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Ob/Gyns are trained physicians who can care for more complex medical needs than midwives, but which you choose depends on your health and comfort
Maybe you’re due for your annual well-woman exam. Or you’re pregnant and need to get your prenatal appointments on the calendar. Or perhaps you have questions about your breast cancer risk.
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Who do you talk to? An Ob/Gyn or a midwife? Does it matter? What’s the difference anyway?
When it comes to your gynecological care, you have choices. And the right provider for you is a matter of your health needs and your comfort.
We talked with Ob/Gyn Natalie Adsuar, MD, about the similarities and differences between obstetricians, gynecologists and midwives — so you can make an informed decision about your care.
The most immediate and easiest way to differentiate between Ob/Gyns and midwives is that Ob/Gyns are trained as doctors and surgeons. Midwives aren’t.
In the United States, obstetric and gynecological medicine is a combined medical program. Meaning, obstetricians are trained in gynecology, and gynecologists are trained in obstetrics. But their practice focus and subsequent training may vary. Many of these doctors, especially those who practice both, use the designation of Ob/Gyn.
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Here’s a quick peek at the differences between Ob/Gyns and midwives.
Ob/Gyn | Midwife | |
---|---|---|
Schooling | Physician. | Varies from self-taught to master’s-level degrees and other certifications. |
Pregnancy care | All pregnancies, including high-risk care and Cesarean deliveries. | Low-risk pregnancies and vaginal deliveries. |
Non-pregnancy care | All, including surgery and complex medical needs. | Routine care for generally healthy people. |
Schooling | ||
Ob/Gyn | ||
Physician. | ||
Midwife | ||
Varies from self-taught to master’s-level degrees and other certifications. | ||
Pregnancy care | ||
Ob/Gyn | ||
All pregnancies, including high-risk care and Cesarean deliveries. | ||
Midwife | ||
Low-risk pregnancies and vaginal deliveries. | ||
Non-pregnancy care | ||
Ob/Gyn | ||
All, including surgery and complex medical needs. | ||
Midwife | ||
Routine care for generally healthy people. |
Let’s take a deeper look.
Midwives aren’t medical doctors. Though some may pursue a nursing or other doctorate in addition to their midwifery education, that isn’t the norm.
Midwifery training can vary, depending on where they practice and the standards in their state.
Certified nurse midwives routinely work alongside Ob/Gyns in women’s health offices and hospitals.
“Certified nurse midwives are an option for regular gynecological care and pregnancy care for people who don’t need surgery or have complex medical needs,” Dr. Adsuar says.
Because they’re not physicians, midwives can’t perform surgery or deliver babies by Cesarean section. But a certified nurse midwife can be a good fit for people who have low-risk pregnancies or who need uncomplicated medical care. That can include:
Some people might tell you that midwives are the better choice for people who prefer to follow a non-medicated birth plan. (As in, giving birth without an epidural or pain-relieving medication.)
And while midwives can help in assisting you in a medication-free birth, having a midwife as your provider doesn’t mean you can’t opt for medicated pain relief.
“Oftentimes, midwives are trained in a broader array of non-medical options for pain management, and they may have the opportunity to employ them more than some physicians might,” Dr. Adsuar clarifies. “But you can work with a midwife and still have medicated pain relief during labor, if that’s your choice. You can also see an Ob/Gyn and have a medication-free birth.”
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Ob/Gyns are doctors. They undergo at least 12 years of education beyond high school before becoming licensed in obstetrics and gynecology. We’re talking:
Ob/Gyns are trained and educated to handle all aspects of women’s healthcare, from annual exams to complex surgeries of the female anatomy.
Essentially, Ob/Gyns can do everything a midwife can do. And then some.
“What sometimes happens is that people will start with a midwife and then, they can ‘risk out’ due to a change in their health,” Dr. Adsuar notes. “An Ob/Gyn can step in and handle more complicated medical care. But Ob/Gyns also care for people who don’t have complex healthcare needs. It’s a matter of your preference.”
You may be referred to an Ob/Gyn, rather than a midwife, if you have certain conditions like:
And some Ob/Gyns choose to focus on particular aspects of women’s health. For example, some Ob/Gyns work exclusively with patients in the hospital as they deliver babies. Others may specialize in specific gynecological conditions or surgeries.
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“The education gives you the credentials of Ob/Gyn, and then any additional training you choose can allow you to specialize from there,” Dr. Adsuar adds.
Whether you should see an Ob/Gyn or midwife for your general healthcare or pregnancy care comes down to two things:
“If you have a medical condition that requires a physician’s care, you should see an Ob/Gyn,” Dr. Adsuar advises. “For people who are generally healthy and don’t necessarily need a doctor’s intervention, it’s more about your comfort and finding a provider that you connect with.”
Often, too, Ob/Gyns and midwives work together to care for patients. It’s called a “collaborative care” model.
“Collaborative care offers patients midwifery support, while physicians address higher-risk medical concerns. This is often the ideal model for many high-risk obstetric patients and families,” she continues.
Remember, also, that gynecological care is highly personal by nature. So, finding a provider that you connect with is important.
“The person that you see can make such a difference, especially with something as intimate and as personal as your gynecological health,” Dr. Adsuar recognizes. “Choose someone that you can have a frank conversation with about what you’re dealing with. The key to your health may hinge on that connection.”
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