Health Care Provider Options for Childbirth: Obstetricians, Family Practitioners, and Midwives
Expectant mothers today have more choices than ever when it comes to pregnancy and childbirth health care. This article looks at the basic philosophies and options available.
Midwifery Model of Care vs. Medical Model of Care
While there are some striking differences in these two perspectives on childbirth, it's important to remember that each caregiver is an individual and you are likely to find a lot of variation. Take a look at the highlights, realizing that this is quite a generalized view.
Medical Model
Focus on managing problems and complications
Labor/birth viewed as dependent on technology
Higher rates of using interventions
Doctor delivers baby
Care is systemized
Midwifery Model
Focus on health, wellness, prevention
Labor/birth viewed as normal physiological processes
Lower rates of using interventions
Mother gives birth
Care is individualized
Pregnancy and Childbirth Health Care Providers
Obstetrician (MD) -
Patient Interaction: Prenatal visits are quick, some less than 10 minutes. Generally stick to the topics that match the current stage of pregnancy. During labor, an OB consults with your nurse by phone or may come to the hospital to check on your labor progress. Obstetricians typically arrive at the hospital at the end of labor, shortly before delivery, and stay through the delivery of the placenta and early recovery. They are surgical specialists who treat the pathologies of pregnancy and childbirth. If mother or baby has health problems during pregnancy or childbirth that compromise health or life, then an OB or a perinatologist (an OB with specialized training to handle very sick mothers and very complicated pregnancies) is necessary.
Family Practice Physician (MD) -
Patient interaction: Prenatal visits may be similar to an OB visit. During labor, a family practice doctor may arrive during the active part of labor and stay through early recovery. Typically, they are present for more of the labor than an OB would be. They care primarily for women with low risk pregnancies and refer to obstetricians if complications arise.
Certified Nurse Midwives (CNM) -
Patient interaction: First prenatal visit typically an hour. Follow-up visits about 20 - 30 minutes. Mother and partner are encouraged to discuss any questions, fears, concerns of any part of pregnancy, labor, birth, or postpartum. Patient education is a key component of midwifery care. In labor, typically begin attending in early to active labor when mom arrives at the hospital, and remain with her through birth and the initial recovery stages.
Licensed Midwives (LM)/Certified Professional Midwife (CPM) -
Patient interaction: Prenatal visits are typically 20 - 60 minutes. In labor, the midwife stays with mom throughout her active labor, through birth, and up to four hours after the birth.
Information in this article provided in part by childbirth educator and professional doula, Kim Palena James. You can find out more about childbirth and pregnancy from Kim's perspective in the following articles:
Create a Better Birthplan: How to Write One and What it Can and Cannot Do For You
For more information, browse the articles in the Truth About Pregnancy and Childbirth
