People in BC can choose a midwife, a family doctor, or an obstetrician to lead their pregnancy care. The right choice depends on your health, your plans for birth, and who has space for your due date.
This guide compares the three and shows how to decide.
What each provider does
A registered midwife cares for healthy pregnancies from early pregnancy through labour, birth, and the first weeks after. A small team follows you the whole way. Visits are often longer than a typical doctor’s appointment. Midwives attend births in hospital and at home.
A family doctor can provide prenatal care. Some family doctors also attend births. Many do not, and they refer you to another doctor for delivery. Ask your doctor early which applies.
An obstetrician is a surgeon who specializes in pregnancy and birth. Obstetricians care for pregnancies with higher risk and perform cesarean births. In many cases you reach an obstetrician through a referral from a family doctor or a midwife.
When a midwife is a good fit
Midwifery care suits people with a healthy pregnancy who want continuity. You meet the same few midwives at each stage. You can ask about home birth. You also get postpartum visits for you and your baby, often at home.
Midwifery care is publicly funded for people enrolled in BC’s Medical Services Plan (MSP). You do not need a referral. You contact a practice yourself. Our guide on how to find a midwife in British Columbia covers the steps and the questions to ask on the first call.
When a doctor is a better fit
Some health conditions call for a physician to lead care. Examples include certain pre-existing medical conditions or a pregnancy with more than one baby. A midwife or doctor can tell you where your situation falls. This is a medical decision, so rely on your own health history and a provider’s advice.
You might also choose a doctor because no midwife near you has space. That is a common reason, and it is a valid one. Many healthy pregnancies are cared for by family doctors and obstetricians.
What happens if your pregnancy becomes higher risk
A midwife can start your care and later bring in a physician. Midwives consult with obstetricians when a concern comes up. If the concern needs a doctor’s care, the midwife transfers some or all of your care.
Ask each practice to explain this before you commit. Useful questions:
- Which concerns lead to a consultation, and which lead to a transfer of care?
- Will my midwife stay involved if an obstetrician takes over?
- Who will care for me and my baby after a cesarean birth?
The answers differ by practice and by hospital, so ask each one.
Pain relief and midwife care
Many people ask whether they can have an epidural with a midwife. Epidurals are given by an anesthesiologist in a hospital. Ask the practice how your care works if you choose one. Also ask what comfort measures the midwives offer in labour. Do this before labour starts, when the answers are easy to take in.
Where you want to give birth
Birth location can settle the choice. If you want a home birth, you need a midwife whose practice attends home births in your area. Not every practice does. Family doctors and obstetricians attend births in hospital.
If you plan a hospital birth, ask which hospital the provider uses. The hospital may not be the closest one to your home.
Can you see a midwife and a doctor at the same time
Plan on one lead provider for your maternity care at a time. You may still keep your family doctor for other health needs. Ask the midwifery practice how it works with your doctor. If you have a lead provider already and want to switch, tell both offices. Switching is possible, and earlier is easier.
Questions to ask any provider
The same short list works for a midwife, a family doctor, or an obstetrician.
- Are you taking new patients for my due date?
- Who attends the birth if you are away or off call?
- Will I meet the others who might attend?
- Where do I give birth?
- What happens if my pregnancy needs different care?
- What care do my baby and I get after the birth?
Compare the answers. Pick the provider whose answers fit what you want and what your health needs.
If you cannot get your first choice
Practices fill early. If your first choice is full, ask about a waitlist. Then book prenatal care with a family doctor or nurse practitioner so you do not wait without care. If you do not have one, call 8-1-1 to reach HealthLink BC, and a nurse can point you to local options.
BC has six tourism regions: Vancouver Island, Vancouver Coast and Mountains, Thompson Okanagan, Kootenay Rockies, Cariboo Chilcotin Coast, and Northern BC. Midwives are more common in larger communities. In a small town, a doctor may be the practical choice for prenatal visits. Ask any midwife practice nearby whether it takes clients from your area.
Confirm your provider is registered
Midwives in BC are regulated by the College of Midwives of British Columbia, which keeps a public register. Physicians are regulated by the College of Physicians and Surgeons of BC. Check the register before you commit.
Midwife List is a new directory of midwives in BC, organized by type of care and by region. It has no listings yet. Check back as practices are added.
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