Finding out you are pregnant can be one of the most joyous, exciting times in your life. And one of the first major choices you have to make for yourself and your baby is who you want to care for you throughout your pregnancy. If you are fortunate enough to have the choice between an obstetrician and a midwife, there are many factors to consider when deciding who will help you bring your child into this world.
Home birth or hospital?
An important first step is deciding where you plan to have your baby.
If, like a lot of women, you want a hospital birth, you are likely still open to the decision of midwife or obstetrician. However, if you would like to have a home birth, like a growing number of expectant mothers, your choice has been made for you!
Midwives will come to your home at the time of the birth, and help you through labour and delivery. While they are not licensed to prescribe medication (no epidural for you!), they are trained in various pain relief techniques, and you can even have a birthing pool in the middle of your living room if you like. Home birth is safe and popular among women who do not like the institutional look and feel (and smell!) of hospitals.
It is important to know that midwives work on an ideal of informed decision making. In a nutshell, this means that you will likely never be forced to take any tests, or do anything that goes against your wishes.
While some tests may be state or province mandated, in general you have choices when it comes to which tests you will take. Midwives are very open and straightforward with your options (which include not having ultrasounds, or taking medication if it is determined you are positive for Group Strep B), allowing you to make the decisions which are right for you. Informed decision means giving you the necessary information to make a choice, and not judging you for the decisions you make.
You should consider as well how important it is to know who the person “delivering” your baby will be. While some midwives will not take credit for delivering the baby, saying that the woman is the one delivering, midwives generally work in teams of two, where you would have your primary caregiver, who you see on a regular basis, and a back-up midwife who is called in during active labour, and who will care for your baby when it is born, while the primary midwife looks after you.
In choosing an obstetrician, you are likely working with a team of doctors on rotation, and, in general, the person delivering your baby is the doctor on shift when you come in. This makes it more likely that you will have a doctor you have not met yet bringing baby into this world. However, many obstetricians will allow a mother to call them, and will come to hospital for the delivery, when possible. This is, of course, at your doctor’s discretion, and not all OBs are as accommodating.
High risk pregnancy narrows options
One other factor will take the choice out of your hands. If you are high risk in your pregnancy (ie: severely overweight, hypertensive, history of miscarriage etc) you will likely not be able to work with midwives, who only deal with low risk pregnancies. If you do choose to work with midwives, and a condition comes up mid-pregnancy that renders you high-risk, the midwife will transfer your care to an obstetrician to ensure the best care possible for you and your baby. Even during delivery, care may be transferred to an OB to ensure that mom and baby are both healthy.
Whether you choose to have your baby in a hospital or at home, with pain medication or without, and with the assistance of a midwife or an obstetrician, being a parent is full of important choices which require a great deal of thought and research. While stereotypes may paint midwives as wild women who live in the forest, midwifery has come a very long way, and is an excellent choice for women who want a say in the care they receive.
Ashlea Langevin - Ms. Langevin is a freelance writer and currently works for the federal government as a Program Assistant in Ottawa, Ontario. She completed ...
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