Medically reviewed by [Name, credentials] on [date].
This article is for general information and is not medical advice. Every pregnancy and every baby is different, so talk with your own doctor or midwife about your situation. If you think you or your baby need urgent care, call 911 or go to the nearest emergency room. Read our medical disclaimer.
One of the first decisions you will make after a positive pregnancy test is who will care for mother and baby for the next nine months. For most couples in the United States the choice is between an obstetrician-gynecologist (OB-GYN) and a midwife. Some family physicians also deliver babies, especially in rural areas.
There is no single right answer. Both can provide excellent care. The right choice depends on your health, your hopes for the birth, where you want to give birth, and the people available in your area. This guide explains the differences so you can make the decision together.
What an OB-GYN does
An OB-GYN is a medical doctor (MD or DO) who has completed four years of medical school and a four-year residency in obstetrics and gynecology. They are surgeons, trained to manage complications and to perform cesarean births.
An OB-GYN is usually the right choice if:
- You have a chronic health condition, such as diabetes, high blood pressure, a heart or kidney condition, or an autoimmune disease.
- You have had complications in a past pregnancy, such as preeclampsia, a preterm birth or a previous cesarean.
- You are expecting twins or more.
- You want or expect to need an epidural, induction or planned cesarean, and want one physician involved from start to finish.
For very high-risk pregnancies, your OB-GYN may refer you to a maternal-fetal medicine (MFM) specialist, sometimes called a perinatologist, who has extra training in complicated pregnancies.
Keep in mind that in a busy group practice you may see several doctors over the course of the pregnancy, and the one who delivers your baby is whoever is on call that day. If continuity matters to you, ask about it.
What a midwife does
Midwives specialize in normal, low-risk pregnancy and birth. They tend to spend more time at each visit, and they see pregnancy as a natural process to be supported, stepping in with medical help when it is needed.
In the US, “midwife” covers several different credentials, and the differences matter:
- Certified Nurse-Midwife (CNM): a registered nurse with a graduate degree in midwifery, certified by the American Midwifery Certification Board. CNMs are licensed in all 50 states, can prescribe medication, and most work in hospitals or birth centers alongside physicians.
- Certified Midwife (CM): has the same graduate education and certification exam as a CNM but is not a nurse. CMs are licensed in only a minority of states.
- Certified Professional Midwife (CPM): certified by the North American Registry of Midwives, with training focused on out-of-hospital birth at home or in birth centers. CPMs are licensed in many states but not all.
A midwife may be a good fit if:
- Your pregnancy is healthy and low-risk.
- You hope for a birth with fewer interventions, more freedom to move in labor, and more time with your provider.
- You are considering a birth center or home birth.
A good midwife knows the limits of her practice. Ask how she works with physicians, and what happens if a complication comes up. In a hospital, CNMs can usually call on an OB-GYN within minutes. Out of hospital, there should be a clear plan for transfer.
Side by side
| OB-GYN | Certified Nurse-Midwife | Certified Professional Midwife | |
|---|---|---|---|
| Training | Medical school and 4-year residency | Nursing degree and graduate midwifery program | Midwifery training, apprenticeship or school |
| Best for | Any pregnancy, including high-risk | Low-risk pregnancy | Low-risk pregnancy |
| Where they deliver | Hospital | Mostly hospital and birth center, some home | Home and birth center |
| Can perform cesarean | Yes | No (works with physicians) | No (transfers care) |
| Can prescribe | Yes | Yes | Varies by state, usually limited |
| Typical visit length | Shorter | Longer | Longer |
A word on faith and conscience
For many Christian couples, a provider’s values matter too. You do not need a provider who shares your faith in every detail, but you do want one who respects it.
Some questions bear directly on conscience. Prenatal screening, for example, is often offered as routine. You have the right to understand what each test is for and to decline any you do not want. If you have convictions about these matters, or about contraception, sterilization at the time of a cesarean, or anything else, raise them early. A good provider will listen and answer plainly.
Some couples look specifically for a pro-life or faith-based practice. Organizations such as the American Association of Pro-Life Obstetricians and Gynecologists, and directories of NaPro-trained physicians, can help you find one in your area.
Questions to ask at the first visit
Bring these to your first appointment or an interview visit. Husbands, this is a great job for you: take notes.
Questions for any provider
- How many providers are in the practice, and how likely is it that you will deliver our baby?
- Where do you deliver, and can we tour the birth setting?
- What is your cesarean rate, and your rate of inductions?
- How do you handle a pregnancy that goes past the due date?
- How do you feel about birth plans?
- What would make you transfer care or consult a specialist?
- How can we reach you after hours?
- How do you respond when patients decline a test or procedure for reasons of conscience?
Extra questions for a midwife
- What are your credentials, and are you licensed in this state?
- Which physicians and hospital do you work with if we need to transfer?
- What equipment and medications do you bring to a birth?
- How many births have you attended, and how many transfers have you had?
Can you switch later?
Yes. Many women change providers partway through pregnancy, and it is never too late to ask for a second opinion. If you start with a midwife and a complication develops, she will help transfer your care. If you start with an OB-GYN and find the practice is not a good fit, you can move, ideally before the third trimester so you have time to get to know your new team.
Deciding together
Sit down together after your visits and talk through what you each noticed. Did you both feel heard? Did the provider answer questions directly? Did they treat the father as part of the team?
Then pray about it. A decision like this is worth bringing to God, and you can trust that whichever good provider you choose, he goes with you.
Once you have a provider, the next decision is where to give birth. Our guide to hospital, birth center and home birth walks through the options.
