The Difference Between a Midwife and an OB/GYN

Nov 18

When it comes to pregnancy and childbirth, many people wonder: what exactly is the difference between a midwife, doula, and an OB/GYN? All of them provide essential maternal care, but their approaches, training, and philosophy can shape the birth experience in very different ways.

Let’s Define Some of the Key Roles of an OBGYN vs a Midwife

OB/GYN (Obstetrician–Gynecologist)

A physician specializing in obstetrics (pregnancy and childbirth) and gynecology (women’s reproductive health).
Trained to manage high-risk pregnancies, perform surgical interventions like C-sections, and address complications.
Typically works in hospital settings and is licensed to intervene medically when necessary.

Midwife

A health professional who supports low-risk pregnancies, labor, birth, and postpartum care. Types include Certified Nurse-Midwives (CNMs) and licensed midwives.
Emphasizes “low-tech, high-touch” care, allowing for more physiological, natural birth processes. As Parents.com notes, midwives “offer care that emphasizes normal physiologic birth and a supportive environment.”
Cannot perform surgery but collaborates with physicians when needed.
You will usually find a midwife available to you in a birthing center as opposed to a traditional hospital setting.

Interventions and Outcomes: What Research Shows

Studies suggest significant differences in birth outcomes for low-risk pregnancies when comparing midwife-led care to obstetrician-led care.

“Patients receiving midwifery care had significantly lower cesarean rates (8.9% vs. 15.2%; p < 0.01)” (PubMed).
“Midwife-led care carried a lower risk of unplanned cesarean … epidural/spinal analgesia, episiotomy, and active management of labor third stage” (PubMed).
“Care from midwives reduces the likelihood of cesarean birth … perhaps due to their greater preference and skill for physiologic births” (PubMed).

Additionally, midwife-led care has been linked to lower costs: “The costs of childbirth for low-risk women with midwife-led care were, on average, $2,262 less than births to low-risk women cared for by obstetricians” (PubMed).

Why People Choose Midwives and Doulas

Birthing people choose midwives because they honor physiological birth and their body’s natural ability to labor and deliver. Midwives practice true informed consent, providing time and clarity around medical options instead of defaulting to hospital routines.

In hospitals, rigid policies can sometimes feel coercive: automatic induction at 39 weeks + 6 days, episiotomies without clear consent, or being forced to push on your back. When in labor, many people feel overwhelmed and unable to fully advocate for themselves. As ACOG notes, “Each woman has the right to make a medically informed decision about delivery” (PubMed).

A doula complements this care by providing continuous support and advocacy. Studies show:

“Continuous labor support significantly reduced the rate of cesarean section deliveries (supported group, 8%; observed group, 13%; control group, 18%)” (PubMed).
“The continuous presence of a doula during labor significantly decreased the likelihood of cesarean delivery … and reduced the need for epidural analgesia” (PubMed).
“Women and their male partners were unequivocal in their positive opinions about laboring with the support of a doula” (PubMed).

Doulas also help interpret medical guidance, empower informed choices, and bridge gaps in underserved communities, often improving outcomes where consistent medical care is limited (MoActionNetwork).

What is a Physiological Birth?

Physiological birth refers to a “natural” and a focus on not interfering with your stages of labor, in many times, unmedicated. Some parents with low-risk pregnancies prefer this holistic approach.

Real medical providers, midwives, and doulas, can all benefit from physiological birth. When the informed parent makes more well educated decisions on their physiology, it can result in less complications during the birthing process. For context and examples of physiological birth and the early connection between mother and child, consist of daily activities and exercises to prepare mental and physical stamina for their upcoming labor due date. This ongoing support and intervention is what makes the difference.

Hiring midwives and doulas can also offset the costs associated with potential needed medical interventions (Lasky, J. (2023).

Risks, Considerations, and the Hospital Role

While midwife-led and birth center deliveries are safe for low-risk pregnancies, there are risks. According to ACOG, “Planned home birth … is associated with a more than twofold increased risk of perinatal death (1–2 in 1,000) and a threefold increased risk of neonatal seizures or serious neurologic dysfunction (0.4–0.6 in 1,000)” (ACOG).

That said, midwives always coordinate hospital transfers if complications arise, and studies show that integrating midwives into hospitals can reduce unnecessary interventions while maintaining safety (Community.The-Hospitalist.org).

Enhance the Motherhood Experience

Although not a replacement for traditional medical care, the doula and midwife offer essential services that improve the overall pregnancy experience. Consider the following before deciding between them:

Risk profile (low vs. high)
Birth philosophy (physiological vs. medicalized)
Desire for autonomy and informed consent
Access to birth centers or home birth
Comfort with hospital transfer plans

For low-risk pregnancies, midwives and doulas provide evidence-based, empowering care that supports natural birth, reduces unnecessary interventions, and honors a woman’s choices. OB/GYNs remain essential for medical expertise, especially in high-risk or emergency situations. Many families benefit from using both, combining medical safety with emotional and advocacy support.

Interested in connecting with a doula or midwife? Find live experts to connect with on the MissPoppins platform.