Tell me about midwives vs. GPs vs. OBs

In My Humble Opinion
1

I’m not sure what forum this should go in, but I’m looking for stories and anecdotes as much as I am for statistics. I’m almost two months’ pregnant, due in January, and my husband and I have been discussing prenatal care and childbirth. Here in Ontario, I have a choice of obstetrician, family doctor, or licensed midwife for my pre (and post, if it’s a GP or midwife) stuff. All are covered under Ontario’s medical coverage.

We’re leaning towards midwife. A friend’s mother, who’s an RN and has done postpartum care and taught breastfeeding seminars strongly recommends a midwife. That option appeals in a large part because a midwife will stay with you during labour. This is my first kid, and I would like someone to hold my hand, someone I have been working with throughout pregnancy. If I choose my clinic’s GP who does birthing, there’s only a 20% chance she’ll deliver my baby.

We’re planning on a hospital birth, and if something goes wrong I’d be transfered to an OB.

I want your stories, and your friends’ stories- what went wrong, what went right, why did you choose the way you did- doctor, OB, midwife. This is all new for me, and any input would be helpful. Thanks.

2

I’m a postmenopausal gal, but if I were young and having a baby I would choose a licensed midwife. I’ve heard lots of hospital horror stories involving childbirth from friends over the years, and most of them involved doctors. My friends who used nurse practitioners and midwives have had nothing but praise for the care they received.

3

I’m going with a midwife, too – a Certified Nurse Midwife. Actually, a practice of them. There are three midwives in the practice, and I’ll meet all of them over the course of my pregnancy (I’m meeting the third tomorrow!), so I will know whoever delivers my baby.

They’re great – because they’re nurses as well, they can prescribe and do all sorts of stuff. If I end up being high-risk or need a forceps/vacuum/c-section delivery, they will refer me to an OB practice they work with. One of the midwives is always on call, and one of the OB doctors is, too. We’ll deliver in the hospital birthing center.

What I like is their general attitude toward the whole process: it’s natural, our bodies are meant to do this, and pregnancy is not automatically a Medical Condition. Their three priorities are 1) A healthy mama and baby, 2) A vaginal delivery, and 3) The birth of my dreams. Which sounds sort of silly, but then you think about how some women want a totally natual birth and some women want drugs at the first contraction, and the “birth of your dreams” makes more sense. So I feel confident that, within reason, my wishes will be respected and listened to. And the staying with me in labor is important, too!

So far (I’m 26 weeks), I’ve been really pleased with my care. They’re supportive and encouraging, and they balance the “granola” and “medical” just right for me. I’m sure that midwives and OBs run the gamut; I might have had a similar experience with the right OB, or a really unsatisfactory experience with the wrong midwife. I think it’s a good idea to meet with a few of each before you decide – here, a lot of practices will do a “meet the doctor/midwife” visit, which is usually in their office (instead of an exam room). You can ask questions and just get a feel for them without signing on for your care.

One thing to keep in mind is that you can change practitioners at (almost) any point in your pregnancy if you don’t like the care you’re receiving. It’s hard, because it feels like you’ve made a committment, but if you’re not comfortable with them in an exam room, how are you going to be comfortable with them during labor? It’s important to find the right practitioner for you.

Good luck! Let us know when you’ve made the decision. :slight_smile:

4

In Midwives vs. GPs I’d put $2 on GP in the 4th round, but OB is a dancer and if it goes more than two rounds he’ll tire 'em out then knock 'em out.

5

I have a friend who is a doula- all of her clients have been very pleased.

6

I have had both the midwife and the OB. Both of my experiences were excellent. A good healthcare provider is a good healthcare provider no matter what his/her title. My midwife (14 years ago, my daughter’s birth) was excellent, using warm compresses and unusual positions to help with my back labor (I have an inverted uterus), but my OB (7 years later – for my son) did the same thing. Both of my children were born in hospitals – so I couldn’t speak of home-birthing. I will say that my OB was a much better provider than the midwife, simply because he and I clicked. He had a very funny sense of humour and was extremely pro-active in my care (I am a high-risk pregnancy, having lost 1 at 3 months, 1 at 5 months and went into to pre-term labor repeatedly with my daughter) – and made every effort to be sure my pregnancy went as smoothly and as close to full-term as possible. In my particular experience, I would pick my OB over a midwife anyday, but that isn’t an option since he is now the administrative doctor over the entire women’s pavillion for his hospital and no longer seeing patients…oh, and I wouldn’t have another pregnancy for all the money in the world.

7

I had two standard hospital births which were pretty yukky except I got babies at the end. I then had a midwife assisted home birth (it wasn’t supposed to be at home, my labor lasted 1 hr 40 minutes from first contraction to delivery) and it was much, much better. I’d vote midwife.

8

I chose an OB. Even though she wasn’t actually the one who delivered either of my babies, I had met the other doctors in the practice during my pregnancy so I was familiar with all the docs. The nurses at the hospital were very supportive during labor for my first baby but because I was in labor for so long (36 hours total), I went through a couple of shifts. The nurse for my second delivery wasn’t quite so nice but it was a much shorter experience. Luckily for me, my husband was with me all the way through both bouts of labor so I had my support.

9

I had an OB deliver both of my children, and was very pleased with my experience both times. The thing about OBs vs. Midwives is that I think they have different roles. Isn’t the midwife with you for pretty much the whole thing? The OB isn’t like that…they check in with you from time to time, perhaps, and then show up for the delivery. It’s the nurses who take care of you during the labor. Of course, you don’t know the nurses like you would know a midwife, so if it is important to you to be familar with the person, then maybe a midwife is the best option for you.

10

I worked as L&D and postpartum RN these past 6 years in the 2nd largest birthing unit in CA, specializing in high-risk. I would go with the CNM. They know their L&D, stay with their laboring moms and have a much more personalized relationship with the whole family. OBs are crazy busy—they want to catch the baby and let the nurses labor with the mom. They want to be there, around somewhere, if something goes bad. GPs are not specialists and if it goes bad, you want OB. I’m glad you’re having your first child with a birth plan!
And feel free to email me for any specifics—education makes things easier.

11

Must hyjack: What is this? Half the pages I find say that it’s when the uterus sort of sinks back and down into the pelvis during pregnancy, bending the cervix over the rim of the pubic bone, (which seems like something it’s supposed to do anyhow) and half are using it as a synonym for a prolapsed uterus (Not something that can happen and still maintain the pregnancy).

The pages that describe it as a sunk, full pregnancy uterus, also say that the condition would traditionally (probably erronously) be corrected during non-pregnancy by surgery. Why doesn’t the uterus move back into a more normal position after invloluting if it was only the pregnancy that was making it shift towards the backbone in the first place?

Now I’m extra confused.

12

Also a slight hijack-for those of you who had long labors (36 hours lilflower? How are you still alive and not insane?) how do you go that long without sleep? I know you are occupied and distracted, what with the trying to push a baby out your hoo-ha and all, but I still would think your body would not take well to the lack of sleep and make the birthing all the more difficult. I don’t have kids and I don’t know that I ever want to have kids but if I did I sure would want one polite enough to know that anything past 12 hours is just bad manners. :slight_smile:

13

My delivery took 24 hours and I understand Mom managed to doze occasionally. In between being terrified, getting stuck with a horse needle and cursing everybody in the world, that is.

14

You’re not generally in active labour the whole time, right? So there’s a little space to doze in between contractions.

A friend just had a three-day labour. I can’t even imagine it.

15

In my case, it means that my uterus slants the wrong direction. In the normal person (forgive me, but one of my dyslexic issues is remembering right vs left/back vs front/ east vs west, so I may be backwards here) the uterus is slanted towrads the belly at the top and towards the back at the bottom. Mine is backwards – slants in the opposite direction. There are no real issues with it except that I find some sexual positions to be less comfortable than others (maybe TMI, but it’s a uterus question!) and during labour, I feel it all in my back. Oh, yeh, and because of where/how my uterus sits my daughter broke my tailbone with her head while I was pregnant with her. Day-today, I have no issues because of it. I understand that my particular type of inverted uterus is one of the most common causes of “back labour.” Apparently, it’s a fairly common issue.

As for your question about why it doesn’t go back into a normal position – mine has always been inverted – my first gynecologist pointed it out to me. Since it has never really caused me issues and requires no medical treatment, I have never researched it, so my information comes from what my doctors have told me over the years (which isn’t much, since it’s a non-issue). Hope that helped, but I understand if it didn’t. :confused:

16

Me too! Exactly the same! They picked mine up years before I was pregnant. Following an infection I had to have my kidneys scanned, and they noticed ‘a problem’ with the uterus, so I went back for another, uterus (uterine?) scan, and what they had seen was my inverterd uterus! No problems, no treatment necessary. Still, having a ‘back labour’ when you already have 3 squished discs at the bottom of your spine ain’t no fun!

17

I had a midwife when my daughter was born. I liked it. It was a lot less “clinical” than a doctor, and she would take the time to talk with me. My daughter was born in a hospital, and the office did have doctors on call in case something went wrong. Also, I found out through a scare that if I started premature delivery, the midwife couldn’t deliver (no big deal, I thought my water broke but it didn’t.)

18

Mine was about 32 hours. I was unmedicated for the first 28, but my body started to give out, so I got an epidural. It was absolute heaven.

Regarding the long period without sleep - it didn’t take much effort to stay awake. For me, anyway (I had back labor), I wasn’t able to snooze between contractions because I was at first really excited, then later I was busy concentrating and even later was in a lot of pain. Then the pain went away and that was another novelty (I hadn’t really been able to talk to my husband for many hours other than grunting at him or yelling “rub harder!” when he was rubbing my back), then it was time to push. For lack of a better way of putting it, it was the way it was. The last thing on my mind during delivery was being tired. It was more like, “Ow. How can I get this thing out of me - now?!?”

I conked out right after I was wheeled up to the recovery room, though (and had some complications immediately after, but what happened was relatively unusual).

Anyway, my OB delivered by baby, which was great, but I did NOT like some of the nurses I had to deal with. I wish that I had had a doula to advocate for me, particularly after the birth, when I was unable to do it myself. If I had it to do over again, I would seriously consider a doula to assist or midwife to do the whole thing. I loved my OB, but I only saw him a few times.

19

What do the nurses do that the doula can insulate you from?

(sorry, I am not having a baby for years but I am curious)

20

Sorry for the double post, but to answer to OP… I live in the land of no midwives. My Ob/Gyn saw me through the whole thing, including the birth. My SO was there, bless him he was fabulous, but seeing MY doctor there made me much more confident about how things would be handled. We had got to know each other well and I felt confident that any decisions that had to be made would be done so with my interests taken into consideration. I had the baby in hospital and would do so again. I chose the hospital based on 2 things: a) my doctor worked there and b) babies slept with the mummies, no taking them off to the nursery unless you asked them to.
Having said that, if I lived somewhere that had mid-wives I would probably go for that. MY Ob/Gyn was there for the entire pregnancy and birth, but not afterwards. I understand that mid-wives come and see you at home after the birth. We were fine, but it might have been nice to have that kind of follow up.