Midwife vs Obstetrician, which suits you best?

First of all, it’s not actually Midwife versus OB, we are team-mates not adversaries! Although you need to choose which type of provider will manage your care, we work together as a team to deliver the highest level of care to birthing people in our city. Obstetricians are skilled surgeons who specialize in high risk pregnancy. Midwives specialize in caring for healthy people from the beginning of pregnancy through to 6 weeks after the birth including the care of their newborns. The Hamilton Midwives has great relationships with the OB team at St Joe’s so if complications arise, each client gets the type of care they need with no barriers to access.

So to highlight the differences between Midwifery and Obstetric care, here are 10 reasons why Midwifery care may be right for you.
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​You want a vaginal birth

• The rate of cesarean section in Ontario is 29%. Ontario Midwives’ cesarean section rate is only 20% which is about a third lower. If you plan to birth your baby at home, the chance of c/section is only 7% which is 76% lower than the provincial average, even if you end up delivering in the hospital!
• ​Check out more stats: Midwifery by the Numbers

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You want a known care provider looking after you in labour

• There is a greater than 90% chance that the midwife who will care for you in labour will be a midwife who cared for you in pregnancy. There are approximately 12 OBs working at St Joe’s and they all take turns covering the birthing unit. This means that it is not very likely that your doctor will be on call the day you go into labour or get induced. ​

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You want someone whose only job is looking after YOU in labour

• One-to-one care in labour is something that sets midwifery care apart. The midwife who attends your birth will have no other responsibilities while they are looking after you
  
• The physician-led model depends on a team of nurses to provide most of the hands-on care so that the doctor can oversee the management of everyone in labour and in the triage department. When you choose an OB, you will have to share their attention with all the other patients on the ward the day you give birth.
  

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You want home visits after the birth

• Caring for a new baby while your body is healing from the birth is tiring and emotional. Midwives provide all the healthcare you and your baby need in the first 10 days to 2 weeks in the privacy and comfort of your home so you don’t have to bundle up your baby and go out to the doctor’s office.
  

You want longer appointments with more opportunities for questions, individualized care planning and support

• Midwife appointments last 30-60 minutes in pregnancy (and take as long as necessary in the postpartum) and we spend lots of time doing health teaching, discussing your plans and wishes, and answering your questions. A full-time OB cares for about 400 clients a year and a full-time midwife cares for about 40. The physician model is built on spending a little bit of time with many patients while the midwifery model is based on spending lots of time with their clients and  giving individualized care. These longer appointments with a small team of midwives are a great opportunity to build a relationship of trust with your midwives.
  

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You want access to your care provider 24/7

• The midwives of THM are available to you at all times if you encounter an emergency or urgent situation. All clients have access to the paging system and will use it in labour, if the water breaks, there is vaginal bleeding or if the baby is ill etc. OB patients are always welcome to present to the hospital if they have an urgent concern but many times midwifery clients can save themselves a trip to the hospital on discussion with their midwife. You may receive advice on comfort measures at home, what to look out for and when to page back or you might be offered a home visit or a checkup in the office.  Although we must reserve the pager for urgent concerns, your midwife is never farther away than the end of the phone if you need her.

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You want to avoid an epidural in labour

• Obstetricians are highly skilled surgeons and their expertise is managing high risk births.
  
• Midwives specialize in normal birth and are highly skilled in facilitating physiologic birth for their clients. We have skills and experience coaching people through the challenge of labour with and without medications for pain relief. Because we care for a smaller number of clients, we can be present throughout the entire active labour giving as much support as is needed. Clients can access epidural if that is their choice, we are trained and experienced in medicated births as well.
  
• For those choosing home birth with THM, we offer nitrous oxide (laughing gas) for pain relief in labour. This works by taking the edge off and giving a feeling of wellbeing.
  

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You want to breastfeed/chestfeed or give your baby your own milk

• Midwives are skilled at providing hands-on teaching and support for clients as they learn how to feed their baby.  We check in on babies frequently in the first week of life to ensure that feeding is going well.  Breast/chestfeeding is natural but it's also a skill that parents and babies need to learn so it’s great to have midwifery support available to help you deal with any challenges.  Midwifery clients have a greater than 90% chance of successfully breastfeeding versus the provincial average of only 60%!
  

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You don’t have OHIP

• Midwives provide care at no cost to any resident of Ontario that needs it. Obstetricians bill OHIP for their services so those without OHIP have to pay for OB visits.
• The only out of pocket expense that a midwifery client without OHIP should expect is the cost of a hospital stay. Home birth is always free. Newcomers especially might be interested to know that The Hamilton Midwives provides free phone or in person translation to clients who need it.

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You want efficient care

• Midwives’ clinics are usually running on time. If we get 20 minutes behind that is really running late! We are able to stay on schedule because of lower client volumes and longer appointments which give us enough time to get everything done. With a midwife you will usually have a short wait and a long visit and with an OB you’ll often have a long wait for a short visit. In the hospital, you will spend less time waiting as well. Because the midwife is the one making the management decisions, we can get you in and out of triage much quicker than when you go the OB route where you see a nurse first, they bring the case to the OB resident and then the OB staff needs to sign off. Remember the OBs are juggling all the patients on the ward while your midwife will usually just have you in triage.
  

And one more just for good measure!
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You are interested in labouring at home before going to the hospital ​

• ​People who want a home birth know that a midwife is the care provider for them. But did you know that most midwifery clients choose a hospital birth? Those planning a hospital birth can opt to have their midwife come to the house first to spend some time labouring at home. They may choose to stay home just for a little while, and others like to stay home as long as possible and move into hospital when it’s time to give birth. It’s your choice whether your midwife works with you at home or in hospital or both. Either way, you will have the comfort and security of knowing your midwife is with you and is skilled at dealing with emergencies in all settings. For people who want a hospital birth, staying at home as long as you feel comfortable is a great option.