Why I’m Choosing a Midwife Instead of an OB for My Pregnancy and Labor

In my first pregnancy with my twin boys, I was 21 years old living overseas in Okinawa, Japan with my husband who was serving active duty in the Marine Corps. I didn’t really have much of a choice of where I gave birth, as there was only one military hospital. Through TriCare, I was assigned an OB and all of my appointments were in that one hospital. My OB was super sweet and made me feel comfortable the entire pregnancy. My OB suggested a planned C-section since I was having twins and I went with it. My water broke 2 weeks earlier than my planned C-section but my OB was conveniently on the floor that day so she was able to do my C-section. I had an easy labor, barely felt my contractions, and the C-section went smoothly with very little pain. My OB and all the staff in the operating room made me feel so comfortable and at ease. I was so happy with how smoothly everything rolled. My boys came out and left to the NICU for precautionary measures and I went back to sleep until my medication wore off and then joined my boys in the NICU where I was able to fit in some kangaroo time.

So, you might be wondering – if I had such a positive experience with my first pregnancy with an OB then why would I be choosing a midwife for this pregnancy?

Well first let’s go over what an OB is and what a midwife is so we can look at the difference. Both specialize in childbirth but both have very different techniques. By definition, an OB is short for obstetrician and a physician or surgeon qualified to practice in obstetrics, which is the branch of medicine or surgery concerned with childbirth and the care of women giving birth. An OB delivers babies in a hospital and takes more of a medical approach. An OB can induce you, get you an epidural or pain medication, and performs cesarean sections and other surgical procedures. OB’s often only appear in the delivery room when you are ready to push (when they are needed in the delivery room the most). A midwife is a person trained to assist women in childbirth. A midwife cannot perform C-sections and other surgical procedures such as repairing serious vaginal lacerations. A midwife takes a more holistic approach to childbirth and spends a lot of time getting to know you throughout your pregnancy to best support you during labor. A midwife can also perform home births, water births, and VBACs (vaginal birth after C-section). A holistic approach for a midwife looks at your nutrition, physical activity, stressors, fears of labor, using less or no medication, and really treating childbirth as a natural part of a woman’s life instead of a medical procedure. 

What are some of the benefits of choosing a midwife?

Lower C-Section Rates

Choosing a midwife would lower your risk for having a C-section for a number of reasons. Since OB’s have a medical-led view of pregnancy and birth, there are more interventions such as scheduled C-sections or inductions. Pitocin is a drug used to induce a woman into labor through the IV. It causes contractions to be longer, stronger, and closer in time together and the pain of labor increases dramatically. The epidural can ease these pains for a little while but the epidural typically wears off, which slows down labor and Pitocin may be needed again. It’s a cycle and in this cycle, the baby may go into distress. If the baby goes into distress, you are then rushed into a C-section and it really comes down to it that it was a domino effect of interventions. There is so much research showing a link between induction and higher C-section rates.

Woman have become so fearful of giving birth because of how it is portrayed in the media and many other reasons that the option for a scheduled C-section seems so much easier. OB’s also like the idea of a scheduled C-section because that’s what they are trained to do and it can easily fit into their schedule, so why not?

The problem with C-sections are they are major abdominal surgery. They involve risk for both mothers and babies and can further complicate future pregnancies. Well known risks include neonatal depression, fetal injury, increased likelihood of respiratory distress, and breastfeeding complications. The baby also misses out on passing through the mother’s good vaginal and intestinal flora that boosts the immune system and a healthy baby. Since a baby’s immune system is then compromised, they are more at risk for negative reactions to vaccines. Babies born via C-section are more at risk for childhood diseases such as type 1 diabetes, Crohn’s disease, multiple sclerosis, allergies, asthma, autism, and so on.

C-sections have no doubt saved many lives and I am so thankful that they exist and that we have well-trained OB’s for women when it is absolutely medically necessary but the truth is they are not normal and should not be treated as a normal method of giving birth.  

I am a mom who made the choice to have a scheduled C-section the first time so no mom reading this should feel shameful for making the same decision I did. I just feel that if I had known what I know now, I would have made a different decision and not have gone with a scheduled C-section. Now I know and now I can do better.

More Experience in Natural Childbirth

Midwives specialize in natural childbirth. They see it every day and know what a real, natural childbirth looks like. OB’s are so accustomed to medical interventions that they rarely ever witness a real, natural birth. An OB’s “go-to” is medical intervention because that is what they are trained in and know best.

More Freedom and Flexibility During Labor

Having a midwife allows you to have more freedom and flexibility during labor. In a hospital room with an OB, you give birth while laying on your back which is definitely not the most comfortable position and can actually cause more pain. With a midwife, you are able to birth in any position you feel comfortable in. Some places even have the option to have water births! The midwives that I will be going to allow you to labor on a medicine ball, in the shower, in the tub, walk around, and so on. If I decided to give birth in the tub, then I can decide to do that without making that decision in advance. I will be able to do whatever feels most comfortable for me when the time comes.

More Comfortable Environment

If you choose a home birth, you will obviously have the most comfortable environment but birthing in a center or in a hospital with a midwife can be comfortable too. You are able to eat and drink as you please, dim the lights (maybe even bring in your own Himalayan salt lamp for some positive vibes), diffuse calming essential oils, and you’ll have the support of your midwife rooting you on the entire time as your midwife doesn’t leave your side.

Less Risk of Tearing and Episiotomies

Since you have more flexibility with how you position yourself during labor, you have less of a risk of tearing or having to have an episiotomy. Midwives also work with you throughout your pregnancy to prepare your body for labor so that you have less of a risk.

Better Chances of Successful Breastfeeding and More Bonding with Baby
The relaxing environment of giving birth with a midwife also sets you up for success to breastfeed and bond with your baby. You have the option to delay cord clamping, which has tremendous health benefits. Since having a midwife lowers your risk of having a C-section, you are able to immediately bond with your baby and give your baby his/her first milk.

That is one thing I regret the most when I had my C-section. I wasn’t able to touch or hold my babies right away. They allowed me to kiss my Noah on the cheek really quickly and then they rushed them off to their incubators in the NICU. By the time I was done with surgery, the NICU nurses had already fed my babies formula and they had pacifiers in their mouths (something I hadn’t really planned on giving them). I fought so hard to breastfeed, trying to get them to latch on but with little success. I pumped as hard as I could for 2 months until I developed mastitis and could no longer produce milk… I knew how important it was to breastfeed for their health and was disappointed that I didn’t have more opportunity to do so. If I can change the odds so that I have more of a chance at successful breastfeeding this time around, I will do everything I can.

More Options for Non-Toxic Testing During Pregnancy

Midwives hold a belief that women can be trusted to make the best decisions for themselves and their families when given reliable, non-biased information. There are many tests given during pregnancy that are unnecessary and even sometimes toxic to mom and the baby. A mom should always be given the choice to decide whether or not medical intervention is needed. As a mom, you have the right to deny ultrasounds or limit your ultrasounds to protect the baby from radiation, choose an alternative test to the glucose sugary drink, internal exams, etc... You're the mom. You have a choice.

Increased Satisfaction of Quality of Care

You have so many options when choosing a midwife and you spend a lot of time getting to know your midwife that it is more likely you will be satisfied with the quality of care. A midwife’s holistic approach makes you feel like you are fully taken care of and can really ease your fears about childbirth.

My decision to use a midwife this time around and many of the other decisions I make as a mom always comes back to my boys. I have learned so much from being a mom, especially an Autism mom. My boys have motivated me so much to do my research and to start making informed decisions. I'm really excited for this new journey I'm about to embark on. 

I have learned so much about pregnancy and childbirth since my first pregnancy and I am super excited to be going through with a natural pregnancy and birth with a midwife this time around. I am no longer afraid of birth and the pain that may come with it. I will be attempting a VBAC (vaginal birth after C-section) and with no medical interventions. I am actually more afraid of the pain from medical interventions than I am of a natural birth after the research I’ve done. It feels so empowering to know that I have choices and that the decision is up to ME, the mom! My new favorite pregnancy book shares this affirmation that I absolutely love and want to share: “My body is open and accepting of the new life within. Giving birth is a natural, normal experience. I am strong. I am able.” How amazing is that?!

Recommended Natural Pregnancy Book:
The Mama Natural: Week-by-Week Guide to Pregnancy and Childbirth by Genevieve Howland


Comment as Anonymous change
This is so inspiring! As we move towards starting a family and looking to the costs of childbirth and whether or not to use a midwife or not, the more I'm convinced of using a midwife. Thanks for being open and honest about your first experience!
This is so inspiring Alex!! Loved it! I know who I'll be reaching out to for advice some day when I'm pregnant... :)