Choosing Your Birth Provider: Understanding the Difference Between OBGYNs, CNMs, and CPMs
One of the first and most important decisions you’ll make during pregnancy is choosing a provider to guide you through prenatal care and delivery. Whether you envision giving birth in a hospital, birth center, or even at home, understanding the difference between OBGYNs, Certified Nurse Midwives (CNMs), and Certified Professional Midwives (CPMs) can help you make the best choice for your unique needs and goals.
Each type of provider has different training, expertise, and philosophies of care, and your decision can shape your birth experience. Let’s break down the key differences to help you feel informed and confident.
OBGYNs: The Medical Experts
Who They Are:
OBGYNs (Obstetricians and Gynecologists) are medical doctors who specialize in women’s reproductive health, pregnancy, and childbirth. They are trained to manage everything from routine pregnancies to high-risk situations and can perform surgeries, such as cesarean deliveries.
Training and Education:
Medical degree (4 years of medical school).
Residency in obstetrics and gynecology (4 years).
Board certification in obstetrics and gynecology (optional but common).
Where They Practice:
OBGYNs typically work in hospitals, although some may offer prenatal care in clinics or private practices.
When to Choose an OBGYN:
You’re experiencing a high-risk pregnancy (e.g., twins, preexisting health conditions, history of complications).
You prefer a hospital birth setting.
You want the option for epidural pain relief or are considering a scheduled cesarean delivery.
You feel more comfortable with a highly medicalized approach to birth.
What to Expect with an OBGYN:
OBGYNs often focus on the clinical aspects of pregnancy and birth, such as monitoring your baby’s growth, conducting ultrasounds, and managing potential complications. While they may have less time for in-depth conversations about your preferences, they are experts in handling medical emergencies.
Certified Nurse Midwives (CNMs): The Balance of Medical and Holistic Care
Who They Are:
CNMs are advanced practice registered nurses who specialize in midwifery care, which includes prenatal care, labor and delivery, postpartum support, and well-woman care (like annual exams and contraception). CNMs are trained to handle low-risk pregnancies and are licensed to practice in all 50 states.
Training and Education:
Bachelor’s degree in nursing (BSN).
Master’s or doctorate degree in nurse-midwifery.
Certification through the American Midwifery Certification Board (AMCB).
Where They Practice:
CNMs work in a variety of settings, including hospitals, birth centers, and home births (in some states).
When to Choose a CNM:
You’re experiencing a low-risk pregnancy.
You prefer a provider who balances medical expertise with a holistic approach.
You want personalized, relationship-based care.
You’re considering a birth center or hospital birth but want a midwife-led experience.
What to Expect with a CNM:
CNMs often take more time during prenatal visits to discuss your preferences, answer questions, and provide emotional support. They focus on empowering you to have an active role in your care and typically prioritize low-intervention births while being equipped to manage complications in collaboration with physicians if needed.
Certified Professional Midwives (CPMs): The Home Birth Specialists
Who They Are:
CPMs are midwives who specialize in out-of-hospital births, primarily home births and birth center deliveries. Their training focuses on low-risk pregnancies and providing hands-on, holistic care during labor and delivery.
Training and Education:
Apprenticeship or midwifery program training (varies).
Certification through the North American Registry of Midwives (NARM).
Training emphasizes out-of-hospital birth settings.
Where They Practice:
CPMs exclusively attend home births and birth center births. They are not licensed to practice in hospitals or handle certain medical emergencies.
When to Choose a CPM:
You’re experiencing a low-risk pregnancy and desire a home birth.
You value a highly personalized, hands-on approach to care.
You prefer a provider who specializes in out-of-hospital births.
What to Expect with a CPM:
CPMs often spend considerable time building a relationship with you and your family, focusing on your preferences and birth plan. They typically bring equipment to monitor your baby’s health and handle basic complications, but they are not trained to perform surgical procedures or work in hospital settings. If a medical emergency arises, they will transfer care to a hospital.
Key Differences at a Glance
ProviderFocusSettingIdeal ForOBGYNHigh-risk pregnancies, surgeryHospitalsThose who want a highly medicalized approach or have high-risk pregnanciesCNMLow-risk pregnancies, holisticHospitals, birth centers, some home birthsThose who want a balance of medical expertise and personalized careCPMOut-of-hospital birthsHome births, birth centersThose who want a natural, out-of-hospital birth experience
How to Choose the Right Provider for You
The right provider depends on your individual needs, values, and birth goals. Ask yourself:
Do I want to give birth in a hospital, birth center, or at home?
How much medical intervention am I comfortable with?
What level of risk does my pregnancy carry?
How important is relationship-based, personalized care to me?
It’s also helpful to interview potential providers and ask questions about their approach to care, experience, and availability during labor. The more you connect with your provider, the more supported and confident you’ll feel throughout your pregnancy and birth.
Final Thoughts
Choosing a provider is a deeply personal decision, and there’s no one-size-fits-all answer. Whether you choose an OBGYN, CNM, or CPM, the goal is to find someone who aligns with your values, listens to your preferences, and supports your journey into parenthood.
Want help navigating your options? I’m here to support you with evidence-based resources and guidance tailored to your unique needs. Let’s make your birth experience empowering, informed, and beautifully yours. 💕