CNM or OB/GYN

Bree124, BSN, RN · Feb 7, 2009

Hi Emily,

I think it ultimately comes down to what you envision yourself doing in life.

Midwives are able to get to know their patients very well, spend time with them during appointments, and support them during the labor and birth process. The midwives I know do have some patients who opt for epidurals and other forms of intervention, but overall they are much more holistic and believe in supporting the patient and her choices through pregnancy, birth, and beyond. Midwifery really is about caring for women throughout their lifespan, not just deliveries.

OB-GYNs deliver babies, but they are a surgical specialty. They have many patients who are low risk, but they also manage higher risk patients as well as women with gyn problems. Rarely will you find an OB who has the time to really connect with her patients and get to know them on a personal level, because the schedule is just too busy.

I am not yet a midwife, just a student, but I went through a similar decision making process so I wanted to chime in. I started out majoring in pre-med when I was in college, but by my second year I knew that I didn't want to be an OB, because it's just not the type of care that I wanted to provide. A few years after college I decided that midwifery was what I was meant to do, and here I am back in school.

Good luck!

ezxoxo322 · Feb 8, 2009

Thank you so much! It's nice to know that someone was in a similar situation as me. I think it would be great to really get to know my patients and provide individualized care. I also think medical intervention during labor is a reason that the infant mortality rate is too high. So, I think I will become a nurse and go from there... who knows I may end up in a totally different specialty!! It's nice to know that there are so many different things that you can do with a nursing degree. My mom is a doctor (optometrist) and she says she would want to become a nurse- anesthetist if she were to go through schooling again!!!

CNM2B · Feb 8, 2009

Thank you so much! It's nice to know that someone was in a similar situation as me. I think it would be great to really get to know my patients and provide individualized care. I also think medical intervention during labor is a reason that the infant mortality rate is too high. So, I think I will become a nurse and go from there... who knows I may end up in a totally different specialty!! It's nice to know that there are so many different things that you can do with a nursing degree. My mom is a doctor (optometrist) and she says she would want to become a nurse- anesthetist if she were to go through schooling again!!!

You sound wise beyond your years! I'm sure you will be successful in whichever path you choose. One really cool thing about being a nurse is that you can always change your mind and do something different! I am a nurse and currently in school to be a CNM, but I also work part-time in critical care! Nursing is a fabulous profession and you sound like you would make a great one! Good luck to you!!

ezxoxo322 · Feb 8, 2009

Wow thanks! Good luck to you, too!

peytonsmom · Feb 9, 2009

I'm currently finishing up my pre-reqs for nursing right now and plan on eventually heading down the CNM pathway. Had I had my head on straight when I was in highschool I may have decided to go into medicine vs nursing but at this point in my life it would be too hard on my familly for me to go to med school...nursing school is tough as is and it's only 3 years!

I think that you can be a great midwife w/o being too crunchy or granola of a person. I had an amazing midwife/OB team when I was pregnant. I started w/ the midwife but had complications so I saw the OB as well. She was totally cool w/ whatever interventions I did or did not want (i.e. epi) and never once pushed me to anything more or less than what I wanted. That is the kind of midwife I want to be. One that focuses less on the "natural" part and more on "what the mom wants". I didn't have a wonderfull birth experience simply because of the complications I had, but I'd love to make a woman's birthing her baby everything she wants it to be, whether that be 100% natural or a mix of natural birth and pain med's or other interventions.

HeartsOpenWide, RN · Feb 9, 2009

I suggest that you read about the midwifery model and the medical model and decide which is more your style. No offense, but there are enough Med-Wives out there. It does injustice to the midwifery model to go the CNM rout simply because you want to practice like an OB/GYN but do not want to go to school as long. And, honestly, now that the NP is moving more towards the DNP requirement getting your CNM is not going to be much shorter than getting your MD. If you want to practice like a midwife then go to midwifery school, if you want to practice a more medical model then go to med school.

ezxoxo322 · Feb 10, 2009

Thank you! That was actually exactly what I wanted to hear. I think right now that I want to be a nurse because there is so much versatility and much more patient interaction. After researching both the nursing and medical models, I feel like my beliefs match the nursing model. Plus, I don't even know if I would definitely want to be a CNM after actually practicing as a nurse. Or am I just confusing myself and I actually want to be a doctor but not go through as much schooling??? But I feel like I couldn't commit to one specialty for the rest of my life. And I do want to eventually have a family, which might be hard if I want to go to medical school. Ok, so I'm just really lost, so does anyone have any advice? Thanks in advance...

CNM2B · Feb 10, 2009

I suggest that you go to a 4-year college and major in nursing. See how you like it and if you want, take the additional science required to go to medical school (a few more chem classes and physics). You don't have to decide anything until you get close to graduation or even later on. See what nursing school has to offer and what areas you enjoy (you might fall in love with something completely different). I went to nursing school CONVINCED that I wanted to work in the OR, and ended up falling in love (rather unexpectedly) with mother/baby....

So, try not to stress and see where the journey leads....you never know. I also know a lot of friends who planned to go to med school, but ended up falling in love and got married instead. Now they are stuck with a useless biology degree and no desire to go back to grad school...if you have your BSN, you can always use that!

peytonsmom · Feb 10, 2009

This is probably a little OT of the OP, but I know a lot of people use the term "medwife" in a derogatory sense and I just don't get why. Isn't there room for that type of provider? I mean, when I was pg, a "medwife" was exactly what I wanted. I wanted someone that would allow me to labor how I wanted to which was different than they way most OB's want their patients during labor, but at the same time I wanted the hospital setting, some of the monitoring and pain meds if I decided to use them. So I was thrilled that I found a midwife (or medwife if you want) that was somewhat of a hybrid between a midwife and OB.

I think too many women are scared away from using midwifes and having the birth exeperience that they want because they think the only way to use a midwife is in a birthcenter w/ a monitor free and drug free delivery. Some women just aren't comfortable with that.

Editorial Team / Admin · Feb 10, 2009

This is probably a little OT of the OP, but I know a lot of people use the term "medwife" in a derogatory sense and I just don't get why. Isn't there room for that type of provider? I mean, when I was pg, a "medwife" was exactly what I wanted. I wanted someone that would allow me to labor how I wanted to which was different than they way most OB's want their patients during labor, but at the same time I wanted the hospital setting, some of the monitoring and pain meds if I decided to use them. So I was thrilled that I found a midwife (or medwife if you want) that was somewhat of a hybrid between a midwife and OB.
I think too many women are scared away from using midwifes and having the birth exeperience that they want because they think the only way to use a midwife is in a birthcenter w/ a monitor free and drug free delivery. Some women just aren't comfortable with that.

Here is an older thread about "medwife": https://allnurses.com/certified-nurse-midwives/medwife-170371.html

cookderosa · Feb 14, 2009

I think you are wise for considering both options very carefully. I'm not yet a nurse- but my current job is a community college instructor and former advisor. I have been doing this for 17 years, and so I spend all my time around students making these kinds of big decisions.

First, remember you can always change your mind.

Second, changing your mind in college will cost you a lot of money and time.

Third, you can still change your mind anyway.

Regarding pregnancy and birth, I have had 4 children all using a midwives. I attended about a dozen births as a labor support person (doula) as well, and in many of those births the mom had an OB. Here is what you have to know- the only thing midwives and OBs have in common, is that they are catching a baby. The two crafts are different from the first trimester all the way through postpartum. It isn't a simple "this or that" as they are entirely different practitioners. Not chocolate vs vanilla- it's broccoli vs applesauce. I think having a clear understanding in the distinction is necessary. (Notice I'm not trying to convince you to become one or the other, because all CNMs will tell you that we need BOTH professions to care for all women)

Some suggestions,

Consider what type of prenatal care and delivery management would appeal to YOU. Many people have a very clear preference right from the start. Do unto others....

Approach your high school counselor, and ask him/her to help you set up a job shadow. This is a visit to a work place where you "shadow" or observe the worker for a few hours (unobtrusively) and ask questions about their career. You should job shadow in several settings, because without a doubt, this will influence your decision greatly! Some suggestions for shadows, do as many as you can:

Male OB in a practice without midwives

Female OB in a practice without midwives

OB in a practice with midwives on staff

CNM who delivers in a hospital setting

CNM who delivers in alternative settings (home birth, birth center, water birth)

If your school counselor has not done this before, or isn't interested in helping you, I can give you detailed help to get you started. All of my students do multiple job shadows, so I'm a huge fan of the process.

Finally, you need to watch births. Network shows like Baby Story are a good start, but you should rent DVDs that include unedited births. It's not a bad idea to watch a few advocacy type videos too- Gentle Birth Choices is one I remember rocking my world LOL, and the Business of Being Born is along the same line. Your OB and CNMs that you meet in your job shadows may have some you can "borrow" too.

How you feel about the process, I think, is very important. Do you feel uncomfortable like you want to help them take away the pain? Do you feel impressed with their strength? Is it shocking or gross? Be honest with yourself, and you will start to get in touch with how you really feel, and I think that is generally the best guide.