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Choosing a Doctor or Midwife

If you are pregnant, you might be facing the dilemma of choosing a doctor or a midwife to take care of your prenatal care and delivery. There are several factors that go into choosing a doctor or a midwife including expectations of delivery, cost and preexisting medical conditions.

When you are deciding between choosing a doctor or a midwife, there are a few things you should take into consideration for both. A midwife and doctor both present different advantages as well as disadvantages of delivery and prenatal care. Ultimately, it is best to choose which option is the best for your expectations of how you want your pregnancy and delivery experience to be. For some, health care and previous health conditions are often the determinant for which option you decide. According to birthing statistics in the United States, only eight percent of women choose a midwife or to birth at home or in a birthing center. However, in other developed countries in the world like Japan and England, about 70 percent of women choose a midwife over a doctor. When you are trying to determine which option is best for you, it might be a good idea to have a preliminary interview with both doctors as well as midwives to figure out which you feel most comfortable with to handle your pregnancy and delivery needs. 

Choosing a Doctor - Pros and Cons:

There are many pros and cons to choosing a doctor or an ob-gyn to handle your prenatal and delivery needs. First of all, if there is a medical emergency with either the mother or the baby, the doctor will have the necessary tools and equipment to handle it on the spot. While there are no guarantees that a doctor is going to be able to solve the problem 100 percent, many women feel more comfortable being in a hospital with a trained ob-gyn there ready to attend to their needs. 

If you are a high-risk patient, ob-gyn's or doctors are often the only choice a woman has to receive medial care while pregnant. High-risk patients typically include a woman that is over 35, has had high-risk pregnancies before, has certain medical conditions that might make pregnant difficult or women that are carrying multiple babies. For those women, a doctor might be the better choice in case there is something that does go wrong at delivery. That is not to say that in some of these high-risk situations that a midwife is not an option. 

Traditionally, at least for the past 100 years, more women in the United States are choosing doctors to take care of their medial needs while pregnant and at delivery. In many cases, medical insurance companies will not insure midwife deliveries. Doctors,ob-gyn's and hospital births are the only type of prenatal care that is covered. For women that are concerned about their finances with a baby approaching, they might only be able to afford a hospital/doctor delivery, if that is what their insurance company offers. 

Some of the cons to choosing a doctor for your pregnancy needs include the amount of interventions that occur during delivery. Hospital's throughout the United States have an abnormally high cesarean section rate, about 1/3 of all hospital deliveries are C-Section. These are high-risk surgeries that are often unnecessary because doctors will choose to induce the pregnant woman into delivering for non-medical reasons. Before choosing your doctor, it is important to discuss how he/she feels about interventions during pregnancy like induction/C-Section, etc. 

Choosing a Midwife - Pros and Cons:

While this is a less popular option for many pregnant women, midwifery and home births are on the rise as more and more attention is being brought to the attention of the media in documentaries and films like The Business of Being Born. There are many advantages to using a midwife vs. a doctor including less medical interventions. Many women like the idea of being able to give birth naturally without an IV, medications, monitors and other interventions. For some, this also be a negative side to giving birth with a midwife if they want to have an epidural or other pain medication throughout the birthing process. However, some women like the idea of being able to give birth at home or in a birth center of a hospital or a free-standing birth center. These facilities are often more homey feeling and don't require you to wear a hospital gown or give birth laying down.

Other advantages of choosing a midwife is also the financial part of it. Some women might not have health insurance, or their insurance does not cover prenatal care. If this is the case, midwives are typically much less expensive - by the thousands of dollars - compared to a hospital birth without health insurance. Many other developed nations agree with the concept that birth is not a medical emergency, which is why America is one of the few countries that have the majority of births in a hospital. However, more and more women are beginning to see the advantages of going more natural. With a midwife, you can have the freedom to labor how you want whether that be standing up, lying down, walking around, in a tub of water, etc. There are much less options when it comes to laboring in a hospital. However, if you are at home or in a birthing center, you are not going to have an epidural during labor option available in most situations.  However, some midwives, like certified nurse midwifes are legally allowed to give some medications, local anesthetics, etc. 

Ultimately, the choice between a doctor and a midwife is up to the individual person. There are many pros and cons to both sides, and doing interviews with reliable and reputable ob-gyn's and doctors is the best way to get started choosing the option that is best for you.


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