Midwife 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. How do you view midwives? Is there a certain stigma that perpetuates among doctors regarding midwives? Is it worth it to keep fighting for med school when I might not get in? How much family time do you have? If you could do it all over again, would you chose something that is basically the same thing with a limited scope and save yourself the years of training?

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

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[GunnarBronson]

Based primarily on the fact that starting a large family soon is one of your priorities, I'd say medical school probably wouldn't be the best idea. You're right in that your "family time" will be extremely hampered throughout your medical school and residency career, and potentially your attending career.

Midwives are legitimate medical practitioners who serve a specific purpose. There's absolutely nothing wrong with that.

 

[iWillOneDay]

I, as a wanna-be DO, do not think we should hold any stigma/negative-view towards midwives. If DOs do not want stigma towards them, they shouldn't hold stigma towards others.

Sometime, you have to sacrifice one thing to achieve another.
Sure, it will be "easier" to have a large family as a midwife compared to an OBGYN but it's not impossible the other way around. I know many physicians who had kids during medical school and residency. It will be more difficult but not impossible.

Also another option is to be a PA. ~2 years and you can practice. I'm sure OBGYN offices have PAs also. By the way, getting into a PA school isn't easy.

 

[RoadNurse33]

So here is where you come in: I need help. How do you view midwives? Is there a certain stigma that perpetuates among doctors regarding midwives? Is it worth it to keep fighting for med school when I might not get in? How much family time do you have? If you could do it all over again, would you chose something that is basically the same thing with a limited scope and save yourself the years of training?

This is the first sentence of my personal statement for my application to medical school: "Sitting in the waiting room of the midwifery practice, my wife began to describe her vision of our son's nursery." Our son is 6 days old as of this posting and he was delivered by a CNM, in a hospital, with in-house OB backup. Additionally, all of the resources available to an obstetrician (OR suite, NICU, neonatal resuscitation team, anesthesiologist etc) were immediately available to our midwife (plus an obstetrician in the event of an emergency, obviously). Most importantly, they were available to my son and my wife had they needed it. I highly respect physicians, I personally want to become a physician, and my older sister is a physician. Yet every interaction we had with a physician during my wife's pregnancy (and delivery) was poor. I did not feel these interactions were poor because of their level of education, knowledge base, experience, or psycho-motor skills. I'm sure they are all excellent clinicians...but they all had terrible bedside manner compared to the midwives. Our first fetal medicine consult (level II ultrasound at 20 weeks) was horrible. I could see my wife fighting back tears while we sat in the doctor's office. Thank god for the midwives. We got to the point of scheduling a followup appointment with the midwives the same day as the ultrasounds. I truly believe that the midwifery practice we used was the absolute best thing we could have done, and I would use them again without thinking twice.

A brief background on myself: I work as a critical care paramedic on a medevac helicopter. My service performs high-risk OB (HROB) transports, and I am required to complete an 8 hour clinical rotation in a HROB setting annually. Pregnancy and delivery are natural events, but I have a jaded perspective since an overwhelming majority of my OB encounters are high risk. At the same time, sh** happens, as I routinely observe in my daily practice. As such, I was skeptical about using a midwife.

I think very highly of Certified Nurse Midwives. This distinction is very important to make, in my opinion, and I believe it to be the best/most responsible form of midwifery. I consider CNMs to be competent, highly educated, and compassionate medical professionals. Conversely, I believe "traditional" or "community" midwives are dangerous. Again, my opinion.

Is your dream to be a physician, or is it to practice as an advanced care provider in the field of obstetrics? I know you are aware that becoming a CNM is not an "easy" task. I would not equate it to medical school and residency, but then again, midwives only manage low-risk pregnancies. The most important skill a CNM can have, in my opinion, is knowing when the needs of the patient are beyond their capabilities.

Lastly, and please do not mistake this as an insult, but "limited scope" applies to procedures, not the capacity to improve a patient's overall health. You may not be able to repair grade III tears or perform a c-section, but that does not inhibit your ability to work with a patient to improve their health.

 

[birdboybird]

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. How do you view midwives? Is there a certain stigma that perpetuates among doctors regarding midwives? Is it worth it to keep fighting for med school when I might not get in? How much family time do you have? If you could do it all over again, would you chose something that is basically the same thing with a limited scope and save yourself the years of training?

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

It seems that you have already done a lot of thinking about this and that is great! However, you seem more confident about your career and lifestyle as a midwife. I would recommend you making a list of Pro's and Con's and to see which one you will be more HAPPIER and satisfied in down the line! I know of a lot of women who prefer to see midwives over OB/GYNS and they have a lot of respect in the medical community! No matter what profession or career path you decide, you can make it as successful and productive as you intend! Stick with your gut and good luck! ♥♥

 

[ananasmed]

OP, I found myself in a somewhat similar situation. I wasn't interested in midwifery specifically, but I was torn between becoming an advanced practice nurse and a physician. I have the grades for med school, but was quivering in my boots about the MCAT, the amount of years I would spend in medical training, and the lifetime commitment that medicine demands. After graduating with my BS, I took nursing pre-reqs, applied, and was accepted to 4 "top" master's entry nursing programs. Each program was slightly different... some were just 2 year programs that train you be an entry level nurse who happens to hold an MSN. Others were guaranteed acceptances straight through to the DNP level in any specialty I might choose after completing the first two years, and others I had to apply to a specific doctoral specialty track right from the start (women's health/midwifery was an available track in these programs - I chose Adult/Gerontology Acute Care based on my interests and experiences). Admission to these programs wasn't quite like med school admissions, but it wasn't a cake walk.

Only then did I really begin to feel the disappointment and think about my life path. I felt that I would be uncertain, unsettled, potentially regretful at a later point in my career. If you DON'T think you'll feel this way, then advanced practice nursing/midwifery is a wonderful option, and I am sure you will have an incredibly rewarding career. If you have any inkling of these regretful feelings, I urge you to go the extra mile to apply to medical school. With my first acceptance to DO school in hand, I am so proud of myself for making this choice. Like you, I hope to have a family (though I'm not sure how many kids I'd like!) and I understand the internal conflict you face between your career aspirations and other goals for your life. However, remember that you are young, and as others have pointed out, it is possible to have children during your years of medical training if this is a priority for you.

Additionally, I'd like to point out that nursing is attempting to change all advanced practice degrees to the doctoral level (DNP) instead of MSN. Nursing isn't quite as organized as medicine, so it's hard to say how long this change will take, who will be grandfathered in, and it's variable from state to state whether or not nursing programs are still offering MSN nurse practitioner programs. For me, the switch to DNP meant that it would have taken me approximately ONLY ONE YEAR LESS to become a nurse practitioner in the specialty of my choice than to become a physician completing a 4 year residency. 2 years of nursing school, approximately 2 years of field experience desired to continue to the doctoral level (some programs may allow you to start school on a part-time basis while you work full-time as a nurse), and then approximately 3 years+ to earn the doctoral degree which would allow you to practice as a midwife or other advanced practice nurse. For you, the path may be shorter depending on what programs you are looking at/if you will be able to complete the pre-reqs during undergrad/if you consider accelerated BSN programs, etc. But I would just like to point out for you and for any others reading this thread that the road to becoming a CNM/ANP is certainly not short or easy, especially if you have already completed an undergraduate degree in a field other than nursing. For those in this position, PA school would certainly be a shorter route.

I hope this post has helped you. Good luck with your decision 🙂 Remember that you really can't go wrong here - both are great career options - and also that it's never too late to change your mind.

 

[RoadNurse33]

I should have mentioned this in my first post, but seeing as this is posted in a pre-osteo forum you probably already understand that most people that cruise these message boards are likely not 1)physicians not 2)nurses and not 3)advanced practice nurses. Emphasis on most, not all. You wouldn't buy a car without test driving it...so shadow before you commit to one profession over another.

But I would just like to point out for you and for any others reading this thread that the road to becoming a CNM/ANP is certainly not short or easy, especially if you have already completed an undergraduate degree in a field other than nursing. For those in this position, PA school would certainly be a shorter route.

I'm glad you mentioned this because for two reasons. First, I was trying to figure out how it was possible for OP to become a CM or CNM by age 25. Maybe it is. I honestly don't know OP's situation. Second, and perhaps most importantly, if you want to practice medicine with significant autonomy, at a high level, then a shortcut does not exist.

Additionally, I'd like to point out that nursing is attempting to change all advanced practice degrees to the doctoral level (DNP) instead of MSN. Nursing isn't quite as organized as medicine

This is one hell of a can of worms. Yes, they are absolutely moving towards a DNP. Yes, the timeline is still undecided. However, I wouldn't go as far as saying that nursing isn't quite as organized as medicine. Not only is APN still a relatively new field (1960s), but the role of the APN today has evolved significantly compared to 50 years ago. Here's the rub: APN education is an entirely different philosophy than physician education. It was originally designed to take experienced nurses and build upon that experience to address the shortage of primary care providers...not an unfamiliar situation that we are in today. As APNs are used in different settings, education requirements have changed significantly. Still, the foundation of being an experienced nurse is essential to the success of this model. Meanwhile, the time-based model of medical education for physicians has been around since 1910. 1910! And it would appear that this "one size fits all" model of medical education is not only producing robot doctors, but it also does not automatically equate with competence.

Not a complete tangent, here is my ultimate point to the OP: there are two different education systems at play here: time-based and outcomes-based. Regardless, they each require a significant amount of time and education. Experience is crucial for APNs because you don't know what you don't know until you know. There really isn't a quick method to becoming an advanced care provider...it takes time.

Good luck in whichever profession you choose. Here's the good news: whatever career path you select...the education/training does not end upon successful completion of a program. It goes on forever!

 

[karling]

I'd just like to point out that medical students and residents can have children while they're in school/residency. The doctor I've been shadowing gave birth to two children during her residency.

You can both become a doctor and start a large family at a "reasonable" age. You don't have to choose one or the other.

 

[gyngyn]

CNM.