OB-GYN vs Midwife: How are They Different?

Every single pregnant woman needs and deserves a high standard of medical care and treatment, as well as emotional support and assistance. Understanding the important similarities and complementary differences between an OB-GYN physician and a midwife enables a woman to make informed medical decisions regarding which medical professional or combination to choose when pregnant and during her birth.

What is an OB-GYN?

An OB/GYN is a physician who specializes in managing the health of women over their reproductive lifespan. They care for women before, during and after childbearing years, diagnosing and treating conditions of the female reproductive system, and provide basic primary care. An OB-GYN also performs C-sections, gynecological surgeries, in addition to vaginal deliveries. OB/GYNs deliver in hospitals, many in joint practice with midwives. They are all state licensed.

Physicians provide independent care for women throughout the woman’s life and have authority to prescribe drugs in all states. Physicians are legal in all states. As far as insurance coverage, they are covered by private insurance, Medicaid, TRICARE, and Medicare.

To become a state licensed OB/GYN, an individual needs to obtain a bachelor’s degree in college which includes science and health courses, attend a graduate program in medicine, and then complete a residency in the specialty of obstetrics/gynecology.

After graduation, an aspiring OB-GYN may voluntarily sit for a national board exam given by the American Board of Obstetrics and Gynecology.¹ During their career, they must complete continuing medical education classes to maintain their state license and national board certification status. ²

What is a Midwife?

Midwives are non-physicians, who, like OB-GYNs, specialize in managing the health of women over their reproductive lifespan. They care for women before, during and after childbearing years, diagnosing and treating conditions of the female reproductive system, and many provide basic primary care. Many midwives can work with the OB/GYN physician during a C-section as the “first assistant” during the surgery instead of another physician. Such cooperation of care between physician and midwife provides emotional continuity of care and added personalization to the birthing care experience for the woman and her family. They are all state licensed.

To become a state licensed midwife, there are two paths ³: the college path or the apprenticeship path. The majority of midwives in the United States are college prepared and are legal in all states. Apprenticeship prepared midwives are legal in 35 states and the District of Columbia.

To become a college prepared midwife, an individual needs to obtain a bachelor’s degree in college which includes science and health courses, attend a graduate program in midwifery, and then complete a residency in the specialty of midwifery/gynecology.

College prepared midwives provide independent care for women throughout the woman’s life and have authority to prescribe drugs in all states. As far as insurance coverage, all states mandate Medicaid coverage for college prepared midwives, as well as TRICARE and Medicare; most private insurances cover college prepared midwives. College prepared midwives can provide basic primary care.

College prepared midwives can deliver in hospitals, with or without OB/GYN physicians, as well as in out-of-hospital settings. Pain relief options are only limited by the location of the birth (in a hospital vs out-of-hospital. They are called certified nurse-midwives (CNMs) or certified midwives (CMs).

To become an apprentice prepared midwife, an individual needs a high school diploma or equivalent, college courses in science and health, and an apprenticeship with qualified preceptors to demonstrate their knowledge and midwifery skills.

Apprenticed prepared midwives provide independent care during the pregnancy, childbirth, and through 8 weeks postpartum. They do not have authority to prescribe drugs, but may administer certain medications in select states. As far as insurance coverage, only select states mandate Medicaid coverage for apprentice prepared midwives; some private insurances cover apprentice prepared midwives. Apprenticed prepared midwives do not provide basic primary care.

Apprenticeship prepared midwives attend births primarily in out-of-hospital settings, therefore excluding the option for the use of an epidural for pain relief. They are called certified professional midwives (CPMs).

After graduation, both types of aspiring midwives may sit for a national board exam. The college path midwives sit for the national exam given by the American Midwifery Certification Board. The apprenticeship path midwives sit for the national exam given by the North American Registry of Midwives. During their career, both must complete continuing medical/midwifery education classes to maintain their state license and their national board certification status. ⁴

What are the Differences Between an OB-GYN and Midwife?

Both OB-GYN physicians and midwives are highly trained, state licensed medical professionals who sit for national board exams. You can rely on them seeking medical assistance before, during, or after a pregnancy. Their roles are complementary in both the hospital and out-of-hospital settings.

Both monitor a pregnant mother for medical conditions that could pose a danger to her and her unborn baby during pregnancy and/or childbirth, including genetic conditions, infections, diabetes, and high blood pressure. Both order lab tests and both physicians and CNM/CMs prescribe medication (CPMs can only selectively administer some medications in some states.)

But what are the differences and how can they complement each other?

OB/GYNs prepare to use medical interventions as a means to good outcomes. Birthing positions for the mother are usually limited to the bed, unless the physician has had specific training in doing births with the mother in other positions besides lying down. Often, their time is limited and focused on the urgent. Physicians practice in hospitals and offices and leave the labor sitting to the nurses, until delivery time.

Midwives focus on supporting the normal physiological process within the social context of her family and community in order to achieve good outcomes. Birthing positions for the mother can be her choice, since alternative delivery positions is integral in midwifery education. This type of care takes time which midwives often have. Midwives practice in a hospital or in birth centers, homes, or clinics. Some of these locations include birthing pools. Midwives often actively participate in the labor sitting process, along with the nurses.

In 2018, the first-of-its-kind study found a strong connection between the role of midwives in the health care system – what the researchers call “midwifery integration” and birth outcomes. States with high midwifery integration generally had better results, while states with the least integration tended to do worse. ^5,6

Midwife-friendly laws and regulations tend to coincide with lower rates of premature births, cesarean deliveries and newborn deaths, according to a U.S.-wide “report card” that ranks each of the 50 states on the quality of their maternity care.

Pregnancy is a life-changing experience. It’s a challenging time for all women but especially for those who are dealing with an unplanned pregnancy and all that this entails. Pregnancy Care Clinic offers a range of free pregnancy services to women who suspect they may be pregnant, including free urine pregnancy testing, ultrasound exams, testing for sexually transmitted infections that could cause complications during childbirth, and medical referrals. What’s more, we also offer counseling, education, and emotional support to women who are considering OB-GYN / midwife care options, or who may even be wondering if they should have an abortion or put the baby up for adoption. Additionally, we offer parenting classes to help new parents learn how to properly care for a new life while at the same time attending to other responsibilities such as continuing their education and/or working a part-time or full-time job.

Are you (or someone you know) struggling with an unplanned pregnancy or trying to find professional help in considering various medical care and treatment options? Our team offers a listening ear, friendly service, and professional advice along with free medical care to help you through pregnancy and childbirth. Get in touch with us at your convenience to receive fast, effective medical help and emotional support and assistance.

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