CNM or OB-GYN?

[Midwife or OB-GYN?]

Hello! I am currently a junior in college forced to make a tough decision. I have to decide to fully pursue my dream of becoming an OB-GYN or to give up my dream and become a nurse-midwife instead.

A little background: My passion is in women's health. I know without a doubt that I have to work within the field in order to be happy. However, my GPA is currently a 3.1. My adviser said that it is tough, but doable if I get 4.0 every semester until I graduate and possibly go an extra year in order to spread out the rest of my classes. That would mean that would be applying for med school when I am 24. I know in the scheme of things, that isn't that old, but I want a ton of kids, which just isn't realistic if I wait until I am done training after I am 32. With that being said, I feel like I could also be happy as a midwife. My understanding is that they basically do everything that an OB-GYN would do expect for surgery.

Part of me feels like this is the smart choice. I could be done with my training by the time I am 25 and have a career and a large family. The other part of me is heartbroken for giving up my dream so easily and fears that the limited abilities of a nurse-midwife would not be enough for me.

I don't know what to do, and I am in a tough situation, as I have to decide within the next day as classes start and I have to switch from pre-med requirements to pre-nursing.

So here is where you come in: I need help. Midwives out there-did you ever consider going to med school? If so, do you regret your decision? Is there a respect level within your career, and do doctors take you seriously? Are you satisfied with the limited scope of your practice? How is your family life?

Thank you for your time and responses. I truly appreciate it.

[Jolie, BSN]

"I don't know what to do, and I am in a tough situation, as I have to decide within the next day as classes start and I have to switch from pre-med requirements to pre-nursing."

Please also understand that when you come to an anonymous website and ask for immediate information because a life-altering problem must be solved today or tomorrow, it is more than a little difficult for thoughtful, experienced members here to offer any ideas or opinions that will be satisfactory to you.

I understand that to a 20-something year old, it can seem that everything in life demands an immediate answer. As you gain experience and maturity, you will come to understand that is not the case, and that making hurried, rushed, poorly informed decisions does far more harm than good.

If OB-GYN is truly your passion, and you are willing to consider your advisor's plan to add a year to your college studies in order to improve your grades and chances of med school admission, then jumping ship tomorrow to pre-nursing classes is not necessary. Furthermore, many pre-med and pre-nursing classes are very similar. It seems likely that you could meet with an advisor and try to re-work your fall semester to take classes that would meet requirements for both possible tracks. That would buy you time to seek information on both professions and make an informed decision on which one to pursue.

[SCSTxRN]

I am going to sound so negative - it is not my intent - and I promise to answer something to your question at the end.

If you have a 3.1 now, unless you've already got bioethics and organic chemistry under your belt, a 4.0 isn't going to be likely. If you've been working as hard as you can for that 3.1, it's less so..

Nursing classes are, for most people, harder than regular undergrad classes.

Competitive MSN programs are looking 3.7 and higher, plus experience, plus PASSION for the field.

I think if your dream is to sign, M.D. after your name - CNM is never going to cut it for you. If your goal is to support women through healthy pregnancies and catch babies.. then M.D. might not have been your thing.

A large family is a HUGE commitment. Delivering babies is a time suck. You need to seriously consider how you're going to deal when your 6 month old is crying with a low grade temp and your mom is delivering and you have to GO.

15 years ago, I had just finished premed and been accepted into one of my top choices for MD, and I kind of lost my mind. Had I known then that NP was a thing - even a possibility... I never EVER would have chosen ANYTHING except NP.

I'm almost done with school now (not CNM - my kids are too demanding for me to deal with pregnant women).. and I can't imagine being satisfied doing anything else.

[mrlittlejeans1]

Also getting a nursing degree does not preclude you from applying to medical school down the road. It gives you an in to a healthcare related position. I've worked with several residents that were nurses first. I've been a L&D RN for 15 years and just got into a CNM program. Both obstetrics and midwifery are demanding and difficult callings. Working in a hospital alongside physicians made me realize that I really did not want to be one - for many reasons - but my family was one of them and my birthing philosophy and the time that I like to spend with patients was another. I am lucky to work with fabulous midwives and doctors. They do very different things and are appropriate for different kinds of patients. Have you worked in healthcare before? Have you worked nights and weekends and holidays. As far as MD's go, OB's have some of the worst call. If you want a lot of children are you comfortable with a nanny or daycare spending far more time with them than you will? These are decisions that are too difficult to make in a short period of time. Even if you do want to pursue a medical degree, a nursing undergrad is a good vehicle for this. I know many OB residents that did not get into school the first time they applied. Working as a RN in L&D gives you insight into the birthing process and providers role in that process that no other experience will. In addition, it's a hell of a lot more marketable than a biology degree or whatever premed course of study you might take. There are so many premeds that lack the grades to get into medical school and have a difficult time finding jobs with their degrees. You can take the premed track science classes while pursuing a BSN and working in a hospital will give you a lot more insight in whether you have the dedication and drive that it takes. I realized while going to school that I wasn't willing to put in the 80-100 hour work weeks at that stage of my life. OB residency is fairly brutal, a midwifery call schedule can be killer as well. Good luck with your decision and future.

[cayenne06, MSN, CNM]

I also wanted to echo the previous posters. I chose midwifery because I wanted to practice midwifery, not obstetrics. I struggled with the CNM vs OBGYN thing too, and in the end it was clear to me that my passion lay in public health. Improving birth outcomes both individually and systemically. This is the purview of midwives.

Midwives are not mini-obstetricians. Midwives are experts in physiologic childbirth. Obstetricians are not. I am both a CPM and a student CNM, and our physician colleagues consult with us for OUR expertise, just like we consult with them.

CNMs can do first assist in c/sections. They can do circumcisions, colposcopies, aspirations for missed ABs, and many other advanced procedures. And depending on the practice, many CNMs care for higher risk patients and do vacuum extractions and other more traditional OB skills. Almost all states currently prohibit non-physician providers from doing abortions, but medical and surgical terminations are well within the skill set of CNMs and will become part of our scope when the physician-only regs are inevitably changed. I love blood and guts and all that stuff, so being able to perform advanced procedures was important to me too.

ETA I have a 4.0 undergrad GPA and a very impressive C.V. Med school is hard to get into but I am very confident I could have made it work. So never was this a case of me "settling." But I WILL say that the lifestyle of a resident was a factor in my decision to not be an OB. I have two kids, and a decent work/life balance is a big consideration for me.

[Rebeccas23]

I'm curious what you ended up choosing to do.