Q. How is a midwife different from an obstetrician in the type of care each provides?
A.Certified nurse-midwives are a very important part of my medical practice. They are nurses with advanced degrees who specialize in normal, natural childbirth and gynecological care of healthy women throughout their life cycle. Midwives and doctors share common goals: to provide excellent care for mother and baby, to create a positive birth experience for the parents and, of course, to deliver a healthy baby.
Obstetricians and nurse-midwives work together to provide a rich experience for birthing women and their families. Both the midwife and physician use their professional knowledge to provide for the physical and emotional needs of each patient, but the midwife is often more in tune with the personal and spiritual changes that birth brings.
Women know themselves well and are most likely to choose the kind of birth attendant and birth experience that meet their needs. Both physicians and midwives provide the full array of pain management options to women. Midwives, however, are skilled at assisting women who seek a more natural birthing experience. Women who choose a physician/midwife team benefit from the skills and perspectives of both professions.
Obstetrician/gynecologists provide care that is focused on the female reproductive system. We are surgeons and primary care providers to women throughout their lives, in times of health and illness. Certified nurse-midwives also care for women throughout their lives providing primary care and family planning services with a specialty in the transformative process of the childbearing years.
While obstetricians and midwives have a common goal of ensuring a safe birth and a healthy mother and baby, complications that require an obstetrician’s intervention can arise during pregnancy, labor or birth. Obstetricians are educated to solve complex medical problems. We provide emergency and surgical care when medical intervention is needed to protect the health of the mother and the baby. (About 20 percent of women will have a complicated pregnancy or birth requiring specialized care.)
In my practice, midwives spend more time with their patients during routine appointments. This provides time for discussion of personal goals and educational needs in order to prepare the family for the kind of birth experience they want. During labor, the midwife closely oversees the laboring mother to promote an optimal labor and birth. If a woman appears to be at risk for complications, the doctor must intervene; but the midwife remains part of the woman’s care team to provide emotional support and continuity of care.
As a physician, I love that my patients can choose between a midwife and an obstetrician. The midwives in my practice care for mothers who are likely to have a normal, healthy birth. This allows our doctors to care for high-risk patients and those with which we have a longstanding doctor-patient relationship. I must admit that I enjoy delivering second, third and fourth babies. No doubt our midwives do too.
Blair Conger, CNMW, contributed to this article.
G. Theodore Hughes, M.D., is the director of obstetrics for Bon Secours Hampton Roads and an OB/GYN practicing with the WomanCare Center at DePaul Medical Center in Norfolk.