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For most people, the benefits of choosing a midwife rather than an obstetrician start well before the birth of the baby. Typically, a woman will choose a healthcare provider as soon as she knows she is pregnant. The differences between choosing a midwife instead of an obstetrician will become immediately apparent.

With an obstetrician, the first visit is a whirlwind of activity. He will take a quick history and do an efficient physical exam. Then, he will provide you with some general information at lighting speed. He will tell you what tests you must have, and which tests are optional. Then he will give you some pamphlets and have you make an appointment in another month.

Choose a nurse midwife and the experience is entirely different. During your first visit, your midwife will want to get to know you. Your personal information is discussed at length. A gentle and caring physical exam will be performed. Information about pregnancy and delivery is discussed at length. The nurse midwife will ask you about your regular diet, and make recommendations for improving it. She will explain to you about all of the tests you should have, and the pros and cons of the optional ones.

There are two very different types of midwives. The lay midwife will not have any type of formal training or have a degree in nursing. She will have been trained by another lay nurse midwife. The certified nurse midwife (CNM) will not only be a registered nurse (RN) but will also have advanced training in midwifery. In most cases she will have an obstetrician backing her up and have hospital privileges.

The risks in having a lay midwife are far greater than with a CNM. With no medical training, the lay midwife will not be as equipped to deal with a complication. She will not have emergency equipment or be able to write prescriptions and order tests.

At your first visit, your nurse midwife will discuss the experience of a home birth. If you have any special requests, such as an underwater birth, she will tell you whether or not she provides this, and how the risks compare with a more traditional form of childbirth. She will discuss with you the pros and cons of having a homebirth, and what type of complications she can deal with, and which ones will require a transfer to a hospital. She will also tell you whether or not she does deliveries at hospitals, and the pros and cons of delivering your baby there.

Finally, the midwife will provide amply time for you to ask any questions you may have, and tell you to call her if you have any questions or concerns. No question is too small, and no concern is considered to be the result of an overanxious mother-to-be.

When the time comes for the birth of your baby, you will have the one-on-one attention of your midwife, rather than a nurse who pops in occasionally. You will not have labor induced or a cesarean section performed by an inpatient physician. Rather than be hooked to monitors and tubes, you will experience childbirth as nature intended.

Learn more about this author, Frances Simon.
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