Frequently Asked Questions about midwifery at UW Medicine. What is the difference between a midwife and an obstetrician (OB)? Obstetricians are physicians with specialized training in obstetrics and gynecology. Nurse-midwives and obstetricians have complementary areas of expertise. Both types of providers can take care of you during pregnancy and childbirth and the frequency of clinic visits, types of ultrasounds and lab tests offered are the same. There are some higher risk pregnancies that need OB care. The main differences are in philosophy and training. Obstetricians have expertise in treating women with more complex and high-risk issues while midwives primarily manage low risk pregnancy and birth. What is the midwifery model of care? The midwifery model of care is a philosophy that views pregnancy and birth as normal physiologic processes and each woman as a unique individual. Midwives focus on wellness and empowering our clients to take responsibility for their own health. We understand that your mental, emotional and social well-being are as important as, and connected to, your physical condition. And we believe in the power of human connection to help you through this most special and vulnerable life transition. What’s the difference between a midwife and a doula? Doulas provide labor support and companionship which can be extremely helpful to the laboring woman and improve outcomes, but they are not trained to provide medical care and deliver babies. (Some doulas are also trained as a midwife, but when functioning as a doula, they are not managing the labor and birth.) Midwives and doulas both provide labor support and they often work together, but a midwife is a licensed healthcare provider who is responsible for managing your care and delivering the baby. A doula may also come to your house to help support you in early labor and some will also do home visits in the days after the baby is born. Where will I give birth? You can see the midwives for prenatal visits at one of a few neighborhood clinic locations and you can choose to give birth at either of our two hospital locations: the Maternal Infant Care Center at UW Medical Center - Montlake (1959 NE Pacific St., Seattle, WA 98195) or the Childbirth Center at UW Medical Center - Northwest (1550 N 115th St, Seattle, WA 98133). Do you offer home birth? No, the UW Midwives only offer hospital birth at either of our two locations: UW Medical Center - Montlake (1959 NE Pacific St., Seattle, WA 98195) or UW Medical Center - Northwest (1550 N 115th St, Seattle, WA 98133). Working in the hospital, we are able to offer midwifery care to many women who would risk out of a home birth practice. We do support the option of home birth for low risk women and there are many community midwives practicing in this region who offer home birth. What if there are complications and I need a doctor? The UW Midwives are committed to providing you with the best care possible. We are experts in normal pregnancy and birth and can manage most pregnancy-related problems. Indeed, most of our clients go through their entire pregnancy, birth, and postpartum period without needing to see a doctor. However, we work with a team of obstetricians, perinatologists (high risk pregnancy specialists), and other providers, so that those who need specialized care for medical complications or emergent events, receive appropriate, timely consultation or transfer of care. An example is if a C-section, or vacuum or forceps assisted delivery, is needed. In this case, the obstetrician will assume responsibility for your care, but your midwife will stay with you and continue to care for you in the postpartum period. We also have anesthesiologists and neonatology providers at the Childbirth Center 24/7. What is meant by “Shared Decision Making”? Shared decision-making is the process by which a patient and their provider share information and cooperatively agree on a plan of care. As midwives, we have expertise in pregnancy, birth and women’s health, but you know your body, your values and all the other aspects of your life. Between us, we have the information we need to decide what plan of care will be best for you and your family. Can I still see a midwife if I am “high risk”? There are some medical conditions that risk you out of midwifery care, but fewer than you might think. You need an obstetrician if you are having twins or if you have significant pre-existing medical conditions such as diabetes or heart disease. We do keep most of our patients who develop gestational diabetes, and we co-manage many conditions such as hypertension because we work within a team that includes obstetricians and high-risk pregnancy specialists. That means if you have high risk aspects of your pregnancy, but you really want midwifery care for your birth, we can usually accommodate you. There are some conditions that would require you to deliver at UW Medical Center - Montlake campus rather than at UW Medical Center - Northwest, but we now have midwifery care available at Montlake. Can I see a midwife for an IVF pregnancy? Yes, many patients come to us after working with a fertility clinic to get pregnant.