Can I use an OB and a midwife?

Even the most decisive pregnant woman might have a hard time choosing between an obstetrician and a midwife. Both options are good choices, for different women and for different reasons. You might have found yourself in a similar predicament trying to determine which option is right for you. In trying to decide, you may have even asked yourself this question: is it possible to have both a midwife and an obstetrician working together to help with your birth?

If you’ve been particularly entranced by both a midwife and obstetrician skills and models of care, it’s clear that you could benefit from the care that each provides. This said, the answer to your question about having both doesn’t have a simple answer. Here’s some information about both kinds of healthcare providers.

Together, midwives and OBs can provide a ‘mixed’ approach to pregnancy and childbirth

Obstetricians and midwives have a shared goal, but they use different approaches to get there. Both want the absolute best health for a mother and her newborn baby. However, a midwife tends to focus more on preventive care, intervening as little as possible. Obstetricians adhere more to a medical model. In a collaboration with a midwife, OBs tend to have a more hands-on approach, and are more likely to intervene right away if complications arise.

Research shows that this collaboration can be extremely beneficial

Numerous studies have examined the effects of OB-GYNS and midwives working together during women’s pregnancies and during labor. For the most part, collaborations between both types of professional result in better birth outcomes for the mothers and their babies, as well as higher rates of birth satisfaction. Working with both an OB-GYN and a midwife can ensure that a balanced look at different aspects of the pregnancy and birth process are taken into account.

Many midwives work in hospital settings

If the idea of having a midwife is strongly appealing, but you want the option of a c-section or other surgical interventions, you might want to opt for working with a midwife at a hospital of your choosing. This way, you can have the experience of a midwife with the reassurance of everything that a hospital provides.

Midwives function separately from physicians, but often work with or under them.

Midwives are typically required to maintain a working relationship with a physician, whether they work inside a hospital or not. If at any point a woman’s pregnancy is determined to need the assistance of an obstetrician – whether she needs a surgical intervention or something more – her midwife can refer her to an obstetrician. There are absolutely cases where midwives and obstetricians function together more loosely and not as a singular unit.

Obstetricians do not work home births or at birthing centers

Obstetricians do not practice outside of the hospital. If you have a low risk pregnancy and are planning on a home birth, you will be able to use an OB-GYN up to delivery, but you won’t be able to use both providers during your delivery, as obstetricians do not help women deliver their babies at home.

Would both be good for me?

Individual factors, including financial costs, will most likely influence your decision. But here are some of the most common circumstances that indicate that you could benefit from both an obstetrician and a midwife.

  • If you might need or want a C-section, but want a midwife’s care
  • If you have certain high risks in your pregnancy, like cardiac irregularities or a metabolic disorder, but want a midwife’s care
  • If you have an obstetrician, but are concerned about cross-coverage (in other words, if there’s a possibility that the obstetrician you’re seeing now won’t be the one who is present at your birth)
  • If you have an obstetrician, but are concerned or know that they could be away during your delivery
  • If you have an obstetrician, but want a more personalized form of postpartum care

No matter what your circumstances are, it’s great that you are considering both options, and that you have found things that you like among the two. As is the case for many other women, it may take some time for you to find a model of care that works for your unique circumstances and needs. Ideally you would be able to build a relationship with whatever provider you choose long before you delivered, but remember that if you want to change things before labor, it’s within your rights to do so. And don’t be afraid to talk to your provider about any of this – they will be able to give you more information about the decisions that you’re making at this time.

  • “Midwifery: Evidence-based practice.” Midwife. American College of Nurse-Midwives, Apr 2012. Web.
  • G Haller, et al. “Effect of crew resource management training in a multidisciplinary obstetrical setting.” Int J Qual Health Care. 20(4):254-63. Web. Aug 2008.
  • “What is the difference between a midwife and an OB?” NWS-OBGYN. Northside Women’s Specialists, n.d. Web.
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