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Midwife vs OB-GYN: What’s the difference?

You’ve gone through all the test sticks in the box, and those little lines keep staring back at you. It’s confirmed: you’re pregnant! First come a mix of emotions ranging from completely thrilled to terrified. Then come the questions:

“How will I tell my family and friends?”

“Am I having a boy or a girl?”

“What do I do next?”

One of the most important next steps is deciding who will care for you throughout your pregnancy and during your labor and delivery. So the next question is: Should you choose an OB-GYN or a midwife?

“You want a trusted, reliable partner who can help you navigate your pregnancy with care and compassion,” says Dr. Katie Krumwiede, medical director for HealthPartners’ OB-GYN. “This is a very personal decision to make. It’s important to know your options.”

To help you learn more about your options, let’s dive into the similarities and differences between midwives and OB-GYNs, where doulas and family medicine doctors factor in, and what you should consider when choosing who to trust with your care.

What’s the difference between a midwife and OB-GYN? Let’s talk about similarities first.

You probably know that both an OB-GYN and a midwife can deliver babies. But they share far more in common.

Midwives and OB-GYNs are both highly trained and certified

Midwives and OB-GYNs are experts in women’s health and pregnancy care who have extensive specialty training and experience in their field. In addition, each has received a relevant certification, which means they have demonstrated knowledge and skill within their area of expertise.

Midwives and OB-GYNs are committed to your safety and comfort

Midwives and OB-GYNs are extremely passionate about what they do. And they want to make sure you and your baby are happy, healthy and safe throughout your pregnancy experience. So, they’ll work with you to honor your pregnancy goals and birth plan, while also offering their expertise and information on all your care options as your pregnancy progresses, including pain management during labor and delivery.

Midwives and OB-GYNs strive to give you the best experience

You probably have a vision or plan for how you want your prenatal care, and labor and delivery to go. However, you might think you need to trade experience for expertise (or vice versa) depending on the type of care provider you choose. But that’s not true.

At HealthPartners, our OB-GYNs, midwives and pregnancy care teams strive to deliver your baby, your way. That means we all want to help you have the care and child birthing experience you’re hoping for, regardless of who you choose as your primary specialist.

Now, let’s talk about the differences between a midwife and an OB-GYN

OB-GYNs and midwives both provide great pregnancy care and safely deliver babies. But there are some fundamental differences.

OB-GYNs and midwives have different credentials and educational backgrounds

While OB-GYNs and midwives are part of the same specialty area, the training, education requirements and credentials they hold are different.

OB-GYNs are medical doctors

An OB-GYN – which is short for obstetrician-gynecologist – is a medical doctor who specializes in women’s reproductive health, as well as pregnancy care and delivering babies. They’re also surgically trained and can perform Cesarean sections (C-sections) when necessary. You may already visit an OB-GYN for your annual well-woman’s visit.

When it comes to training and education, OB-GYNs complete four years of medical school, a four-year residency program and a three-year fellowship.

Board-eligible vs. Board-certified OB-GYNs

OB-GYNs – like other medical doctors – can also pursue certification from the American Board of Obstetrics and Gynecology (ABOG) after they’ve completed their residency and gotten their license to practice. Board-certification is optional but a mark of distinction, implying that a doctor has gone above and beyond the minimum standard of education in their field.

The path to certification requires passing a qualifying exam, preparing an extensive case list demonstrating expertise in multiple categories, and then passing a certification exam. At HealthPartners, all our OB-GYNs are board-certified.

Midwives are trained and experienced health professionals

Like OB-GYNs, many midwives can provide a broad range of women’s health services such as annual checkups, birth control and menopause care. But pregnancy, birth and postpartum care is what they’re most widely known for.

They work closely with the rest of your health care team (e. g. OB-GYN or family doctor) to meet your needs during your pregnancy. Many women continue to use their midwives for care after their delivery, too.

There are three levels of midwifery credentials:

• Certified professional midwife (CPM) – Certified professional midwives are specialists who have demonstrated their knowledge and skills in providing midwifery services, and been certified by the North American Registry of Midwives.
• Certified midwife (CM) – Certified midwives are non-nurses who have earned a post-graduate degree in midwifery, and have also been certified by the American Midwifery Certification Board.
• Certified nurse-midwife (CNM) – Certified nurse midwives are registered nurses (RNs) who have master’s or doctorate degrees in nursing. They have also received their American Midwifery Certification Board certification.

In the United States, the vast majority of midwives have completed graduate degrees. At HealthPartners, all of our midwives are CNMs.

OB-GYNs and midwives have different birthing specialties

Birthing specialties are one of the most important differences between midwives and OB-GYNs. Why? Depending on your needs, certain specialized care may be required for you and your baby’s health and safety. And depending on your preferences, you may be looking for someone who has specific experience. Here are a few examples:

• High-risk vs. low-risk pregnancies – OB-GYNs can manage high-risk or complicated pregnancies such as women who are expecting twins or have preexisting medical conditions. Midwives, on the other hand, can manage low-risk pregnancies and births.
• Water births – While water births (or tub births) are becoming increasingly common in hospital settings where OB-GYNs are the primary care provider, they are very common within the midwifery specialty. So, if you are leaning toward a midwife, chances are high that water births are among their top specialties.
• C-sections – Midwives can’t perform C-sections, whether they’re planned in advance or become needed to safely deliver your baby. OB-GYNs have the surgical training to perform scheduled, unplanned and emergency C-sections, which is one of the reasons they can handle high-risk or complicated pregnancies.

Midwives sometimes deliver babies outside a hospital setting

OB-GYNs almost always deliver babies inside a hospital-based birth center. But midwives can deliver babies in a few different ways:

• Home births – When women with low-risk pregnancies plan home births, midwives are the professionals who support the labor and delivery process.
• Freestanding birth centers – Freestanding birth centers are not part of a hospital and they’re designed to provide a home-like, non-medical environment for birth. While some freestanding birth centers may have OB-GYNs on their care team, midwives are usually the main care providers.
• Hospital-based birth center – Midwives – like our certified nurse-midwives – can also be part of a larger care team at a hospital. A hospital setting is the safest place for giving birth. There, midwives can offer more pain management options and connect you with other specialized care if need be. All our midwives deliver at hospital-based birth centers.

Midwife vs. OB-GYN: A side-by-side comparison

Want to see the differences between a certified nurse-midwife and an OB-GYN at a glance? Here’s a quick overview of OB-GYNs versus midwives:

Doula vs. midwife: Another part of the pregnancy care equation

As you’re considering your options, midwives and doulas may come up in your research and conversations with friends. And it’s important to know what sets them apart.

So, what is a doula?

Doulas are trained professionals who provide physical, emotional and informational support throughout the pregnancy, birth and postpartum experience.

What’s the difference between a doula and a midwife?

While doulas are trained professionals, they’re not trained health professionals like midwives. Doulas do not deliver babies, rather they provide support through the process. Midwives (and OB-GYNs) deliver babies and are responsible for the health and well-being of their patients. At HealthPartners, we can help connect expectant mothers with doulas and welcome them in our hospitals.

What about family doctors? Can they provide pregnancy care?

Yes. Family medicine doctors can provide care during pregnancy, delivery and postpartum. But not all family doctors practice pregnancy care. And for those that do, not all have trained to perform C-sections.

So, if you already have a family doctor and think you may want to continue to see them, check with them to see if they can provide you the right care.

Choosing between an OB-GYN and midwife for pregnancy care: What to consider

Choosing who to trust with your pregnancy care and child’s birth is a very personal decision. Your goals, preferences, and health and safety should all be top of mind. Here are some things to consider as you weigh your options.

Is your pregnancy considered high risk?

If your pregnancy is deemed high risk or complicated, you’ll work with an OB-GYN who may also coordinate care with a maternal-fetal medicine doctor, who specialize in high-risk pregnancies. Remember, midwives focus only on low-risk pregnancies and births.

What is a high-risk pregnancy? If you have a preexisting medical condition like diabetes or high blood pressure, you may be considered high risk. If you’re expecting twins, triplets or other multiples, your pregnancy may be considered both high risk and complicated.

Where do you want to deliver your baby?

If you’re low risk and are considering a home birth or a freestanding birth center, a midwife is likely at the top of your list of potential care providers.

But the vast majority of births happen at hospitals or their attached birth centers, where both OB-GYNs and midwives can deliver babies. Hospitals are always the safest place to deliver your baby.

However, most OB-GYNs and midwives only deliver at one or two select hospitals. So, when you’re choosing between a midwife and OB-GYN, you may also be choosing a hospital to give birth at.

How do you want to deliver your baby?

If you’re low risk and leaning toward a water birth or hypnobirthing, an experienced midwife is who you’ll want to look into. But regardless of risk, if you think you’d be more comfortable with a medical doctor providing your care, then an OB-GYN might be the best fit.

If you want a wide range of birthing and pain management options so you can have flexibility when birth day arrives, finding a midwife or an OB-GYN who delivers at a hospital is key.

How do you want to manage pain during labor and delivery?

Whether you’re planning to forgo pain medication or you know you want an epidural, both midwives and OB-GYNs can provide you with a range of options.

That said, midwives often specialize in natural or little-to-no pain medication births. So, make sure to ask any midwives you’re considering about their experience in this area.

Your pain management options will also be limited if you choose a home birth or a freestanding birth center. So, if there’s any chance that you may want more options or you just want some peace of mind, make sure you choose a hospital to deliver at.

What kind of team do they work with?

The person you choose will likely be part of a larger team. Some teams are multi-disciplinary, meaning they work alongside a lot of different specialists. Other teams may be more focused within their specialty area.

It’s important to understand what kind of team your midwife or OB-GYN works with for a few reasons:

• If you choose a midwife for care, you’ll want to make sure they have the ability to coordinate care with an OB-GYN and other specialists if complications arise.
• Depending on the appointment type, you may not see your OB-GYN or midwife for every prenatal appointment. So, it’s good to find out who you may be getting care from on a regular basis.
• The midwife or OB-GYN you choose for prenatal care may or may not be the one to deliver your baby. Every clinic is different but OB-GYNs and midwives usually share hospital on-call duties with a group of others in their field. That means “your” doctor may not be on-call when baby decides to make their entrance. So, for peace of mind, it’s good to know who’s on their team.

What kind of ongoing care do you want?

OB-GYNs and midwives can provide ongoing care for your reproductive health. So, as you’re looking at your options, think about whether you want someone you can see for years (and maybe even pregnancies) to come. Think about the qualities and areas of expertise that are important to you, from preventive care to fertility.

What kind of coverage does your insurance plan offer?

Many women wonder if there is a cost difference for an OB-GYN versus a midwife. But the cost of delivering a baby primarily varies based on where you deliver and what type of delivery you have, not who delivers your baby.

It all depends on your health insurance plan. The one exception here may be home births. Home births are usually not covered by most insurance plans.

Also, it’s quite possible that not every hospital or birthing center is included in your specific insurance plan. Likewise, there are different insurance coverage levels associated with C-sections and vaginal deliveries.

So, before you make any appointments, it’s best to check with your health plan to understand your coverage. There’s no such thing as a silly question. Member services representatives are there to answer exactly these types of calls.

If you have HealthPartners insurance, you can log into your HealthPartners online account. Or, call Member Services at the number on the back of your member ID card.

Ready to find your pregnancy person? We can help.

We try to make it as simple as possible for you to find the right specialist for your pregnancy care.

Through our doctor match tool, you’ll answer a few simple questions and we'll match you with doctors and certified nurse midwives who fit your preferences. From there you can make an appointment with the person of your choice, or you can explore their individual profiles and reviews to help you choose.

Another way we make it easy for you to get great care is by offering a range of appointment options, which includes in-person and video visits for prenatal care.

Midwife job description

 Sample form 

 APPROVED 

0003 
 legal form) official, 
 
 authorized 
 
 to approve official instructions 
 
) 
 
 "" ____________ 20__ 
 
 
 
 m.p. 
 
 
 
 ______________________________________________ 
 
 (name of organization, enterprise, etc.) 
 
 
 
 " " ______________ 20__ N_________ 
 
 
 
 This job description was developed and approved on 
 
 on the basis of an employment contract with __________________________________________ 
 
0003 
 ____________________________________________________________ and in accordance with 
 
 this job description was drawn up) 
 
 provisions of the Labor Code of the Russian Federation and other regulatory acts 
 
 regulating labor relations in the Russian Federation. 
 
 
 
 1. General provisions 
 
 
 
 1.1. The midwife belongs to the category of specialists. 
 
 1.2. A person with an average of 
 
 medical education in the specialty "Obstetrics" and having 
 
 ______________________ qualification category. 
 
 (II, I, higher) 
 
 1.3. Appointment to the position of a midwife and dismissal from her 
 
 is made by order of the head of the institution. 
 
 1.4. A midwife should know: 
 
 - laws of the Russian Federation and other regulatory legal acts on 
 
 health issues; nine0003 
 - fundamentals of women's hygiene during pregnancy and after childbirth; 
 
 - course of normal childbirth and their variants; 
 
 - management of pregnancy in case of complications, basic methods of prevention 
 
 and control of complications; 
 
 - rules and asepsis and antisepsis, sanitary and anti-epidemic regime 
 
 obstetric institutions; 
 
 - principles of prevention of gynecological diseases, basics 
 
 of contraception and a healthy lifestyle; nine0003 
 - legislation on labor and labor protection of the Russian Federation; 
 
 - internal labor regulations; 
 
 - rules and norms of labor protection, safety measures, 
 
 industrial sanitation and fire protection; 
 
 - rules and methods for providing first aid; 
 
 - _________________________________________________________________. 
 
 1.5. The midwife reports directly to _________________________. nine0003 
 
 
 2. Responsibilities 
 
 
 
 The midwife performs the following duties: 
 
 2.1. Carries out medical and prophylactic 
 
 health education work, care for patients in accordance with the profile of the department under the guidance of a doctor 
 
. 
 
 2.2. 
 
 Carries out preparatory work for the medical and diagnostic activities of an obstetrician-gynecologist and his own activities. nine0003 
 2.3. Provides medical and diagnostic assistance to pregnant women, 
 
 women in childbirth, puerperas, gynecological patients as prescribed by a doctor or 
 
 together with him in the department, at the reception in the antenatal clinic, at home. 
 
 2.4. Provides medical care for uncomplicated childbirth 
 
 independently or with an obstetrician-gynecologist in case of pathology of childbirth, in the postpartum period 
 
, performs primary treatment and, if necessary, 
 
 neonatal primary resuscitation. 
 
 2.5. Provides emergency pre-hospital medical care in case of acute 
 
 diseases and accidents according to the profile of activity, followed by a doctor's call 
 
 or referral of the patient to a medical institution 
 
. 
 
 2.6. Informs the obstetrician-gynecologist, senior midwife, 
 
 head of the department or the doctor on duty about emergency situations at 
 
 the condition of the patients. 
 
 2.7. Assists in some obstetric and gynecological 
 
 surgeries. 
 
 2.8. Monitors the health and development of children in the first year 
 
 of life. 
 
 2.9. Carries out patronage at home of pregnant women, puerperas, 
 
 gynecological patients with the implementation of organizational and therapeutic measures. 
 
 2.10. Conducts preventive examinations of women in order to identify 
 
 gynecological diseases (together with a doctor or independently), 
 
 family planning work. 
 
 2.11. Carries out measures to comply with the sanitary and hygienic regime 
 
 (compliance with the rules of asepsis and antisepsis, proper storage, 
 
 processing, sterilization of instruments, devices, dressings) 
 
 in the department (antenatal clinic, office). 
 
 2.12. Prepares medical documentation for the relevant 
 
 divisions. 
 
 2.13. Improves your skills. 
 
 2.14. _______________________________________________________________. 
 
 
 
 3. Rights 
 
 
 
 The midwife has the right: 
 
 3.1. Receive the information necessary for the accurate performance of their 
 
 duties. 
 
 3.2. Give instructions to junior medical personnel on 
 
 compliance with the sanitary and epidemiological regime of the department (office). nine0003 
 3.3. Make proposals to the management of the institution to improve 
 
 the work of junior and senior medical personnel. 
 
 3.4. Be a member of the Council of Midwives and Nurses, 
 
 Participate in the work of professional medical associations. 
 
 3.5. Get a qualification. 
 
 3.6. ________________________________________________________________. 
 
 
 
 4. Responsibility 
 
 
 
 The midwife is responsible for: 
 
 4.1. For improper performance or non-performance of their official duties 
 
 provided for by this job description - 
 
 within the limits of the current labor legislation of the Russian Federation. 
 
 4.2. For offenses committed in the course of carrying out their 
 
 activities - within the limits of the current administrative, criminal and 
 
 of the civil legislation of the Russian Federation. 
 
 4.3. For causing material damage - within the limits of the current 
 
 labor and civil legislation of the Russian Federation. 
 
 4.4. 
 
 for serious consequences for patients - within the limits of the current legislation of the Russian Federation 
 
. 
 
 4.5. ________________________________________________________________. nine0003 
 
 
 
 
 The job description was developed in accordance with __________________ 
 
 (name, 
 
 ___________________________. 
 
 number and date of the document) 
 
 
 
2222222222___ 
 
 ________________ ) nine0003 
 
 
 " " _____________ 20__ 
 
 
 
 agreed: 
 
 
 
 The head of the legal department 
 
 
 
 (initials, surname) 
 
 ___________________________ 
 
 (signature) 
 
 
 
 "__________________ 20__g. 
 
 
 
 
 
 I am familiar with the instructions: (initials, surname) 
 
 _________________________ 
 
 (signature) 
 
 
 
 " " _____________ 20__ 
 
 
 
 Obstetrician and midwife: do everything | Motherhood 
 
  Obstetrician and midwife - not all expectant mothers know the difference between these two main assistants in childbirth. Some women believe that everything in childbirth depends on the doctor, others - on the professionalism of the midwife. In fact, the work of each specialist is important in childbirth, but what exactly each of them does, we will tell you in more detail. nine0318 
 
 
 
 
 Obstetrician-gynecologist: who is he?   
 An obstetrician (or, to put it correctly, an obstetrician-gynecologist) is a doctor. For six years he studied at a medical institute, that is, he has a higher medical education, then for another two years he studied in the specialty of obstetrics and gynecology. And only after that the doctor has the right to start official work. By the way, a doctor can have many specializations: someone deals only with gynecology (female diseases of the genital organs), others help women get pregnant if there are problems with this (fertility specialists), and still others - endure pregnancy (specialist in miscarriage). There are obstetrician-gynecologists who only conduct pregnancy (at the antenatal clinic or medical clinic), but do not take birth. And there are doctors who work in the maternity hospital (for example, in the pathology department or in the postpartum), and in parallel take birth (on duty or under contract). nine0319 
 
 
 
 Obstetrician at childbirth   
 During childbirth, an obstetrician has his own job: he controls the whole process, and only he decides what to do next and how. Speaking specifically, the doctor regularly examines the woman in labor, prescribes examinations, evaluates their results, and determines the tactics of childbirth. That is, he oversees the entire course of childbirth. Many manipulations are also done only by a doctor: he opens the fetal bladder, performs an episiotomy (perineal incision), sutures tears after childbirth, and makes a manual separation of the placenta. And of course, the obstetrician-gynecologist leading the birth performs a caesarean section. After childbirth, the doctor also has a lot of work: he assesses the degree of blood loss, decides whether any medical prescriptions and medications are needed. Then the doctor determines when the mother needs to be transferred to the postpartum ward, when she can get up, what to eat, and, finally, when the woman can be discharged from the hospital. It turns out that in childbirth and after them, the obstetrician among all medical workers is the most important. nine0319 
 
 Who is the midwife?   
 The word "midwife" comes from the French  accoucheur , which literally translates as "one who stands at the bed", and its modern meaning is an assistant in childbirth. But do not confuse the midwife with the now fashionable doulas or the so-called spiritual midwives. Unlike a midwife, a doula does not provide medical care; her work is more focused on moral and psychological support. By the way, they study as a doula for only a few months, and sometimes even online. A midwife is a specialist with a secondary medical education. This specialty is obtained in a medical college and study as a midwife for three or four years. And the work of a midwife in childbirth is no less serious and important than that of a doctor. nine0319 
 
 Midwife - what does she do?   
 As soon as a woman enters the birth unit, the midwife, with or without a doctor, examines the woman in labor and determines at what stage the birth process is. Then the main medical task of the midwife is to constantly watch how the cervix is ​​opening and check where the baby's head is. The midwife will inform the doctor about all these changes. The midwife should also measure the mother’s blood pressure and pulse and, if necessary, carry out some doctor’s prescriptions: for example, give injections or install a CTG device. By the way, the midwife does not have the right to independently decide how the birth will take place, or prescribe any medical procedures - all this is the doctor's business. nine0319 
 Another important task of a midwife, and a doctor too, is to help a woman psychologically: to calm and support her if she is having a hard time with contractions, to explain what is happening to her and the baby. And the obstetrician and midwife can tell you how to breathe properly or restrain attempts, how to find a comfortable position to endure contractions. 
 
 If there are several births at once in the maternity hospital, then the midwife is forced to constantly approach one woman in labor, then another. She simply does not have time for psychological support, to have time to provide medical assistance! That is why it is often possible to hear that a woman saw a midwife only directly at the time of the birth of a child (at this time the midwife is always next to her mother) 
 
 
 Birth of a child   
 In the second stage of labor, a midwife performs her most important work: she directly controls the process of childbirth. She tells her mother when to push, and when to hold back, this is the time when the birth is commanded by the midwife. And in order to prevent the head from moving forward too quickly and strongly, the midwife holds it with her hand, thereby protecting the perineum from damage. During the birth of the baby, the midwife gently guides the baby's head, and then, after her birth, helps the baby turn around and release the shoulders. nine0319 
 The woman in labor almost does not pay attention to the routine medical manipulations performed by the midwife during labor (at this time she is simply not up to it), other work of the midwife is much more important for her 
 
 
 Important little things   
 clamps the umbilical cord and crosses it (if dad is present at the birth, then he can do this). Traditionally, the midwife shows the baby to the mother, asking, "Who was born?" After that, the baby is applied to the mother's chest, and then transferred to the changing table for processing. And here again there is work for the midwife: she washes the baby with warm water, removes blood, mucus, meconium and wipes the baby with a warm sterile diaper. Then he puts a staple on the umbilical cord, cuts off the rest of the umbilical cord. While the neonatologist is assessing the condition of the newborn, the midwife, together with the obstetrician-gynecologist, monitors the birth of the placenta, then the obstetrician looks to see if there are any parts of the placenta left in the uterus, and the midwife weighs and measures the "baby place". 
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