Midwives, in the U.S., are having a moment of growing awareness and popularity. In 1980, midwives attended only about 1% of births in the U.S. By 2021, this was 12%. A new nonprofit, BirthFund, has been in the news recently, aiming to raise funds to support midwife care for Black women specifically, to improve maternal health outcomes.
The midwifery model, while still relatively less common in the U.S., is closer to the norm in many other places. In the U.K., about half of births are attended by midwives, and rates are high in many other areas of Europe as well. For a very, very long time, midwives delivered all babies. Even when “doctor” was a formal job, births were nearly always attended by midwives. This slowly changed over time, and not always for the better. (Before hand washing was widely seen as necessary, doctors assisting in births were much more likely to kill their patients, since they often came to a birth directly from an autopsy.)
In the U.S., midwifery can still feel a bit mystifying — as in, Isn’t it just for home births in a tub? This post aims to explain what a midwife is, what the data says about birth outcomes with midwives, and whether this could be right for you.
Note: Most of this post focuses on hospital births attended by midwives, not home births or alternative birthing spaces, like a birth center. As discussed below, most midwife births are at hospitals. I talk about home births in Expecting Better and will look to revisit this sometime in the future.
What is a midwife?
Broadly, a midwife is someone who provides prenatal care and attends births — the formal definition is someone who is “trained to assist in childbirth.”
Currently in the U.S., there are four main types of midwives, with different levels of training.
- Certified nurse midwife (CNM): A nurse who has completed graduate-level midwifery training and has passed a certification exam from the American Midwifery Certification Board.
- Certified midwife (CM): Someone without a nursing degree who has completed graduate-level midwifery training and has passed a certification exam from the American Midwifery Certification Board.
- Certified professional midwife (CPM): A midwife who has completed certification from the North American Registry of Midwives, based on an exam. Qualification for the exam is based on apprenticeship, completing an entry-level course, or graduating from a certified program.
- Direct-entry midwife: This type of midwife does not have any formal credentialing.
The CNM designation is qualified to practice in all states; the others vary. Overall, about 90% of midwife-attended births are with a CNM or CM, and those two credentials would cover nearly all midwife-attended births at hospitals.
There are several misconceptions about midwives and their practice that are worth dispelling.
First, many people imagine that midwives largely or exclusively attend home or birthing center births. This is not true. Although a large share of home births are with midwives, most midwife-attended births are at hospitals. (There are a few ways to infer this from the data — only about 2% of births in the U.S. are home births, and midwives attend 12% overall, so the vast majority are not at home. We also know that 93% of births attended by CNMs or CMs occur in hospitals.)
Second, many people imagine that one cannot use a midwife and have an epidural or other pain medication. This isn’t true. Although use of these medications is lower with midwife-attended births, likely due to who chooses to use a midwife, anyone who gives birth in a hospital has access to pain-control options offered by that hospital.
Finally: A common statement — and one I admit to having made myself — is that midwives are appropriate only for “low risk” pregnancies. This notion is vague and, in most interpretations, probably underestimates the share of women who could use a midwife for prenatal care and in delivery. A more precise statement is that midwives are not surgeons, whereas an OB-GYN would be trained in surgery. If a C-section is necessary, this would require a transfer from a midwife to an OB-GYN.
There are many risk factors in pregnancy that could make someone “high risk” — prior preterm birth, advanced maternal age, prior C-section — that would not rule out using a midwife. As we’ll see in the data, midwives could increase the chance of a good outcome in these cases. If you know you will need a C-section, or suspect you might, you are likely to need an OB-GYN at some point. But even this wouldn’t rule out working with a midwife for prenatal care.
All of this is to say, a midwife birth provider is likely to be an option for a much larger share of women than currently use one. If you’re pregnant or expecting to be, is a midwife for you? One input to this answer is about what experience you want to have; a second is about what the data says about outcomes.
How is the experience different from an OB-GYN?
Below, I dive into the data on outcomes, but I wanted to spend a moment on the experience differences.
A core difference between midwives and OB-GYNs, on average, is in time spent with patients in prenatal care. Midwives tend to have more time per patient and see fewer patients per hour. There are some basic economics behind this — because OB-GYNs can also do surgery, there is an economic incentive to use more time in surgery and less time in routine care.
This time also translates to births. It is not uncommon for a midwife, even in a hospital, to be present for all of labor and delivery. This is less likely for an OB-GYN, who will often arrive during the second phase (pushing) because of other patient visits, overlapping births, or simply differences in how care is managed. Patients with midwifery care are also, on average, less likely to have labor induced, which influences the timing of birth (since, for example, inductions tend not to occur on weekends).
This is true on average; of course, distributions overlap. Some OBs spend more time, some midwives spend less. There are certainly OB-GYN practices and individuals who will be at your entire birth, and midwives who will not be.
On the other side, if you have midwife care, it is more likely that you will need to switch providers partway through your pregnancy or birth. Because there are some complications in pregnancy and some experiences in birth (a cesarean section, for example) that a midwife is not trained for, if you encounter these, you would need to switch providers. This is generally possible — indeed, many practices have both midwives and OB-GYNs — but it is a consideration.
Many midwives and OB-GYNs work inside larger practice groups, so your primary prenatal provider will not necessarily be the person at your birth. This is perhaps slightly more true for OB-GYNs, but it is true for both. If a guarantee of who will attend your birth is important to you, that’s a conversation worth having up front.
Beyond the above, many aspects of the experience will be similar — a similar schedule of prenatal visits, testing, and ultrasounds — assuming you are using a midwife for a hospital birth. If you have a home birth, visits are more likely to be at your home and there are more clear differences in birth experiences.
What is the evidence on improving birth outcomes?
If we are looking for causal impacts — asking the question of what the causal impact of midwifery care is on birth outcomes — I will always look first to the gold standard, randomized data. In this case, we’re looking for studies that, in some way, randomly allocated some patients to midwives and some to OBs.
There are studies like this, fortunately, and they’ve been combined in a meta-analysis so we can get a sense of overall impacts, even when individual studies are small.
To give an example of how randomization works in this question, we can look at one of the larger individual studies, which was run in Ireland in the early 2000s. In this study, women coming for prenatal care at two hospitals in Ireland were asked to participate in the study. If they consented, they were randomly allocated to midwife care (two-thirds of patients) or doctor care (one-third). The patients were followed and their outcomes were compared. This study and others use an “intent-to-treat” design: they compare women based on which group they were assigned to, not who they ultimately delivered with. If someone had a midwife assigned but ended up needing a C-section with an OB, they were still assigned to the midwife group for analysis.
This should make clear: these studies are not about home birth. They cover midwife-assisted births in hospital settings. Again, home birth is a different question.
The Cochrane Review meta-analysis (which was updated in 2024) combines 17 studies similar to this, with over 18,000 women. The authors look at many outcomes. Within each outcome, they judge the evidence based on the differences across groups and how confident they are about the data.
In the table below, I summarize their results.
This is a lot of data, but it paints a fairly consistent overall picture. For the women in these trials, being assigned to midwife care seemed to increase the chance of a vaginal delivery without instruments and, correspondingly, to decrease the risk of a cesarean section or instrument-assisted delivery. These impacts are significant but quite small: overall, a 4-percentage-point increase in spontaneous vaginal births, which seems to come about equally from reductions in cesarean section and reduction in instrument usage.
Many other outcomes are either uncertain or seem unaffected by the care provider. There was no data for maternal health, including maternal mortality. In conclusion: For the women who were in these trials, midwife care shows some slight advantages and no disadvantages.
What is very good about these studies is that they are randomized. What is much less good is that they are all run outside of the United States, where the alternative care models, financial models, and risk profiles are different. We do not have any randomized data from the U.S. Studies we do have in this country are observational, meaning they compare women who choose an OB-GYN with those who choose a midwife.
In studies like that, I worry about differences — observed and unobserved — in the patient groups. Generally, these studies suggest large benefits to midwifery care. Among the better examples is this paper, which analyzes data on over 20,000 low-risk births at a single hospital in Washington State. The two groups — those with a midwife and those with an OB — are broadly similar on observed demographics, and the paper finds much lower C-section rates (30% lower) in midwife-attended births.
This would suggest that the randomized data understates the benefits of midwives, but, again, it’s hard to know by how much. Further, some of the more direct policy questions in this area aren’t addressed at all in this research. Organizations like BirthFund have emphasized the need for more available midwife care for Black women in the U.S. This evidence does not speak to the impacts of midwives for that group, and it would be valuable if we had data that did.
There is narrative work on the potential of midwifery care for Black women — notably, this excellent review on the history of care and the possible role in encouraging more prenatal visits. Studies, either observational or randomized, are more limited. There are ongoing studies of women with more complications and women in poverty, which should help fill in these gaps in knowledge.
The bottom line
The evidence on midwife care is very encouraging. It isn’t surprising that the share of births with midwife providers has gone up in the U.S. over time. It is not going to be for everyone, but it should be a consideration for a larger share of women.
In my view, though, as or probably more important than the type of provider you choose is who you feel is a fit for you. In my own (N=2) experience, I had one birth with an OB provider and one with a midwife. My midwife experience was better, but I attribute this far more to having found someone I felt comfortable with. My current primary care doctor is an OB, and my co-author on The Unexpected is trained as an OB and an MFM. I am confident that if I had given birth with either of them, the experience would have been just as good.
Primary takeaway: it’s worth being open to a wide variety of providers, and finding one who works for you. If you do want to explore finding a midwife, this website may help.
I am very grateful to Ann Ledbetter, CNM, for helpful comments on a draft of this post.
Did you consider a midwife for your care or see a midwife during your pregnancy/birth? What was the experience like for you? Join the conversation in the comments.
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Midwives provide most of the care for pregnancy and childbirth in Australia. I am quite surprised this isn’t the case in the US! There are different models of care depending on your location and preferences but all births are attended by midwives and a doctor only attends if you have engaged a private OB (I did for my first) or there are complications. Had two amazing midwives help deliver my second baby and a doctor only came afterwards to give me a few stitches. Almost all of the midwives I encountered were absolutely amazing and they are supportive of low intervention vaginal births as much as possible.
With my first pregnancy, I exclusively saw the OB’s in my mixed provider practice, mainly because I didn’t know about the option to see midwives. But lo and behold, when I went in to be induced due to high bp, the head midwife was covering L&D almost all week and she caught my baby. So I feel like that was a mini randomized experiment lol. Obviously it’s impossible to know what the alternate universe would have been if an OB had managed my delivery, but I loveddddd my experience with the midwife. Even just the warm bedside manner and focuser attention on me as a “person” not just a patient went a long way to make me comfortable. Needless to say now with my second I requested to see the midwives in addition to OB’s.
The GW Midwives in DC require that you be in perfect health, have a very low risk pregnancy, have a very restrictive diet, and do a lot of exercise each day: https://gwdocs.com/specialties/midwifery-services I didn’t meet many of requirements which worked out ok for me since I ended up having a 3rd degree year from my baby’s 99% percentile sized head and a postpartum hemorrhage from my huge fibroid. Thankfully my OB team saved my life and had enough blood for my two blood transfusions. When I arrived to the hospital for my induction a midwife happened to be on call to do the rounds and she told me that I could eat whatever I wanted but when she left the nurse told me to ignore what she said because I wasn’t allowed to eat anything except a liquid diet.
Edit: year = tear
Kaiser Permanente in Honolulu, Hawaii, has a state of the art labor and delivery system that is centered around midwifery care. Each birth team includes CNMs, an RN, and there is only one OB on staff. I delivered two children there with the care of their midwives. One labor was long and arduous (36 hours) with a posterior 9+ pound baby and for the second, I opted for induction. Even with the induction option, they respected my wishes for as minimal medical intervention as possible (e.g. low dose pitocin vs increasing levels quickly). It was clear that the midwives had delivered 100s/1000s of babies vaginally and were so experienced in caring for the laboring patient, providing thoughtful cervical exams and actually listening and reading the birth wishes. I wish every hospital operated in this way.
Two wonderful births with a midwifery group associated with the hospital here in Oregon and they were both great, one induction with epidural and one non medicated birth where I delivered standing up! In both I felt cared for and respected for my wishes, also lots of coaching to help with baby positioning during labor and helping offer labor positions that hope to help reduce tearing in both instances which I really appreciated. I continue to see them for my gynecological care and can’t say enough good things about my experience.
I applaud you for highlighting the option and potential benefit to working with midwives!
For context, I’m in the US, NYC area, had my first child with midwives for prenatal care and the birth. It was fantastic, and I’m now with number two and sticking with them for it all! The visits were personable, not rushed, and they focused on educating so I felt involved with the pregnancy (as opposed to it just happening to me). The birth was low intervention and they brought up options in advance so we had a thought out plan with built in plan B’s. I felt safe, supported, and empowered by the whole experience and would highly recommend seeking it out if that resonates with you.
I think we think of pregnancy/birth as something that happens to you and you just survive through it, but it can be more than that. Staying aware of what your body is achieving throughout pregnancy and working with it as opposed to against it during labor can give you personal growth and strength to carry you through the postpartum believing in yourself as a new mother.
I chose a midwife for my first birth because I wanted an unmedicated birth. The midwife team I worked with was hospital-based but very supportive of unmedicated and low-intervention births. I was so thankful for my midwife because I ended up pushing for about 3.5 hours before naturally delivering my (almost 9 lb) daughter. Throughout the pushing phase, I kept saying “I don’t know if I can do this, maybe I need a C-section” but my midwife kept calm and told me everything was going fine and a C-section wasn’t necessary. Because of her experience with natural births, I was able to find the strength and confidence to vaginally deliver. With an OB, I’m sure they would have been much more likely to suggest a C-section in my case because of the long pushing and large baby, so I’m happy I was able to avoid that!
I had a CPM for prenatal care during my first pregnancy. Unfortunately I had to transfer to a hospital for an induction after my water broke but I didn’t go into labor. It ended with a c section after classic cascading interventions. The c section was very traumatic and I will never forget how rude and dismissive the OR team and the OB I saw afterwards were. I opted for a CPM and a homebirth for my second baby. The contrast in care during labor was really striking. My second baby needed some help getting into position, too, but my CPMs were able to resolve the issue through positioning and patience. In the hospital, the same issue immediately started talk of how long it would be before I needed a C-section. It was a fascinating experience in a physiological approach to birth vs. a medicalized approach to birth. I’m very grateful I live in a state where it is legal for women to have out of hospital births after C-sections and legal for CPMs to attend them.
Love that midwives are being highlighted as are a great option that many Americans seem unaware of, and can lead to great outcomes. For us, a conservative couple who didn’t have any friends using midwives 15 plus years ago, we ended up switching from OB to midwife in San Francisco as OB thought I was crazy to do a birth not on my back and/or natural. Ended up having a non epidural but induced and vacuumed midwife attended birth ordeal in hospital and pretty sure it would have been a C-section if no midwife, or doula! She was awesome, esp for our first birth. Second birth in Denver was a midwife attended natural water birth in the hospital. Third birth was in a hospital we wanted to use in southern CA but they barred midwives at that time but we thought we knew the routine by then and went ahead with an OB and like many have said, not so great an experience. For our fourth birth we chose a midwife and birthing center but they counseled me to an OB and hospital when I went over the due date and cause I was 40. It went ok and all was fine in the end, but the doctors insisted I stay trapped in the hospital unless I sign many legal papers to go home after one night. So another thing to think about is how doctors might treat you differently after the birth- it was all legalese and very disruptive to bonding and sleeping, in our experience. A birth center with a midwife will likely get you home quicker. And I recommend Ina May Gaskin and other authors discussing midwives and more natural births – was so eye opening to other cultures and practices and how there are good and different ways to go about childbirth.
One other comment: this post makes me think of my mother’s pregnancy with me. Our family was in Ithaca, where the 5 OBs there were collectively known as the 50 fingers. Yeah, not complimentary. She got such terrible care there that she eventually sought midwifery care across state lines.
I internet searched and was able to find one blog reference to the 50 fingers, so I know this was a term commonly known locally at that time.
I used hospital-based midwives for both my births. I’m glad I did, but I’m not sure it was that different than finding an OB group you like. I was somewhat surprised the post-partum visit was so brief. I thought we were going to unpack the births and analyze them at length. Instead it was a pro-forma check of healing and a lot of insistence on depression screenings. Overall I was fine with most of the midwives but they weren’t so touchy-feely that they all uniformly paid attention to the (controllable) things most important to me (thinking of the multiple providers who contributed to screwing up my strong preference not to find out the sex until birth, both times, and the non-stop harping on my supposedly being too thin).
I just wanted to recommend the book The Pull of the Stars by Emma Donoghue. It is a phenomenal book that takes place in a maternity ward during the Spanish flu epidemic in Ireland and follows a midwife as she navigates the way that the pandemic (a century before the one we just lived through) affects the health of mothers, particularly those already suffering from poverty. It is uncanny how it presages the experiences we just lived through in the Covid pandemic, and is an insightful historical picture of midwifery within hospitals a century ago. I’m teach literature at a university, and I teach this book in my courses, where it’s always a favorite.
I also enjoyed that book!
My OBGYN practice has a mix of midwives and doctors, and the hospital I delivered at uses midwives for most deliveries, unless a c-section is necessary. I went into pregnancy with a tremendous amount of medical anxiety, and ended up having several minor pregnancy complications, including preterm contractions. I found the doctors I met with to be brief, impersonal, and dismissive, while the midwives actually listened to me, followed up, and eased my anxieties. When it came time for delivery at the hospital, the midwife on call (whom I had not previously met) made the entire experience wonderful. She was calming and encouraging, as well as extremely capable. She did everything she could during pushing to help prevent me from tearing (successfully!) and stopped my hemorrhaging without complication. I was induced at 41 weeks and had an epidural, but despite being medicated in a hospital setting, my experience felt very personal, non-medical, and beautiful. I have continued to see the midwives in my practice for my standard GYN visits as I feel most comfortable with them.
I feel so passionately about midwifery care!! I had my first baby 2 years ago and appreciated the more personal, holistic care I got with my midwife. I ended up needed an emergency C-section but my midwife was there with me the entire time as well as afterward in the hospital. I’m in Ontario, Canada and they also do home visits for the first week or 2 weeks (can’t remember), and my midwife even increased my visits because I was recovering from surgery and also having breastfeeding/baby weight gain problems. And then both YOU and baby (not just baby!!) receive post-natal care until 6 weeks.
I’m pregnant with my 2nd now and have elected to have midwifery care again, but will have to have a scheduled c-section and an OB just for surgery. My midwife will be there for surgery and after 🙂 I also agree with another commenter that it’s important to find a midwife who you jive well with. I’m a big believer in following the data and so was my midwife. Some of them are a little too “woo woo” for me and I wouldn’t have liked someone like that for my care.
I went with midwives, gave birth in a hospital, and had a great experience (Minnesota, US). Our local clinic has a midwife team- there were 6 midwives on it when I was pregnant, and you had whoever was on call when you have birth. They made sure you saw every midwife on the team over the course of your prenatal care, so whoever you gave birth with was someone you had at least met. I ended up being induced at almost 42 weeks, and I did get an epidural. I felt very supported in my choices and informed about my options, and the prenatal care was great.
I went with a midwifery practice and doula for my first baby born in 2020. I ended up having life-threatening complications and needing an emergency C-section that was incredibly traumatic. Because it was during the pandemic, my doula could not be there in person and was not helpful once things took a turn for the worst and became very medical. However, the midwife on call stayed with me throughout the C-section, which was a lifesaver because my husband wasn’t able to make it through the whole thing. In an emergency situation, the room was filled with medical personnel but it felt like the midwife was the only person that was there to support me. I credit her with helping me make it through the experience – it would have been even more horrific without her there. My second was a scheduled C-section but my OB practice had a midwife so I chose to see her for many of my appointments. In my experience, midwives feel more focused on the human element of the experience of pregnancy and childbirth; you feel more like a person and mother with them, rather than a patient.
I was cared for by a midwife practice within a teaching hospital. Excellent prenatal care, thankfully no complications. The midwife on duty attended both births which were by C-section
1st child was breech (I was 39 years old)
** followed by a miscarriage at 12 weeks **
then twins born when I was 42 (multiple factors ruled out VBAC)
Great experience all around!
I had an OB and a doula for my first, and am using the same providers now for my second. My OB is wonderful, experienced, encouraging, and supportive of my goals to have minimal interventions. With my first, I pushed for 4 hours and she never even mentioned any interventions as baby and I were both fine. She’s part of a practice that does a lot to ensure your OB is at your delivery, but I know it’s not a guarantee. I like the other providers I’ve met, but having our doula is important to me. I like knowing there will be one experienced person who we know will be with us, she also knows my OB, and is a resource for more care both pre and post natal which I value. If I didn’t have such a wonderful OB, a midwife is absolutely something I would consider. I think like Emily ended with, being with a provider you like and trust is really important.
For my first pregnancy and birth, I used midwives in a hospital setting, and had a very positive experience. I felt as if my goals for pregnancy and birth were closely matched to their practice’s, and even during the height of the pandemic I felt well cared-for.
The practice sadly fell apart in the interim between my births, so I used OB/GYN care for my second pregnancy and birth. This experience was very different. My goals and the goals of my practice were not aligned, and much of the time was spent fending off their insistence on interventions that weren’t supported by data or my specific circumstances. Lacking trust that my preferences would be heard and valued was an exhausting experience.
I can’t speak for all providers and provider types, but my experiences were very different and gave me the impression that midwives are providing more holistic care to both mother and baby while OB/GYNs are mechanics interested in eliminating risk at any cost. I don’t plan to have a third, but would seek a new midwifery practice if I did!
As a norwegian, this was a baffling read! Here midwives are the standard, you see them during your pregnancy and they’re usually the ones present during birth. Doctors are on call for C-sections, I believe our C-section rate is about 15% last I read, with only 1/3 of those being planned. I had an emergency C-section, and was cared for by midwives and nurses before and after. They were all great! Here it seems there are so few doctors, and they are super busy since they have to run all over the building (I mean, also true for midwives and nurses).
Also just compared the education needed, here to become a midwife you need a bachelor in nursing + at least a year of practice, then 2 years of education in pregnancy care, birth help and women’s health. Afterwards you can also get more education for ultrasound (also mostly done by midwives), breastfeeding guidance, acupuncture and more.
I was under the care of midwives (just had my baby in May) and it’s my first pregnancy. I was intent on the “least hospital like” birth I could have (but had to be in the hospital due to some placenta complications).
I had a lovely experience and felt very cared for. Midwives are intuitive and listen to those instincts in a way that I trust more than some experiences with medical professionals who seem to follow some kind of checklist.
One thing I will say is that not every midwife is built the same. You might still find midwives that you don’t jive with (the attending midwife for the beginning of my labor was one of those and I didn’t have an excellent experience, but luckily shifts change). Just as you should shop around for an OB that you feel comfortable with, if that’s your choice, know that you might have to do that same shopping around for midwives.
I wish we had more research into additional outcomes of wellbeing on midwives. I delivered with midwives at a hospital, and in many ways did not have the ideal birth. I was not induced but I was in labor for a long time (31+hours), had an extended second stage (pushed for 3+ hours), had a 3rd degree tear and needed an episiotomy. But, the care I received from the midwives throughout was compassionate, dedicated and comforting. As various interventions became needed, I was asked and consulted throughout. My provider gave me the option on the episiotomy, while clearly explaining why she felt it was necessary. Because of the 3rd degree tear, the OB on call did some of my stitches, a transition that was totally seamless (midwife was with her the whole time, they stitched together). There was also a moment where it seemed a vacuum might be needed, and I know that the midwife would have stayed with me through that, even though the OB would have been in the lead.
My recovery was hard, 3rd degree tears are no fun at all. But I feel much more at peace with how my birth went than I would have with a more rushed, typical US OB practice. My midwife helped me throughout to avoid interventions, by helping me be in different positions, letting me push not on my back, massaging my perineum, etc. Ultimately, my baby wasn’t well positioned and had a big head. I know it’s hard to measure these sorts of outcomes, but to me the greatest advantage of working with midwives was the trust I built with them through my prenatal care, and the comfort I felt even when my delivery didn’t go as planned.
In my firs pregnancy, I switched from OB to a midwife practice around 35 weeks. I did not feel listened to or reassured at my regular OB office. All my prenatal care visits felt rushed, and I had so many questions. I am the kind of person who likes to plan as much as possible and know as much as I can before having an experience. I was feeling more and more uneasy, and finally the OB said I just needed to trust them. That was NOT a good answer for me. She said, and this part was true, that I needed to trust whoever I was seeing, and if I didn’t, I should switch providers. I called my mom in tears when I left, because at that point I absolutely felt I needed to switch, but was worried it was too late and how did I even find a midwife? I did find a practice of midwives that would deliver at a hospital (that is what I needed to feel safe) that was farther away and used a different hospital than I was registered for, but it was worth it. My visits weren’t rushed – they wanted to talk to me about things as insignificant as what to pack for the hospital (iced tea – a great suggestion), and gave thoughtful answers as to what would happen if part of the placenta was stuck inside (it had happened to my mother), while giving me the perspective of them seeing it maximum once a year and they do x number of births a week. It was so much more personal and exactly what I needed to be able to trust them. For my second pregnancy, I started with them immediately. One of them and I had a whole chat about being birthday buddies! I have many friends who are doctors, and have a lot of respect for them and their grueling education and residencies, but what doctor has time to chat with a patient about being birthday buddies?!
(This was in NJ in the U.S.)
I used a midwife for all of my prenatal care, most of my laboring, and then had to last minute switch to the OB team for vacuum birth. I also showed up as a high-risk labor with surprise preeclampsia. Even though I was no longer under their care, the midwives stayed with me through the rest of labor and delivery, and made several visits during my hospital stay. The OB team after delivery was useless with little to no follow up care and bad attitudes and poor judgements. This was in Michigan and all of 2020. I currently live in a state that doesn’t allow midwives for birthing (PA, need to confirm if true) and that puts another check in box for no more kids. My SIL just had a baby with an OB team her pregnancy and the mismanagement and lack of information given to her astounds me.
PA resident here! Just had a wonderful hospital birth in Pittsburgh with a midwife group – Midwives at Magee. I believe AHN also has midwifery options but not at every hospital.
Based on my sisters experiences before me, I opted for a midwife for delivery from the start. My ob practice didn’t have any midwife’s but the hospital I was delivering at had several on staff. I chose to deliver with whatever midwife was working at the time of my delivery instead of using my OB/Gyn despite having never met her before. It was a great experience overall. I have nothing to compare it to but I would definitely do it again. Where I live I haven’t found many OB practices with midwives however most of the hospitals have them as an option for delivery. Note- I am in the US
I was almost taken aback to read that midwives were somewhat of an unknown for many women in the US! I had my first baby in Ireland & have had two more in New Zealand. The model here in NZ is completely midwife lead. When you find out you’re pregnant you go to a website called ‘Find My Midwife’ and choose someone who you think may suit you and your wishes. They only refer you to a GP or suitable hospital doctor if there is any need or risk but even then the majority of women will remain with their midwife right up until 6 weeks postpartum. It’s a really lovely system where you build a relationship with the person who is going to bring your baby into the world. They also visit your home often during that first week postpartum and for the next 6 weeks. This meant a lot to someone living at the other side of the world to their family. In Ireland, midwife lead care does exist as you have mentioned in that study but it’s not the main system in place. My experience having my first child was quite isolating there as I was meeting a different doctor/ midwife at each visit and therefore it felt as if it lacked continuity of care with each professional just ticking a few boxes at a checkup rather than following how the mother was actually doing in an overall sense.
Thank you for all your interesting, meaningful and engaging work 😊