scale or on a regular tabletop scale. Your midwife or nurses will also check your baby’s vital signs, skin, ears, eyes, umbilical cord, and reflexes.
If there is something specific you want your midwife to look over before you depart, do not be afraid to ask. They are there to help you and your baby transition into a new time period.
Can you provide references or testimonials from previous clients?
Most midwives will be happy to provide you with references and testimonials from previous clients. It is not uncommon for your midwife to wait on this, however. Although they are not doctors, they still have a confidentiality agreement with their clients that they must abide by. Ours simply asked for permission from us to give my number and email to previous clients so that they could contact us. Do not be weary if your midwife does the same.
What are your fees?
What are your fees for prenatal care, labor and delivery, and postpartum care? Do you accept insurance, and what is the billing process like?
Most midwives sadly are not in an insurance network. If you are looking to have insurance cover your costs, contact your insurance company, and they will give you a list of dedicated midwives who are in their network,
Midwives generally provide fees anywhere from $3000-$10,000. Most, however, offer major discounts if you or your spouse is active military, if you pay the full amount in one lump sum, and some base fees off of your yearly income and number of dependents. Also, I know that you may not want to ask for help, but the majority of jobs, family members, and friends will help without a doubt. You can also ask for medical bill help instead of baby shower gifts.
How often will I have prenatal appointments, and what will they entail?
What tests and screenings do you recommend during pregnancy, and why? How do you handle prenatal education and counseling?
Midwives offer most of the same tests that doctors offer. You will still have a pap test, blood work, mental health evaluation, as well as ultrasounds for the baby. Most tests will be able to be done directly with a midwife, other times they will send you to another doctor. If you go over your due date, your midwife will likely send you to a specific type of ultrasound that checks the amniotic fluid levels.
Overall Choice
Choosing a midwife for your prenatal care is a significant decision that can profoundly influence your pregnancy and childbirth experience. To make an informed choice, it’s crucial to ask the right questions during your initial consultations. By discussing aspects such as their qualifications, experience, approach to care, and emergency procedures, you’ll be better equipped to select a midwife who aligns with your values and needs.
If you would like to view my questions to ask an OBGYN instead, you can view them here!
It’s important to note that the choice between a midwife and a licensed doctor may depend on individual circumstances, risk factors, and preferences. In some cases, a collaborative approach involving both a midwife and a doctor may be the best choice to ensure comprehensive care. The decision should be made after careful consideration of one’s specific needs and medical history.
Ultimately, this collaboration is the foundation for a safe, supportive, and satisfying journey through pregnancy, childbirth, and the early days of motherhood. Your choice of midwife can make all the difference, so don’t hesitate to inquire and ensure a comfortable and confident path towards motherhood. You are the only one that can choose what’s right for you and your family to be.
Don’t forget to check out my other blog posts for helpful tips and tricks!