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Birth choices: Should you use an obstetrician or a midwife?

From free birthing to water births to an in-hospital suite decked out with candles and soft music, the options available to pregnant women these days are plentiful. Many mothers ponder the pros and cons of using a midwife versus an obstetrician, as public opinions touting which choice is best are also in abundance. So, we’re attempting to help you cut through the clutter.

Pregnant woman with midwife

As well as deciding whether you want to use a midwife or an obstetrician for your baby’s birth, you’ll also likely give thought to other factors surrounding the big event: vaginal delivery or caesarean? In hospital or at home? Water birth or on dry land? Go drug-free and natural, or reach for the epidural?

Your preference in these areas will often inform your decision when it comes to which health professional to use. Before you decide which option is right for you, it’s worth taking the time to understand the exact difference between an obstetrician and a midwife.

The main differentiating factor is that midwives are trained to deal with women who have a normal, uncomplicated, low-risk pregnancy. On the other hand, obstetricians have gone through extensive training to ensure they can handle a range of birthing situations and any complications that may arise.

The case for midwives:

The World Health Organisation (WHO) recommends that midwives be seen as the best caregivers for healthy women with normal pregnancies. Midwives provide specialist care, education and support during pregnancy, birth, postnatal and the early parenting period. Importantly, midwifery care includes the detection of complications in mother and baby – and the subsequent referral to other specialists, when necessary.

On the other hand…

If you opt for a midwife-assisted birth, you may wind up in a team midwifery system, whereby no continuity of care is assured: in other words, you are cared for by a team of midwives throughout your pregnancy, labour and birth, each of whom may offer differing advice, strategies and support. Some hospitals offer special midwife-run clinics and birth centres, or you may be able to see one midwife who manages your case the entire way through. It’s best to check with your selected hospital early in your pregnancy to ensure their policy matches with your preferences.

The case for obstetricians:

These specialist doctors are trained in the management of complicated pregnancies and births, so they are the go-to experts on everything related to the safe arrival of your precious baby. A private obstetrician provides prenatal care at private rooms, rather than in the maternity ward, and they will be closely involved in your care during labour (even though they may not be present for all of it).

On the other hand…

As medical specialists, obstetricians offer a premium service, so you can bet they charge a premium price tag. Obstetrician appointment fees are usually around $100 for a 15-minute session (part of these fees can be claimed back through Medicare) and you’ll meet with them every month, and then as your pregnancy progresses, every fortnight, then every week.

The real costs kicks in for the delivery of your bundle of joy, when an obstetrician may charge a “delivery” or “management” fee. This can range from $1,500 to $5,000-plus, and only a small portion can be claimed back through Medicare and private health insurance. This means that even with insurance, you’ll be financially out of pocket using an obstetrician, which is why the choice between midwife and obstetrician is often a financial one.

Which is the best option?

Ultimately, the decision rests with you and will be based on a range of factors, including your pregnancy risk and your financial situation.

One final consideration may be using a doula, which is a carer who is not necessarily medically trained, but who is present for the birth and offers support to the mother. They make sure that your preferences are followed, any medical jargon is explained, and the best interests of your baby are taken into account.

More pregnancy tips

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Tips to stay fit while pregnant
Answers to common pregnancy questions

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