Midwife or Obstetrician – Which One?
Choosing the carer that fits
Not long after the excitement (or shock) of a positive pregnancy test comes the first of many important decisions. We’re not talking baby names just yet – the top of your list should be choosing who is going to look after you throughout your journey from bump to baby bundle.
In New Zealand, this is known as a Lead Maternity Care or LMC.
Your LMC will be by your side through pregnancy, labour and birth, and for four to six weeks after the birth as you adjust to motherhood. Midwives and obstetricians can both act as LMC, being well-versed in prenatal care. While they essentially offer similar services, how do you choose what’s right for you? Here’s a look at the differences and similarities between the two, along with a few factors that will help you make the final call.
The key differences between obstetricians and midwives
Midwives are the experts for a normal pregnancy, whereas obstetricians’ skills and experience come into play for more complicated pregnancies and births. You’ll get more scans with an obstetrician (in some cases at every appointment) and generally a more medical approach is taken in your care.
From an educational perspective, a midwife needs to complete a four-year Bachelor of Midwifery. An obstetrician studies to become a doctor with six years of medical school and a further eight years of practical placements combined with exams. Unlike midwives, they can jump in and perform surgeries like C-sections and use other aids like forceps and vacuums to help with delivery if needed. The financial outlay for an obstetrician can be between $3,000 and $5,000 in New Zealand, while midwife care is completely free.
Keep in mind that even if you’re seeing a midwife, specialist care will still be available if you need it at any stage. It’s usually provided through your local hospital, and in that case, it’s free.
Choosing your carer – what’s right for you?
Scouring the internet and talking to friends and family, you’ll find that some people are firmly team-obstetrician or team-midwife. So how do you know what’s right for you? Here are a few things to consider:
Seeing your baby regularly
Most obstetricians perform a quick scan at each appointment to accurately measure and chart growth rates. Having your growing baby seen regularly can be reassuring – particularly for first-time mothers or people who experience anxiety during pregnancy. If you’re seeing a midwife, growth and positioning checks are made by feeling your abdomen and you’ll be referred to an ultrasound clinic for two or three specialised scans.
Plans for pain
While both obstetricians and midwives can facilitate epidurals, you’ll find midwives lean towards unmedicated methods of pain relief. They might recommend massage, showers or birthing balls over epidurals. If you’ve got your heart set on a specific method of pain relief, this can dictate your choice of midwife or obstetrician.
Finances
It’s estimated to cost $16,000 a year to raise a child – that’s a lot! Stumping up $5,000 for an obstetrician before your baby’s birthday can be completely out of the question for some, while for others, this feels like money well spent (having a baby is a major life event).
Are you considered high-risk?
If you have a condition that makes your pregnancy high-risk (such as diabetes or a twin pregnancy) it’s generally recommended that an obstetrician takes care of you and you give birth in a hospital.
Place of birth
Dreaming of a home, water or birthing-suite delivery? Midwives are generally more open to a holistic birthing approach, whereas it tends to be off-limits for hospital-based obstetricians. Keep in mind that no medical pain relief is available outside of hospitals and interventions such as caesareans aren’t on offer. These days almost 90 per cent of Kiwi women chose to give birth in hospital, with only around 3.4 per cent opting for the comfort of their own homes. Make sure your LMC’s values align with yours when it comes to delivery day.
You’re in it together
While the medical approach of an obstetrician can provide reassurance for some, many women find the more personalised approach of a midwife more important during such a major life event. Midwives tend to offer emotional support and will be present for all of your active labour and birth. Obstetricians generally pop in and out throughout your labour, sometimes just in time for your baby to pop out. Obstetricians (whom you might not have met) will work alongside a midwife during your labour and birth whereas your own midwife will be with you every step of the way.
You just gel
Finding a patient-centred carer who makes you feel comfortable from the start is perhaps the most important thing. From a personality perspective, there are some people you just instantly gel with, whatever the job title.
It’s all about you and your baby
Like a lot of things baby-related, choosing an LMC is often about trusting your gut. A baby marks a whole new chapter in your life and your LMC plays an important role in that journey. Whoever you pick, make sure you have upfront, frank discussions about where and how you want to give birth, and that your philosophies align. Remember, if at any time it turns out you’re not on the same wavelength, you’re entitled to change carers.
