Midwife or OB/GYN?

A conversation with a Seattle OB/GYN midwife

Have you ever considered using a midwife for your prenatal and delivery care? In the past few years, we’ve seen many of our patients choose this alternative over using a traditional physician to deliver their baby. But what exactly is the difference between the two? We had the chance to speak with a midwife from one of our favorite clinics, Seattle OB/GYN, to learn more about the two options many women and families are choosing between.

Erica Wikan is a Certified Nurse Midwife, and works in the Midwifery group at Seattle OB/GYN. Erica was a pediatric ICU nurse before completing her Masters degrees in Nurse Midwifery and Pediatric Nurse Practitioner. She is one of three Nurse Midwives who make up the midwifery team at Seattle OB/GYN. 

A quick note on this clinic: it is divided into two groups – midwives and physicians. While many clinics may see this as a hard divide, at Seattle OB/GYN they work as a cohesive team and it is an opportunity for both the OB/GYNs, midwives and even the patients to learn from this collaboration. One of the biggest takeaways from our conversation with Erica was that the midwives and physicians are constantly working together. She described the doctors as the most “midwife-like” physicians she’s ever met. 

Erica explained her physician colleagues are highly dedicated to helping their patients stick to their birth plan, and encourage a vaginal delivery whenever possible. This fact is supported by their much lower than national average cesarean section rate. They were just rated in the TOP 3 NATIONALLY for lowest C-Section rate!

When newly pregnant and going to Seattle OB/GYN for pregnancy care, how should a patient decided between a midwife and an OB/GYN? If you are considered a “low risk” pregnancy, Erica suggests making your initial appointment with the midwifery team.  Set for week 8, your appointment will be 40-60 minutes long and you’ll meet with one of the three midwives. At the appointment you’ll discuss things like your ideal birth plan, how much support you would like during your labor, and your past and current health history. If you are unsure about what type of birth you would like, they will talk through the different options with you. Based on this information, the midwife will be able to tell you if you’re a good candidate for the midwifery group, or if you would benefit from a physicians care. 


Patients who have are considered “high risk” may be those with:

  • History or current diagnosis of diabetes
  • Hypertension
  • Endocrine disorders
  • Twin pregnancies

These patients will be evaluated and will most likely end up under the care of a physician.

Erica says there are a few things you can expect if you decide to work with the midwifery group. First, the nurse midwives take a team approach, meaning as a patient you will see all three throughout your pregnancy. This means that no matter what, you will know the midwife at your labor.  Secondly, they have a low number of patients in circulation at any given time to make sure they are able to maintain long appointment times and be present at all deliveries. Lastly, during labor and delivery the midwife on call can be with you throughout the entire process, helping with things like pain coping techniques, labor progression, and vaginal delivery.  If a cesarean section was required out of medical necessity the patient is passed to a physician surgeon’s care, with the nurse midwife assisting where possible. 

Though not all clinics are set up this way, midwifery care can be the right choice for many women and families. Our team has always been confident referring our patients to both physicians and midwives, and our conversation with Erica further solidified this! When looking for care make sure you find a practitioner or team who you feel comfortable with and who will follow your ideal birth plan when possible. 

Thank you Erica for chatting with us!
 


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