QuestionI was wondering the benefits and disadvantages to choosing a Medical Doctor over a Midwife? What type of training does a mid-wife have?
AnswerHi Lindsey,
Before I really get into answering your question, please understand that this is not really a subject that I can be objective about. I really do believe that for the majority of healthy women, midwives provide a more comprehensive scope of care. So that being said....
Medical doctors have more training in the true medical emergencies of pregnancy, whereas midwives are trained to recognize these problems and to seek appropriate care for their clients. So, for higher risk women, MDs are a better choice. In most states, midwifery clients are put through a screening process that risks out any women who might have or has a history of complications or medical conditions that would be problematic in a home birth setting.
Prenatal care in a medical setting is usually a 15-20 minute appointment that is fairly impersonal and focused on the testing that takes place during a routine prenatal appointment, such as urine screen, blood pressure, weight, etc. Prenatal care in a midwifery setting usually lasts from 45 minutes to an hour. It will include all of the same medical tests that a MD performs (except for routine ultrasounds and more specialized tests such as amniocentisis), but also includes a lot more time to talk and to really develop a relationship with your healthcare provider.
During labor and birth, in a hospital setting, most of your support comes from the people you bring with you and the nurses on duty at the time. Typically, your doctor is in and out and especially if there are no problems, present during the delivery and then pretty quickly leaves. Keep in mind too, that the doctor that you have chosen may or may not be on call when you actually go into labor, so you may end up with somebody else (If you do choose a MD, this is something to ask them about). Labor with a midwife is much different. Your midwife will be with you during all of your labor and birth. This provides a much more supportive and continous care, that can be very important to your experience of labor and birth. Who really wants to be experiencing one of the most intense physical and emotional things you will ever do with people you don't know and may or may not be comfortable with?
In terms of training, there are different kinds of midwives, and their training is also different. The two main kinds are nurse midwives and direct-entry midwives. Nurse midwives are nurses who have received considerable additional training in obstetrics. They can practice in hospitals, birth centers and in some states, can have home birth practices. Direct entry midwives can receive their training in different ways. There are several schools around the country, or they can learn through a traditional apprenticeship program (such as I did). They are experts in normal, natural birth and have enough training in complications to be able to identify them and take appropriate steps.
In the end, you will have the best experience in whatever setting and with the people that you feel the most comfortable with.
Hope this helps :)
Shawn House, LM
www.BirthintheNaturalState.com
