My OB saved my life. My OB almost killed me (and my children). This was all during the same pregnancy.
Katie's comment on my OB/Midwifery post got me thinking. I, too, can say an OB saved my life. Problem is, it was the OB who put me in danger in the first place.
First and foremost, I must say that OBs do have their place. They do save lives. Often, though, they create emergencies or make situations appear as though they are emergencies when they are not. Midwives are trained to calmly assess. OBs are trained to provide medical interventions to correct the problem or the perceived problem. Often times, there are circumstances that doctors consider high risk whereas a midwife does not. This isn't because midwives are blind, but rather because midwives are trained to recognize and treat challenges very early. They want to keep you in their care and the only way to do that is to keep you low risk. OBs typically don't have that focus on prevention because there's the idea that they can treat whatever comes along. Granted, there are situations where OBs can provide care that a midwife cannot. I'm not denying that. If a situation like that occurs, a midwife is trained to recognize it quickly so that the mother can either transfer to an OB's care or can be taken to the hospital. Midwifery is not opposed to obstetrics. They can actually work hand-in-hand if need be.
The Midwifery model of care includes preventing challenges (aka "complications"). They have diet guidelines to keep you healthy. They provide tests to check for problems (although these are typically far less invasive and far less often than the tests required with an OB). That way, they can help you come up with a treatment or, if necessary, refer you to an OB if one can better complete your care. That, however, seems to be fairly rare and in those cases, you may be able to continue seeing the midwives for some or all of your prenatal care. Midwives typically have access to standard medical treatments (medications, labs, etc), but many are also extensively informed on more natural alternatives which have been used and proven for centuries. You won't be denied a necessary prescription drug, but she may recommend either an alternative or a natural treatment that compliments the prescription. Although, typically, with midwifery, the final decision is yours.
The Obstetric model of care is that anything can be treated. You will be tested repeatedly during your pregnancy. Although, there is very little preventative medicine. If the problem continues, you may be given a prescription. If it persists, you may be given a number of different prescriptions and most likely more tests. If those don't help, there's bedrest. If that doesn't help, there's always induction. If that fails, there's always a c-section for mom. If it's too soon, well, there's the NICU for the baby.
For those women who truly have a higher risk (and the OB model of care considers many patients to be "High risk" even when a midwife might not consider them so), OBs are fabulous. Please don't think I'm taking issue with women who are truly high risk and who seek an OB's care.
I will leave you once again with this fabulous quotation:
"Midwives see birth as a miracle, and only intervene if there's trouble. Obstetricians see birth as trouble, and if they don't intervene, it's a miracle." Gentle Birth Choices.
Aug 30th edit: I have edited portions of this post as a result of recent on-going discussions/information.