Mithu Kuna 
If you’re facing the decision on whether to have a doctor or midwife care for your pregnancy, you might be wondering what the differences are.
With many different types of midwives and varying education levels, it can be difficult to know what your options are and what’s best for you.
In this guide, you’ll learn:
- The differences between varying midwife certifications in the United States (and variations in different states)
- The differences between midwifery around the world
- Insurance coverage for midwife services by state and variances by country
- The differences between midwife and OB-GYN-led care
- Factors to consider when choosing between a doctor and midwife
Ready to learn all about midwife care during pregnancy? Keep reading!
What is a Midwife?
In the United States, a midwife is a trained medical professional. They are trained to monitor and provide care during pregnancy, birth and the postpartum period. When a person uses a midwife, they typically do not use a doctor during pregnancy.
In the United States, there are three different types of midwives that vary by their educational requirements. Here’s a quick run-down of each:
- Certified nurse midwives (CNMs). CNMs have gone through nursing school and also have a graduate degree in midwifery. These professionals work in hospitals or homes and provide many services, like prescribing medication and diagnosing conditions.
- Certified midwives (CMs). CMs are only licensed in a few states. They have a master’s degree in midwifery, although their undergraduate degree was not in nursing. These professionals can prescribe medications.
- Certified professional midwives (CPMs). CPMs are only licensed in some states. They work in birth centers or homes but cannot prescribe medication. They have completed some courses and are certified by the North American Registry of Midwives.
- Unlicensed (Lay) Midwives. Some midwives aren’t certified and are either self-taught or have received an alternative type of training. Unlicensed midwives usually work in homes.
What is a Midwife Nurse?
Certified midwife-nurse (CNM) is the highest designation in the nursing profession in the United States. They differ from other midwives in a few ways:
- Education. These professionals have both a nursing school degree and a degree in midwifery.
- Workplace. They are typically the only midwives who can work in hospitals. However, they may also work in birthing centers or in homes.
- Services offered. Unlike other certified or uncertified midwives, CNMs can provide a wide range of services.
Midwife nurses offer services like:
- Prenatal appointments
- Diagnosing conditions
- Ordering ultrasounds and bloodwork
- Prescribing medication
- Care through labor and delivery
- Postpartum and newborn care
- Providing education on fertility, lactation, etc.
OB-GYNs vs. Midwife: What’s the Difference?
If you’re trying to choose between having pregnancy care by an OB-GYN or midwife, you’re probably wondering about the similarities and differences.
Both midwives and OB-GYNs offer care during:
- Pregnancy
- Labor and delivery
- Post-partum period
The differences between midwives and OB-GYNs boil down to their education and approach.
Midwives:
- Are usually highly supportive and may offer more “emotional” support
- Often take a more natural approach
- Often thought to be a more relaxing and personable experience
- Didn’t attend medical school, but may have attended nursing school depending on their certification
- Can’t treat high-risk pregnancies
- Can’t treat complications
In general, people often choose midwives when they have a healthy pregnancy and are open to more natural and/or personable approaches.
In contrast, OB-GYNs:
- Are doctors who’ve attended medical school
- Offer a medical approach
- Provide care for high-risk pregnancies
- Provide care for and treat complications
- Are often thought to offer less personable care
In general, people may choose OB-GYNs when they’re comfortable with a more traditional and medical approach to pregnancy. People with a high-risk pregnancy usually do not have a choice and are the most safe when treated by a doctor. In some cases, a person may have midwife care but need to transition to doctor-led care if they have complications. You may also have care by both a doctor and a midwife (although insurance plans may not cover both).
Keep in mind that while these comparisons apply in the United States, the difference between doctors and midwives varies by country.
Midwifery Differences by State and Country
It’s important to note that the educational requirements and coverage of midwifery vary by country, state or province.
For example, in the United States, depending on their education, midwives can be:
- A certified Professional Midwife
- A Certified Midwife
- A Certified Nurse-Midwife
Insurance plans vary in their coverage of midwives. For example, your state Medicare program will cover CNM services but coverage by a CM or CPM varies (here is a chart detailing coverage in all states). Some workplace health insurance plans do not cover any midwife services.
In Canada, midwives require a university degree but no nursing degree and registration is only required in some provinces. Some provinces, like B.C., give residents under the health plan the choice of having a doctor or midwife during pregnancy. However, other provinces, like Ontario, only cover doctors under the health plan.
In the UK, pregnant people can choose between midwife-led and doctor-led care.
Should You Get a Midwife: 5 Considerations
If you’re trying to choose between having pregnancy care by a doctor or midwife, there are many factors to consider. We highlight a few main considerations below. Also, consider that care may be combined in some cases.
<h3>Health and risk factors
The most important thing to consider when choosing between doctor-led or midwife-led care is your health. If you have a complicated or high-risk pregnancy, it’s safer to choose a doctor. Doctors have more education and have medical interventions more readily available, should you need them. They are also better trained to manage and treat some conditions.
If you have a healthy pregnancy, both a midwife or doctor may be suitable for pregnancy care.
Birth plan
Another main consideration is whether you want to give birth at home or in the hospital. A midwife may attend a hospital birth where a doctor provides care. However, since doctors typically don’t attend home births, midwives are usually the only option.
Insurance coverage
Usually, your choice between doctor and midwife boils down to your health insurance policy and what is covered during pregnancy. Policies may cover some types of midwives or none at all. Since this varies highly by state and policy, be sure to check with your provider before making any decisions.
Cost
If your health insurance policy doesn’t cover midwife services, you may consider paying for them out of pocket. The decision on whether to pay out-of-pocket typically depends on the cost, which varies widely depending on a midwife’s certification and your location.
To give you an idea, one study estimated the average home birth in the United States to be about $4,650. However, consider that rates can be much higher, nearing $10,000 and over.
Personal preference
Simply put, whether you choose a midwife or doctor may come down to what you feel comfortable with.
For example, some people feel more comfortable with a traditional approach to pregnancy and feel safer with doctor-led care. This choice is suitable for those who feel better knowing that medical interventions are readily available. In addition, you may feel more comfortable with a professional with more education and training.
On the other hand, people may be more comfortable with a midwife who provides a more personable approach. These professionals are often better trained to deal with the emotional changes during pregnancy and may provide better support. In addition, you may feel more comfortable with a midwife who is open to natural pregnancy approaches. People who wish to give birth at home typically have a midwife.
Summary: Should You Get a Midwife?
In the United States, midwives can vary in their education. This ranges from self-taught and uncertified midwives to Certified Nurse Midwives (CNMs) who hold both a nursing degree and a graduate degree in midwifery. The most educated midwives, CNMs, are similar to doctors in that they can provide prenatal appointments, diagnose conditions, prescribe medication and provide care through delivery. However, doctors have more education, provide more traditional care and have medical interventions more readily available.
If you’re facing the decision of whether to choose a doctor or midwife, the first thing to consider is your health. High-risk pregnancies are usually best cared for by a doctor. For low-risk pregnancies, there are many other factors to consider, like insurance coverage, your birth plan and what you’re personally comfortable with. If you’re unsure whether a doctor or midwife is best for you, consider talking to both.
P.S. Have you Tried a Fetal Doppler Yet?
A fetal doppler is an at-home device that allows you to hear your baby’s heartbeat while they’re still inside the womb. Similar to an ultrasound, you use a probe to glide over your stomach and amplify your baby’s heartbeat! Parents say the BabyDoppler helps them bond with their baby before birth, adding another layer of connection!
<h4>Get Connected to Your Baby. Use the BabyDoppler Today!
