Choosing who will care for you during pregnancy and birth is an important decision. An OB/GYN and a midwife can both provide pregnancy and childbirth care, but their training, approach and scope of care can differ.
Understanding the differences between an OB/GYN and a midwife can help you choose a provider who fits your health needs, preferences and goals for your pregnancy and birth. Where you choose to give birth is another important part of the decision.
Sarah Shoemaker, DNP, CNM, a certified nurse midwife with OSF HealthCare, explains what to consider when choosing an OB/GYN or midwife and how to choose the right birth setting for your delivery.
What is an OB/GYN? (H2)
OB/GYN stands for obstetrician-gynecologist. An OB/GYN is a medical doctor who specializes in pregnancy, childbirth and reproductive health. They are also trained in surgical care and can perform procedures such as cesarean sections (C-sections) when needed.
You may already see an OB/GYN for routine women’s health care, such as pelvic exams, Pap tests and other preventive care. During pregnancy, an OB/GYN can provide prenatal care, monitor your health and your baby’s development, and care for you during labor and delivery.
Obstetrics focuses on pregnancy, childbirth and care after delivery. Gynecology focuses on reproductive and women’s health outside of pregnancy. An OB/GYN is trained in both areas, although some doctors may focus their practice more heavily on obstetrics or gynecology.
If you have a high-risk pregnancy or develop complications during pregnancy, your OB/GYN may work with a maternal-fetal medicine specialist, a doctor with additional training in high-risk pregnancy.
What is a midwife?
Certified nurse-midwives (CNMs) are registered nurses with advanced education and specialized training in midwifery. They provide care during pregnancy, labor, birth and the postpartum period, as well as provide a range of other women’s health services.
Midwives may spend more time providing hands-on support during labor, including helping you try different breathing techniques, positions and other comfort measures. It’s a common misconception that choosing a midwife means you cannot have an epidural. Midwives can care for patients who choose an epidural and can support a range of pain management options.
“Midwives very often have time built into their schedule devoted to education and labor support, so they can be more involved in the labor process,” Sarah said. “If having that kind of support is important to you, no matter what pain management you choose, a nurse midwife may be the right provider for you.”
Unlike OB/GYNs, midwives are not surgeons and do not perform C-sections. They primarily care for people with low-risk pregnancies. If a pregnancy becomes high risk or complications develop, a midwife may work with an OB/GYN and/or maternal-fetal medicine specialist to make sure you and your baby receive the care you need.
What is the difference between an OB/GYN and a midwife?
Both OB/GYNs and midwives can provide care during pregnancy, labor and after delivery. The biggest differences are their education and credentials, the types of pregnancies and births they specialize in and the settings where they provide care.
Credentials and Background
OB/GYNs are medical doctors who complete medical school and specialized residency training in obstetrics and gynecology. Their training includes both medical and surgical care.
Certified nurse-midwives (CNMs) are registered nurses who complete advanced education and specialized training in midwifery. Their education focuses on pregnancy, childbirth, postpartum care and women’s health.
Birthing Specialties
OB/GYNs are trained to care for a wide range of pregnancies, including those with medical complications or other factors that make a pregnancy high risk. They can provide both vaginal and Cesarean births and manage complications that may arise during pregnancy or delivery.
Midwives primarily care for people with low-risk pregnancies and support vaginal birth. They often take a more hands-on approach to labor support and may spend more time helping patients with positions, breathing techniques and other comfort measures. Choosing a midwife does not mean you cannot receive pain medication, including an epidural.
If complications develop or additional medical care is needed, a midwife can work with an OB/GYN or other specialist as part of the patient’s care team.
Delivery Setting
OB/GYNs typically deliver babies in hospitals, where patients have access to medical and surgical care if complications arise.
Midwives may provide care in several settings, including hospitals, freestanding birth centers and, for some low-risk pregnancies, planned home births. The vast majority of nurse midwives work in the hospital setting.
What is a doula?
A doula is an optional member of your birth team who provides emotional, physical and informational support during pregnancy, labor and delivery. Doulas are trained professionals, but they are not medical providers like OB/GYNs and midwives.
A doula can help you think through your preferences for birth and create a birth plan that reflects what matters most to you. During labor, they can offer encouragement and help you make decisions with your birth preferences in mind.
Doulas can also provide hands-on comfort measures, such as massage, position changes and breathing techniques, to help you cope with labor.
Doula vs. Midwife
The biggest difference between a doula and a midwife is their role in your medical care.
A midwife is a health care provider who provides medical care during pregnancy, labor, birth and after delivery. A doula provides nonmedical support and does not deliver babies or make medical decisions.
You can choose to have a doula as part of your birth team regardless of whether you choose an OB/GYN or nurse midwife.
How to Choose a Pregnancy Care Provider
Browse our OB/GYN and midwife team
Choosing a provider for your pregnancy is a personal decision. Your health, pregnancy, preferences and the type of birth experience you want can all help guide your choice.
If you don’t already have an OB/GYN or midwife, your primary care provider may be able to recommend someone. You can also check with your health insurance plan to see which providers and hospitals are covered.
“Don’t hesitate to ask questions and spend time building your birth team,” Sarah said. “It’s important to find health care providers who listen to you and who are strong advocates for your needs.”
Consider Your Health and Pregnancy
Your health and the type of pregnancy you have can help determine which providers are appropriate for you. If your pregnancy is high risk or complications develop, you may need care from an OB/GYN and possibly a maternal-fetal medicine specialist, a doctor who specializes in high-risk pregnancies.
If you have a low-risk pregnancy, you may have more flexibility in choosing between an OB/GYN and a midwife.
Think About Your Birth Preferences
Consider what matters most to you during labor and delivery. You may want to think about:
- Your preferred pain management options
- How much support you want during labor
- Who you want with you during delivery
- Whether you want to move around during labor
- Which elements of a birth plan are important to you
- What type of birth setting you prefer
You don’t have to know exactly how you want your birth to go. Your preferences may change during pregnancy or labor, and your care team can help you understand your options.
“Once you know what your goals are for pregnancy and birth, that can help guide your decision-making,” Sarah said. “Advocate for yourself, interview providers, get to know them and pick one that fits your needs.”
Consider the Care Team and Birth Setting
The provider you choose will likely be part of a larger care team. Ask who may provide your care during pregnancy and who might be on call when you go into labor. In some practices, the provider you see for prenatal appointments may not be the person who delivers your baby.
It can also help to find out where your provider delivers and what medical and specialty services are available there. If you think your baby may need specialized care after birth, ask if the hospital has a Neonatal Intensive Care Unit (NICU) and what resources are available for newborns who need additional support.
If you’re considering a midwife, ask how they coordinate care with OB/GYNs and other specialists if your needs change during pregnancy.
Check Your Insurance Coverage
Before choosing a provider or birth setting, check with your health insurance plan to understand which providers, hospitals and services are covered. Coverage can vary depending on your plan and the type of care you receive.
Questions to Ask Your Care Team
Talking with a potential provider can help you decide whether they’re a good fit. Consider asking:
- What hospitals or birth centers do you deliver at?
- What pain management options are available?
- How do you support a patient’s birth plan?
- How much can I move around during labor?
- Who will care for me if you aren’t on call when I go into labor?
- How do you support patients if complications arise?
- What happens if my baby needs specialized care after birth?
- Will my insurance cover my care and delivery?
The right provider is someone who makes you feel heard, respected and supported throughout your pregnancy.
“Your health care team should be there to listen to you, answer your questions and help you feel confident in your decisions,” Sarah said. “Finding someone who fits your needs can make a big difference in your pregnancy and birth experience.”
How to Choose Where to Give Birth
Choosing where you meet your baby for the first time is one of the most personal decisions you’ll ever make. Think about what environment makes you feel most supported, the care team you’ve chosen to be present during delivery and what each birth setting offers, from technology and pain management to emotional support and recovery care.
It’s also a good idea to check with your insurance provider early to learn which hospitals or birthing centers are covered under your plan. Being prepared with this information can help you choose the birth setting that best fits your needs and personal preferences.
Hospital Birth
There are many factors that can influence your decision to give birth at a hospital, including your insurance, distance to your home and whether your provider is employed at the hospital.
Many OB/GYNs only deliver in hospitals because of the resources available, including access to an advanced NICU Some hospitals offer tours that allow you to see the birthing suites and meet members of the care team before delivery day to get a feel for the environment.
If you’re giving birth in a hospital, you’ll have access to many emergency services in case something happens. Hospitals also offer the most options to manage labor pain, including nitrous oxide, IV pain medication and epidurals.
“For patients with uncomplicated deliveries, many choose to go home the next day,” Sarah said. “If you have a C-section, you will probably stay for two or three days.”
Hospitals are staffed full-time with medically trained professionals, like doctors, advanced practice providers and nurses. Hospitals also have other specialists on staff that can help if needed, like neonatologists and lactation consultants.
Some health systems, including OSF HealthCare, offer advanced, AI-powered remote maternal and fetal monitoring. This monitoring alerts your care team to changes in vital signs to keep you and your baby safer.
If you have a high-risk pregnancy or a planned C-section, a hospital birth is often the safest option for delivery.
Birthing Center
A birthing center is a place outside of a hospital where babies are delivered.
While some birthing centers have an OB/GYN available for consultation, care is typically provided by midwives and nurses. These centers focus on natural, holistic approaches to childbirth. Many also have nitrous oxide available for patients, which is similar to the “laughing gas” you would get at the dentist, and water birth is usually an option.
Birthing centers are designed for low-risk pregnancies. If you’re unsure whether you qualify, contact the center for guidance. Because they don’t offer epidurals or IV pain medication, make sure you are prepared for an unmedicated birth before choosing this setting.
In some cases, complications during labor or delivery may require you to transfer to a nearby hospital for additional care. Make sure the birthing center has plans in place to coordinate a safe transfer if this becomes necessary.
Home Birth
Some families consider delivering their baby at home for a more personal or natural experience. Some midwives see patients in their home before they give birth as well as for labor and delivery care. Similar to a birth center, there are less options for pain relief in a home environment compared to a hospital. While birth centers often have nitrous oxide as an option, this is not available for home birth.
It’s also important to understand that more advanced medical resources aren’t immediately available in a home birth. If complications come up during delivery and you need to transfer to the hospital, emergency medical care may be delayed for you and your baby.
This delay can have an impact on outcomes, so it is very important that the midwife has a planned transfer protocol and concrete set of criteria for transfer. The midwife should also be well-trained in neonatal resuscitation and not hesitate to transfer when medically necessary.
For these reasons, most providers recommend giving birth in a hospital or birthing center, where immediate medical support is available if needed.
Questions to Ask When Choosing Where to Give Birth
When touring hospitals and meeting with care teams, here are some helpful questions that will guide you in your decision:
- How often does this facility perform C-sections?
- Are labor and delivery rooms private or shared?
- How will my baby and I be monitored during labor and delivery?
- What high-risk services are available in case any issues come up?
- Where do I check in when I go into labor?
- What breastfeeding support is available?
- What prenatal classes are offered?
- What amenities are available?
- Will I get to do skin-to-skin, delayed cord clamping or any other special requests?
- How many support people are allowed in the room?
- Is there a place for my support person to sleep in the room?
- Are visitors allowed?
Sarah said that flexibility is key. Even if you have a plan for where you give birth, who’s there and how everything goes, it’s important to keep expectations realistic.
“Working with your provider to come up with a plan, as well as contingency plans during birth, helps to prevent birth trauma,” Sarah said. “Birth and pregnancy can be unpredictable, and it’s important that your choices and needs are supported. Building a team you trust and working together helps provide the best outcomes for you and your baby.”
Last Updated: October 8, 2026