What Are the Honest Pros/cons of Having a Midwife?

Updated on November 20, 2010
B.P. asks from Rocky River, OH
15 answers

I think I've asked more questions in the past few days than I ever have, but here goes. ;)

If I offend anyone with this post I really don't mean to. I don't mean to make anyone feel like I am ripping on midwives but after some soul searching and some heavy research on my part I decided to look into switching from an O.B. to a midwife for my upcoming birth in April. This was a really hard decision for me. I never knocked moms who chose midwives but I ALWAYS thought I would not feel comfortable without a doctor. I would always be afraid the midwife would miss something. My husband is feels this way even more. His philosophy is "If you trust to a doctor for everything else why not for prenatal care too?" We are both well educated and fairly well read on child birth. But, I really want a VBAC this time.
So.....here are my questions.

1. What are the honest pros and cons of having a midwife. The one I am looking at delivers at a good hospital. Do midwives offer
most of the same tests and prenatal precautions that I would have with an O.B.?

2. Can anyone recommend a book, article, video etc. which might give some more insight into the honest pros and/or cons of having a midwife. I want my husband to feel comfortable with this decision and I want to feel like we've really looked at this from both sides because I do believe that there are two sides to the midwife/O.B. decision.

Thanks in advance guys!:)

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So What Happened?

Wow! Thanks so much for the input guys. Ina your comment really hit home. I think that summed up why I am leaning toward a midwife right now. I have had three O.B.s and I have always felt safe but never really felt like they took much time to look at my individual case history. For example, they have all told me that they are doubtful of my abililty to have a VBAC because my daughter was under 6 lbs and this baby would most likely be bigger. But none of them have actually taken into consideration the actual reason I had a section last time! When I tell them more about my birth they say "Oh.....well I didn't realize that" Hello! It's in my file! LOL!

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answers from Columbus on

I think you should watch The Business of Being Born. It was produced by Ricki Lake. Quite good, and controversial!

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answers from Seattle on

I went with a midwife and was very happy about it.
A few cons are that your midwife will refer you to the OB she's working with if you need any invasive procedures done, like an amnio or a version.
For Ultrasounds you will be referred to an ultrasound tech, if you midwife doesn't have a machine in her office (mine did).
My midwife offered ALL the tests that are also available through an OB, but instead of just making me have them, we wnet through every single test offered, pros and cons and it was my decision whether to have it or not.

I opted for a drug free birth (my wish), but my midwife would have been comfortable if I had wanted pain meds. Overall she was very respectful of my wishes.

As a matter of fact I still see my midwife for my well woman's care, contraception and any gynecological issues. I will never go back to an OB, unless I develop a condition that she can't treat.

Not all midwives are the same. You need to find a provider you "click" with, someone who is supportive and respectful of your wishes. they should act as a navigator guiding you through your pregnancy and birth, rather than taking over the steering wheel and ordering what they feel most comfortable with. There are OB's out there who provide this kind of care (or so I have heard)... but chances are you are most likely to find it with a midwife.
Good luck!

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answers from Los Angeles on

We used a Doula, at our hospital. She was fabulous and very helpful. I was completely focused on having an epidural-free birth, and I went into the hospital with a written-out birth plan which all the nurses and the doc on duty had. The Doula was there to not only help me, but see to it (along w/ my husband) that my birth wishes came to fruition. They did and all went well until the very end, after the baby had arrived. Some of the placenta did not come out and to spare you the gory details, I'll just say that it had to be manually removed and I lost almost two pints of blood in the process (I passed out, actually). The next day, while still in the hospital, my doc came in and we discussed what happened. His comment, "It's a very GOOD thing you were in the hospital after what happened" has always stuck with me and I completely agreed w/ him.

So, while I loved the Doula experience, I was SO glad that I was in a hospital setting with her!

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answers from Eugene on

With my first son I was able to use a nurse midwife and due to complications--that THEY picked up on--I had to deliver at the hospital, but with my wonderful midwife. They do all the same tests and order the same labs. With my second son I also used nurse midwifes (who deliver at the hospital). They were awesome. I moved in the middle of that pregnancy and had to use a doctor. What a letdown and terrible experience--and this was the doctor I chose after interviewing a bunch of them. She was always so busy--and never really seemed to listen. And the delivery was the worst! She was so busy bullying me and my husband around that she didn't listen that I had to push and wasn't even the room when I pushed my son out. I was lucky to have two unmedicated births, but despite the first being longer and not exactly knowing what I was doing it was 100x less scary because my midwife talked me through it, explained things, and encouraged me. My doctor only seemed concerned with the fetal monitor--and frankly I could tell her when I was having a contraction better than the darn machine!

My friend who is a medical student did OB rotation and said--OBs are trained surgeons and they are good surgeons, but they don't seem to teach them anything about how to help women give birth. Plus if you work with a midwife at a hospital she'll have an OB who does backup and believe me, your midwife will transfer you to their care if she has ANY concerns!

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answers from Honolulu on

I had an awesome midwife. She was affiliated with the hospital and yes ALL tests and prenatal precautions were taken. I think people have the preconceived notion of a midwife and this old lady who comes to ones home when you're ready to deliver and whose only knowledge is based on how many births they have done.

Midwives are very well educated and are specialized on just that. The most important thing is choosing someone that shares the same views as you and someone you can see working with. During my pregnancy, I had a little bit of a scare and I was immediately transferred to an O.B doctor. Once it was over though, I went back to my Midwife. So maybe you can look for a hospital that provides both. A Midwife would not continue to take care of you if he/she feels that you are high risk. It was an awesome experience for me and I think you'll love it too. Just make sure you find someone who you can get along with.

Good luck on your birth

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answers from Cleveland on

The only difference I ever had with a midwife was that they actually listened to me and cared what I wanted. not that my doctors haven't I've had 2 midwives and 4 doctors for my various pregnancies. But rather than jut say, here's a pill to take, my midwives always had other options for me as well for the various issues, and I had more freedom during labor. They do all the same tests, and check all the same things as any doctor, they just normally take a more natural approach to things, if that is what you want.

And as long as you deliver at a hospital, all the same medical equipment is there and a doctor is on call, and while I'm not offended and wasn't by your other post, I think you need to do a lot more research on midwives in general because your information seems to be very lacking.



answers from Mobile on

I just had a VBAC with a midwife in June, and I'm so glad I did. I also delivered in a hospital. During delivery my midwife (and the nurse) was so wonderful--she was calm and attentive. At one point, it seemed that the baby's heart rate was going down during contractions, and it became clear that the doctor on call was keeping on eye on things from outside the room because she came in to see how things were going. She conferred with my midwife and then let us be. My midwife had changed my position and had me push just with every other contraction. I heard her quietly request a vacuum extractor (Is that what it's called?) at one point as a precaution, but she kept reassuring me everything was fine (I think the baby was just a little stubborn about getting started under my pubic bone). She was open to an emergency C if anything really worried her, but instead she made adjustments that allowed me to have the natural childbirth I wanted (in less than 6 hours from water breaking/no contractions to the arrival of our daughter!). I'm almost certain I would have had another C had an MD been supervising the birth even though it clearly wasn't necessary. My experience is that midwives pay attention and listen way more than most doctors. And yes, I had all of the standard prenatal tests and care. Do you have a midwife in mind? Are you comfortable with her? Ina May is kind of the superhero of American midwives--you could check out books by her if you want more info on how births with midwives usually work and what they typically do in rare emergency situations (although she focuses on births outside hospitals). Good luck--I hope you can agree on a choice that makes both of you happy and comfortable.

BTW, I was getting prenatal care from midwives for my first also, but she was transverse, so I ended up with the C-section, but the doctor they worked with was wonderful, and one of the midwives still came for the birth, so an MD who works with midwives might be another good choice. Sorry for the breathless sentence!



answers from Chicago on

Good for you!!!! A midwife is WONDERFUL!!! I had my dd with one and love her dearly and recommend her to anyone that's pregnant, wanting to get pregnant or just needed a new GYN.

My daughter went into distress during delivery and Patty just did an amazing job of making everything go well and taking care of me and C. C had the cord wrapped around her throat. I truly trusted that Patty would get us through it safely and she proved it.

The hospital that I delivered at required a doctor to be on site during any deliveries in case there is a need for foreseps, suction or c-sections. Though they paged the OB, Patty and I worked together so well that C was out before the OB could ever get to the room.

Midwives offer all of the same tests that an OB offers and around Chicagoland most work in an office with OBs so they can consult on anything.

A midwife will work with you for a natural birth or you can get an epidural if you want...though they are more on the natural side. Less chance of having to get an episeotomy. She will also be in the room with you the whole time if you want (as long as there are no other babies being born that day), unlike a doctor who only comes for the delivery. So if you are in the hospital for hours and hours, you could end up with a number of different nurses checking you that you may or may not like, instead of the person who's been with you since the beginning. Midwives are also less likely to induce or have a c-section. Doctors tend to push this to stay on their schedule and not the babies.

Actually midwives taught doctors a lot about health because people used to get so sick and die yet the midwives had great success. It turns out that the midwives would wash their hands before going between moms and the doctors didn't. So, if they just treated a very ill patient and then delivered a baby, the baby and the mom got very sick.

Baby catcher by Peggy Vincent is an incredible story about midwifery. I laughed and cried so much reading that book.

It's been 4 yrs since I had my daughter, and as you can see, I still have such fond memories and strong feelings about my wonderful experience with a midwife. Feel free to PM me if you have more questions and I'll see what I remember. ;)





answers from Cleveland on

There are a lot of great answers here! I jsut wanted to add that I had an OB for my first birth. I thought I loved the experience until I had my second birth with a midwife.

A doctor visit would be 10-15 minutes long. He would ask if I had any questions, check fetal heart rate, and say "see you in a month." I always left thinking it was a waste of time. Although the appointments were short, I would spend a ton of time waiting to see the doctor.

With my midwife, visits were 30 minutes long. She would ask if I had any questions, and even if I didn't, the appointment would last 30 minutes because she would talk about new things to expect or options with tests/treatments/etc., she checked the heart rate and encouraged me to write a birth plan (something my ob didnt do). I would leave the visits excited to go back.

It varies amongst providers, but my midwife delivered all of her patients' babies with the exception of being sick or something. If she was going to take a vacation, she wouldn't accept patients who were due to have a baby during that time.

Again, Ina May is a great resource. Good luck and follow your gut. :)


answers from Lexington on

Congratulations on your pregnancy! I know that choosing a care provider is a big decision, and one that you certainly must be comfortable with. I switched from an OB to a homebirth midwife halfway through my second pregnancy, and was extremely happy with that choice. My husband was deployed during my third pregnancy, and insisted I use a certified nurse midwife. I'm a true homebirther at heart, and thankfully ended up with the beautiful unassisted birth I desperately wanted. However, in my experience the prenatal care from the CNM was exactly the same as I'd received with an OB. Since you seem to be planning a hospital birth, I would certainly expect the same type of care. Homebirth midwives, on the other hand, generally spend more time with their clients. Often, they provide more in-depth information on nutrition and possibly natural remedies. However, their prenatal standards also include: checking weight, bp, fundal height, fetal heart tones, and urine for blood, glucose, etc... One thing some people consider as a possible con is not having a hospital backup. However, that does not seem to be an issue in your case. Otherwise, I cannot think of a downside to midwifery.

It all comes down to what you really want. Obstetricians are trained surgeons who rarely see a natural childbirth. If you think about it, natural birth kind of makes their job obsolete. However, midwives are trained birthing professionals. As someone who has had three homebirths, two of which were unassisted, I recommend really educating yourself on maternity care. Much of it is not evidence-based, but rather for the time and convenience of caregivers. In a hospital setting, some CNMs may get a little too caught up in standard practices. No matter what you choose, a well-written birth plan is a must.

As for information to share with your husband, one important thing to note is that every study has shown homebirth to be as safe or safer than hospital birth. I know you are planning to birth in a hospital, but want to show you some statistics related to midwifery. Ina May Gaskin is probably the nation's premier midwife. Over a 30-year period more than 2,000 babies were safely delivered by her practice at home or in their birthing center. Out of all those mothers and babies only 1.3% transported to the hospital for an emergency, while an additional 3.6% were non-emergency transfers. Only 1.4% of her clients required c-sections. Those are incredible numbers when compared to the national average. You can check out more information about Ina May and midwifery here: http://www.inamay.com/?page_id=28 I also highly recommend reading the book Born in the USA, How A Broken Maternity System Must Be Fixed to Put Women and Children First. It is written by Dr. Marsden Wagner. I promise it will be very eye-opening. http://www.amazon.com/Born-USA-Broken-Maternity-Children/... I wish you all the best!




answers from Dayton on

Read Ina May Gaskin's book, Guide to Childbirth. She is a midwife and the book is great. I recommend Dr. Stephen Guy (an OB who works with midwives at Miami Valley Hospital.) With Dr. Guy, you get the best of both worlds.

If you want a VBAC, the only way is to go with midwives or some enlightened OB like Dr. Guy.



answers from New York on

If your midwife delivers in a hospital and has dr backup, sounds like a dream to me.

When I was pregnant, I thought - who would ever use s midwife. But by the end of my prignancy, I loved the midwife and hoped that she would be the one in the practice to deliver me (no such luck - I had the newbie dr. who made all off the mistakes possible).

Try an ICAN meeting in your area. Not sure if that's totally applicable to your situation but there will be many midwives in attendance and will make you feel at ease.

Good luck and congrats.



answers from Chicago on

The friendship and support offered by a midwife is incomparable to anything a surgeon is willing to offer.

I home birthed. Did you realize that I had the same tests, but better care? I saw my midwife 3 times within two weeks of having the baby. She was there, a direct call away at anytime of day.


answers from Dallas on

I had a mid-wife delivered my first child and if it wasn't for insurance I would have a mid-wife delivered my other two. The mid-wife worked for a doctor's office, there were actually 3 mid-wives and 1 doctor; the doctor nice and all but he only dealt with the serious pregnancies. I got to meet all three ladies because you never knew which one was going to be working the day you went into labor. She was great, she stayed with me majority of my time at the hospital and especially the first 2 hours I got there, left for awhile, because she could tell it was going to be a long time before I gave birth, then the last three hours right by my side for the most part. She was GREAT!!! The doctor I had for my second birth was a jerk, and my last one was a c-section at midnight, where my doctor wasn't on call.
I referred all my friends to the mid-wife and would have loved to have gone back to them with my other two births. I cannot say anything negative because the whole experience was positive!!!
The one thing I noticed the most about midwife is that they don't leave you as much as doctors do and come in for the last minutes of labor.
Congrats on your baby to come!!!



answers from Wichita on

I have to say, honestly, if you want to go with a midwife and you find a good one who delivers at the hospital in case of complications, go for it!

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