Midwife or OB?

Expectant mamas in the low-risk category have a big choice to make when it comes to who will be providing their prenatal care. There are two schools of thought when it comes to prenatal care. The 'Midwifery Model of Care and the Medical Model of Care. They can be as different as apples and oranges when it comes to birth philosophies. In the Midwifery Model of Care, the focus is on health, wellness and prevention. It is generally a more holistic view. Care is typically more individualized, patients are often called "clients" and feel like their care provider is really invested in their goals for their birth. I had a girlfriend that said it best about how it feels after a prenatal appointment with a midwife, "It's like I just spent an hour with a friend and she just happened to be able to check on my health and the baby." Midwives traditionally believe that birth is a normal, physiological process, and that the mother gives birth, they are just there to observe and assist her if needed. Midwives also usually have lower rates of intervention use during labor, and a MUCH lower cesarean rate. In stark contrast, practitioners in the Medical Model of Care, focus on managing problems and complications and their symptoms. They typically have higher rates of using interventions and cesareans, and care that they provide is routinized. They believe that labor and birth is dependant on technology and that the doctor delivers the baby, not mom. Of course there are practitioners that cross party lines. There are OB's that are very progressive and are closer to the Midwifery Model of Care than the Medical Model. And there are midwives that are more medical, nicknamed "med-wives." So what is a girl to do? Well, to help make this decision, you need to figure out where you stand on birth issues, to make a plan, a birth plan. Do you want to have an epidural or give birth without any medications? Are you all right with an induction? Do you want to be able to move freely during labor? In what position might you want to give birth? These questions are a good start, and you need to have a frank discussion with your provider about their opinion on your major issues. Do research on the interventions, and on movement and positioning in labor and giving birth in the traditional lithomy (lying on your back) position. A couple of books that I recommend are Henci Goer's The Thinking Woman's Guide to a Better Birth, Active Birth by Janet Balaskas, A Good Birth, Safe Birth by Diana Korte and of course Ina May's Guide to Childbirth by Ina May Gaskin. Of course there are many more to read, (just peek at my recommended reading page under resources lol) but this a start. Once you figure out where you stand when it comes to these things, you can then start to find a practitioner who shares most-if not all- of your views. You need to prioritize what you want to stand firm on. Would you be ok with having your membranes ruptured (water broken) after a certain point but absolutely want to avoid an episiotomy? Know the issues that you can negotiate on with your provider if needed. If you are looking for a midwife in PA, two websites to start with are: www.pamidwives.org www.pennsylvaniamidwives.net You can search by county/location on both of those. Another way to go about it is to contact a doula in your area and ask if they can recommend a midwife or OB. If you don't know where to find a doula visit one of these sites: www.birtharts.com www.doulanetwork.com www.doulaworld.com Join a Holistic mom's group, if that suits you and talk to moms! www.holisticmoms.org to find a group near you. Finding the right provider is essential to getting the kind of birth experience that you desire.


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