Choosing an OB-GYN or Midwife

If you are already pregnant and do not have an obstetric provider (or if you have one but feel it's not a good match), begin your search as soon as possible. When you call, let them know you are pregnant. They may bring you in immediately or ask you some questions over the phone and schedule an appointment in a few weeks' time.

Medical Training

Obstetrician-gynecologists are physicians who have completed four years of medical school and an additional four-year obstetric residency program. They take a written and oral exam to become board certified by the American College of Obstetricians and Gynecologists. Some OB-GYNs undergo additional years of training specializing in areas such as reproductive maternal-fetal medicine, endocrinology (infertility), and gynecologic-oncology (cancer of female reproductive organs).

Certified nurse midwives are registered nurses, the majority of whom have completed an additional two years master's program in midwifery. As a part of their studies they are required to complete a program of clinical training. CNMs must pass a certification exam to be certified by the American College of Nurse Midwives (ACNM) and are licensed in the state where they practice.

What Exactly Is a Certified Nurse Midwife?

The word midwife derives from the Anglo-Saxon mit wif meaning "with woman." CNMs regard birth as a natural, albeit challenging, experience rather than a medical condition in need of a cure. Nurse-midwifery is legal in all 50 states and the District of Columbia.

"The focus is on prevention, on emotional support, and on health and wellness," says Lisa Summers, CNM, DrPH, senior technical advisor at the American College of Nurse Midwives in Washington, D.C. "If you want someone to support you in making your own decisions about your birth, then midwifery care might be a good match for you."

Certified nurse midwives offer women the same nonsurgical, gynecological, and obstetrical services as an OB-GYN. These include annual gynecological exams, full-spectrum prenatal care with all tests and screenings, birthing privileges at hospitals and birth centers, and postpartum follow-ups. While not averse to the use of pain medication, most CNMs favor other relaxation and pain management techniques such as deep breathing, massage, visualization, varying a woman's position during birth, and laboring in a warm bath.