The short answer is: the initials after a person’s name do not signify the quality of care they provide. You want an ob provider who is medically competent and with whom you feel comfortable asking questions. These can take the form of either a doctor or a midwife. If you want the detailed answer, read on:
What is the difference between a doctor and midwife?
A doctor has a medical degree and training (4 yrs college + 4 yrs med school + 4 yrs ob-gyn residency). A certified nurse midwife has a regular nursing degree plus two to three years’ additional training in “low-risk” obstetrics. Often midwives are previous ob nurses who, after years of working as a nurse decided to make the transition to certified nurse midwife and become a baby catcher.
A midwife who was a labor nurse in “her previous life” often has loads of experience managing pregnant women–“low” and “high” risk–sometimes 10 or 20 years.
The Person, Not the Letters
As in any field, it’s not the letters after the name that make a person a good practitioner. Bet you can’t tell if this woman is a doctor, midwife, or labor nurse just by looking at her. She could be any of the above.
Who is “nicer”–doctor or midwife?
I’ve known several doctors who I thought were terrible and midwives who I thought were extremely competent and (even better practitioners than some doctors). The reverse is also true: I’ve known many wonderful doctors and some truly horrifying nurse midwives.
The degree does not make the person.
You have to evaluate whether you’re a match with your ob provider by how comfortable you feel with her credentials, her knowledge base, her demeanor, and her bedside manner.
Are you more likely to have a c-section if you see a doctor?
Maybe. Since doctors are able to perform c-sections (and mid-wives are not) they offer them more readily to their patients. A midwife who’s labored with you for 12 hours may have more emotional investment in your labor and be less likely to abandon the attempt at vaginal birth to call her physician back-up in to do a c-section.
Doctors also bear the brunt of the malpractice risk: people don’t sue midwives, they sue doctors. So doctors may be more likely to practice defensive medicine for fear of being sued. When an obstetrician is sued it is usually for “not doing” a c-section, rather than”not doing” a vaginal birth. The combination of defensive medicine and patient choice cesarean has led the c-section rate to skyrocket to over 31% from 26% in the past ten years. History check: the c-section rate in 1970 was 5%.
So now, who will you pick and why?
My first baby was delivered by a doctor, someone who I really enjoyed working with. My second baby was delivered by my best friend, an outstanding certified nurse midwife. Both births were wonderful experiences (and yes, I did get epidurals for both).
What was your birth experience like with a doctor? with a midwife?