Dr. Jacqueline Gerhart: Prenatal Care
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears weekly on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.
Dear Dr. Gerhart: I'm pregnant. What is the difference between seeing a midwife, a family doctor and an OB?
Dear Reader: Congratulations! This is going to be an exciting time for you. Let me outline the basic differences in prenatal care and the philosophies of midwives, family physicians and obstetricians. Remember though, that no two individuals practice prenatal care the same way or with the same philosophy. What is most important is for you to find a good fit for you and your family.
First, the similarities: All three are licensed in the state of Wisconsin to deliver babies. They all will work with you to determine the type of prenatal and birth experience you would like. All three can tailor your care to be as "hands on" or as "hands off" as they can - while keeping in mind the health and safety of you and your baby.
The differences: In addition to the differing educational training they receive, midwives, family physicians and obstetricians have different schedules. So be sure to ask who will be caring for you during your prenatal visits, who will deliver your baby and who will care for your baby afterwards.
Midwives are usually registered nurses who complete additional training in women's health and maternity care. They focus on offering a "holistic approach" to the birth process. Sometimes they work individually, but often they are part of a group. Therefore, you may see one midwife for your prenatal visits, or you may rotate among all of the midwives in the group.
At delivery, one of the midwives in the group will deliver your baby. If your birth becomes more complicated (like requiring complex IV medications or a C-section), then a physician usually coordinates your care.
Midwives do not take care of babies after the delivery, so you will need to find your baby a physician (family physician or pediatrician) after delivery. Midwives can continue to care for you after you deliver your baby for general female checkups, but most patients will continue their care with their primary care physician or general doctor.
An obstetrician is a doctor who has been trained specifically in women's health. In general, they work in group practices, which means you may not see the same physician for all your prenatal visits and the physician you choose may not be on call the night you deliver.
OBs usually function in call teams, where they are in the hospital for 12 to 24 hours, and then the next physician comes in for his or her shift. If your labor continues during a shift change, you may have one obstetrician start with you during labor and a different one deliver your baby. If you were to have complications during your labor, the obstetrician in the hospital will manage your complications, especially if you need a procedure like a C-section.
After your baby is born, you can continue to see your obstetrician for general exams, or you can go back to seeing your primary care physician. Your baby will need a different doctor - again, a family physician or pediatrician.
Family medicine physicians are doctors focused on seeing the whole family. Usually, their goal is to be your primary care doctor before pregnancy and follow you through pregnancy at your prenatal appointments, then go to the hospital to deliver your baby and take care of you and your baby afterwards. They are trained in general medicine, obstetrics and pediatrics, so they can provide all three types of care.
If you choose to see a family physician for your pregnancy care, usually the physician you see during pregnancy will be the one delivering your baby. If your pregnancy would require a C-section, some family physicians provide this service, while others would ask one of their obstetrics colleagues to perform the C-section.
Having a baby is often exciting and scary. Be sure to check out your care options and find the best fit for you. Congrats again!
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.
Date Published: 05/15/2013