A Case For Midwives
Tuesday, July 7, 2026
We almost never tell people what they should do: Birthsmarter is, quite literally, built on the idea that advice, especially around health care and parenting, is never one-size-fits-all.
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That said... you should probably find a midwife. (Or, at the very least, make the decision not to work with one after you've actually met one.)
In case you’re not 100% sure why: a midwife is a medical professional who provides healthcare throughout the lifespan. Midwives can provide routine gynecologic care, support conception, pregnancy, postpartum recovery, perimenopause, and menopause.
During pregnancy, in particular, midwives order and interpret blood work and your vital signs, monitor your baby's growth, care for you during labor, catch babies, deliver the placenta, and care for you after birth.
While many people (in the United States) associate midwives with home births, most Certified Nurse-Midwives in the United States actually practice in hospitals, where their patients also have access to labor nurses, inductions, epidurals, cesarean birth, neonatal specialists (NICU support), and obstetricians whenever additional medical care is needed.
And, just to be super-duper clear, a midwife is not a doula.
A doula is not a medical provider.
(Doulas provide emotional, physical, informational, and logistical support. We help you stay comfortable, suggest labor positions, massage your back, support your partner, answer questions, carry bags, and help you process what's happening.)
There is wonderful overlap between doulas and midwives…but they are not the same. Midwives and OB-GYNs, on the other hand, kinda, are (the same).
While midwives and OBs are both medical providers, for most people in the United States the choice between them isn't really a choice at all. The default in our culture is to just find an Obstetrician/Gynecologist.
That's a problem for women's health generally, but it's an especially big missed opportunity in pregnancy. Pregnancy is one of the few times in our lives that we receive continuous medical care over many months in the absence of illness, and the philosophy of the person guiding that care has an enormous influence on how we experience it.
As much as I believe in childbirth education—and believe me, I do—I've been reminded that there is a limit to what even the best class can accomplish if the person providing your medical care expects you to adapt to their model of care instead of adapting their care to you.
It's 100% true that education can change outcomes. It gives people confidence, language, and perspective they wouldn't otherwise have. But no amount of preparation can fully compensate for a provider whose default answer is, "This is how we do things," when what you need is someone who begins with, "Let's talk about what's important to you."
(And, if part of you is thinking, "Who am I to have preferences? They're the medical professionals," I'd challenge that assumption. Good medicine isn't about asking you to surrender your judgment to someone else's expertise. It's about combining clinical expertise with your values, your goals, and your lived experience. You don't have to choose between being listened to and receiving excellent medical care.)
That's one of the reasons I keep coming back to midwifery. For healthy pregnancies, it isn't just kinder and more empathetic—it's exceptionally safe care, rooted in an understanding of physiologic birth and backed by decades of evidence.
And after fifteen years of teaching, attending births, and watching thousands of families navigate this system, I have become convinced that one of the most informed decisions you can make is to at least explore midwifery care before deciding who you want beside you.
If you want to think more about this, I wrote two posts that go much deeper.
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