Choosing Between an Obstetrician (OB) and a Midwife

Co-written by Deja Ramos, a Certified Doula (DONA), ICCE, and Co-Founder of The Birth Companions and Anna Morales, Co-founder of Mila Support

Why does it matter?

Your choice of birth provider plays an important role in your pregnancy and delivery experience. Both Obstetricians (OBs) and Midwives are trained professionals who care for pregnancy and birth, but offer different approaches.

Key Factors to Consider When Choosing a Provider

A Midwife may be the right fit if:

✅ You prefer a natural, low-intervention birth.

✅ You want personalized support during pregnancy and labor.

✅ You are considering birth center or home birth options and you have a low-risk pregnancy.

An OB may be the right fit if you:

✅ Have a high-risk pregnancy or pre-existing medical conditions.

✅ You are planning for a c-section.

✅ You prefer a clinical, medicalized approach.

💡 Fun fact: Most babies in Europe are delivered by Midwives!

⚠️ Noteworthy: Many doctors and midwives work in groups that share on-call responsibilities. Ask your care provider how they handle it, so you can be prepared in case the provider you see during your pregnancy won't be the same as the one delivering your baby.

Making the best choice for you

Choosing a provider you trust is the most important criteria. Take time to ask questions, tour hospitals or birth centers, and discuss your birth preferences with potential providers. Your care team should align with your values, preferences, and medical needs. When talking to your provider, do you feel they are listening and considering your concerns and preferences?

Your Provider Options: Midwives

Midwives offer holistic, low-intervention care and support unmedicated, physiological births. They see pregnancy as a normal process, stepping in with tools only when needed. There are two main types:

• Certified Nurse-Midwives (CNMs) are registered nurses with 6–8 years of training. They can attend births in hospitals, birth centers, or at home, depending on state laws. CNMs in hospitals may follow more medicalized approaches due to hospital policies.

• Certified Professional Midwives (CPMs) or Licensed Midwives (LMs) are trained specifically for out-of-hospital births. They complete 2–4 years of hands-on training under experienced midwives and must pass a national exam. They’re well-equipped to handle emergencies and support safe home or birth center deliveries. Not available in all states, click here to find the status of CPMs/LMs in your state.

A midwife’s setting shapes their approach—hospital-based midwives may be more clinical, while home and birth center midwives focus on minimal intervention.

Your Provider Options: Obstetricians

OBs are physicians and surgeons trained in hospital-based care, high-risk pregnancies, and surgical procedures like C-sections. Some OBs specialize solely in surgeries (e.g., hysterectomies, oophorectomies) and may not attend births at all.

They complete four years of medical school, followed by a four-year residency in obstetrics and gynecology, and are certified by the American Board of Obstetrics and Gynecology (ABOG).

OBs generally view pregnancy and birth as clinical events requiring active management to ensure safety. This perspective often leads to more frequent use of medical interventions. Delivering with an OB is more common in the US than with a Midwife.