Senior midwife doing a routine check in the home of the pregnant mother.

Should I Have a Midwife Deliver My Baby?

The short answer is no.

I don’t want to offend you. Maybe you had a terrible experience with your last delivery in a hospital by an impersonal OB/GYN. I get it. Not all doctors have a great bedside manner. Hospitals can be impersonal. The bean counters have done a good job of driving up corporate profits at the expense of any possibility of a warm, caring relationship with your doctor. 

But I would never recommend having a midwife deliver a baby.

I have five children. Three daughters. (All of whom have delivered multiple babies.) I have seven grandchildren with two more on the way. They are the center of my life. I love children. 

Obviously, obstetricians and hospital nurses who handle labor and delivery make mistakes from time to time. 

I get it. Obstetricians and labor nurses are not perfect.

But your odds of getting a safe, healthy baby are so much better in a modern hospital with a trained obstetrician.

Here’s the difference between a midwife and an obstetrician.

The midwife has a two-year degree. (Some midwives claim they have four years of training but it’s usually just two.) It’s not a particularly competitive or difficult degree to get. People who are the “cream of the crop” academically do not, as a rule, choose to become midwives. 

An obstetrician gynecologist has eight years of intense, difficult, challenging training on top of a difficult four-year undergraduate degree. Medical school is extremely competitive. An obstetrician must then complete a four-year residency to become fully certified. He or she will perform hundreds of C-sections and hundreds of deliveries during the residency. 

This is no guarantee, of course, that your doctor will have a “warm and fuzzy” personality. 

Your baby does not care! Your baby has one goal. To be born safe and healthy. Without a brain injury. Without a seizure disorder. Without a lifetime disability. Your baby doesn’t care if a hospital is impersonal or if obstetricians are expensive. 

Think about your baby. 

Here’s what I say to anyone who wants to give birth at home with a midwife. Before you do that, spend a week taking care of a catastrophically injured child with cerebral palsy. Go to therapy with that child. Make sure that baby gets his anti-seizure medication. Change that 12-year-old child’s diaper knowing that he will never be potty trained. Help that 120 pound child make the difficult transfer from bed to wheelchair. 

Spend a week doing that. Then ask yourself whether you want to take a chance with a midwife. (The parents who take care of children with devastating birth injuries are true heroes. They are the best people I’ve ever met.)

Here’s what a midwife cannot do: He or she cannot perform a cesarean section to get your baby out quickly in the event of a medical emergency.

27% of all children in the United States are born via cesarean section. Think about it. That’s more than one in four children. The overwhelming majority of C-sections are performed because a qualified obstetrician decides, in conjunction with the parents, that that’s the best way to have a safe, healthy baby.

(One of my five kids was born with a C-section. She is a beautiful, healthy 34-year-old mother of three children. She is brilliant and delightful.) 

When my kids were little, we used to take them to the neighborhood swimming pool. The lifeguard was always on duty standing right next to the pool. 

The lifeguard will save your child if she gets in trouble. He will jump into the pool and immediately get your child to safety. 

The obstetrician is like a good lifeguard. He or she is right there. If your baby needs surgery, it gets done immediately. 

I know I’m going to offend some people by saying this. But the midwife is a lifeguard who is watching the pool 10 blocks away on a video monitor. He or she cannot jump in immediately. She can call for help, but the midwife cannot do a C-section herself. What if the obstetrician can’t get there for 30 minutes?

Here is a short list of some of the medical emergencies that will require an immediate cesarean section: Placental abruption. Uterine rupture. An ominous fetal heart tracing. Absent or minimal variability. Terminal bradycardia. Arrest of descent.

The list goes on and on.

I don’t care if your midwife promises to deliver your baby in a hospital. Doesn’t matter. The midwife is still the lifeguard who is 10 blocks away who can’t jump in and save your baby. The obstetrician can get your baby out in an emergency. The midwife has to call somebody more qualified. In the meantime, your baby’s brain may not be getting the oxygen it needs. 

Your midwife may have a beautiful website. (We just sued one the other day who had a fantastic website which made her sound like she was beautiful, caring, and super competent.) Guess what her website did not mention? She could not do a C-section in the event of a medical emergency. And she doesn’t have insurance to cover the expenses of caring for your baby if something goes wrong.