OB vs. Midwife: How to Choose the Right Provider for Your Pregnancy

By Boston Area Doulas, Jane Gajsiewicz

One of the first big decisions you’ll make during pregnancy is choosing your provider. The good news? If you’re in the Boston area, you have an incredible range of high-quality options, and there truly is a provider out there who will feel like the right fit for you and your family.

We talk to many parents-to-be who know they want thoughtful, supportive care, but aren’t quite sure whether they’d prefer an OB/GYN or a midwife. Both are excellent choices, and both play a critical role in pregnancy and birth. Let’s break down the similarities, differences, and common misconceptions to help you decide what might work best for you.

What OB/GYNs and Midwives Have in Common

At their core, both OB/GYNs and midwives are trained to support your reproductive health holistically.

Both can provide: 

• Fertility support

• Family planning and pre-conception care

• Prenatal care throughout pregnancy

• Support during labor and delivery

• Postpartum care

• Gynecologic care, including STI screening and treatment

In other words, both are fully qualified professionals who guide families through pregnancy and birth. The differences lie mainly in their training models, scope of practice, and care approach.

Key Differences to Consider 

1. Training & Medical Background

OB/GYNs

• 4 years of undergraduate study 

• 4 years of medical or osteopathic medical school

• 4 years of residency (with additional optional fellowship training)

• Trained as physicians and surgeons

OB/GYNs are trained to diagnose, manage, and surgically treat complications. Their education emphasizes medical decision-making across a wide range of scenarios, including emergencies.

Midwives (Certified Nurse Midwives / CNMs)

• Bachelor of Science in Nursing

• 2–3 years of graduate education (MSN, CNM, or Doctorate/DNP)

• Specialized training in pregnancy, birth, and women’s health

Midwives are experts in physiologic (normal) pregnancy and birth, with strong training in patient education, shared decision-making, and holistic care.

As Susan Hudson, CNM, explains:

“Midwives are trained to look at pregnancy and women’s health through the lens of ‘normal’ and to recognize when things move beyond that scope. OB/GYNs, on the other hand, are trained to diagnose and treat medical conditions, which is essential for when complications arise.”

2. Types of Pregnancies and Births Supported

OB/GYNs

• Care for all pregnancies, including high-risk and medically complex cases

• Attend vaginal births, cesarean sections, and operative vaginal deliveries (forceps or vacuum)

Midwives

• Typically care for low- to moderate-risk pregnancies

• Attend vaginal births

• Collaborate closely with OBs and transfer care when higher-level medical intervention is needed

In many hospital systems in our area, OBs and midwives work as part of the same team, allowing patients to benefit from both models of care.

3. Labor & Delivery Experience

OB/GYNs

• Often manage multiple laboring patients at once

• Move between rooms and responsibilities on the unit

• Typically present for delivery, but may not be in the room throughout labor or pushing

Midwives

• Generally care for fewer laboring patients at a time

• Often spend more continuous time at the bedside

• More likely to remain with you throughout active labor and pushing

• Prenatal visits may be longer and include more emotional support and education (though this varies by provider)

Neither model is “better”—it often comes down to how much continuity and bedside presence you value, and what feels most reassuring to you.

Common Misconceptions

“If I work with a midwife, I won’t be able to get an epidural.”
Not true. Midwives who practice in hospital settings can absolutely order epidurals and other forms of prescription pain relief.

“Midwives only support unmedicated births.”
Also false. You can have a fully medicated birth, or an invention free delivery, with either an OB or a midwife. The goal in both cases is informed choice and supportive care.

“Midwives only attend home births.”
Many midwives practice exclusively in hospitals and attend hospital births every day. Home birth is just one setting where some midwives practice. This is not a requirement or defining feature.

So… Which One Is Right for You?

Choosing between an OB and a midwife isn’t about right or wrong, it’s about fit. Some parents prioritize medical complexity and feel most comfortable with an OB. Others value a more holistic, continuity-based approach and are drawn to midwifery care. Many families love hybrid practices where OBs and midwives work together.

Your pregnancy, your values, your history, and your comfort level all matter. Ask questions, meet providers, and trust how you feel in the room.

All Boston and surrounding area hospitals have OB/GYNs. Some hospitals in our area also have midwives, including: Brigham, BMC, Newton Wellesley, South Shore hospital, Mt Auburn, CHA Cambridge Hospital, MGH, Beverly, Salem, and Emerson. Some hospitals like MGH and Brigham may have OBs and midwives rotating on the floor at the same time.

And remember: no matter which path you choose, you deserve care that makes you feel informed, supported, and confident every step of the way.