Food for Thought: I have thought a lot about how women decide whether to use a midwife or doctor for their birth. I think it really comes down to life perspective. Do you focus on what can go wrong in life or on what can go right? This will be the defining reason for your choice. You will seek out and feel most comfortable with a care provider who mirrors your view of life.
Here is Marsden Wagner, Ob-Gyn on the different perspectives of doctors and midwives. "Though midwives know what can go wrong during pregnancy and birth and know how to identify problems early and to cooperate with doctors in managing complications, their focus is on birth as a life-enhancing experience." This makes midwives a good match for women who naturally gravitate to a world and personal life view of staying in touch with everything that is right in the world and their bodies.
"Obstetricians, on the other hand, tend to focus on what can go wrong during pregnancy and birth. All doctors are trained to look for trouble (diagnose a problem) and decide what to do about it (decide on a treatment), and that is what comes naturally to obstetricians." So if your way of interacting with the world is to keep your eye focused on what can go wrong in life so as to prevent it from happening, then a doctor is a better fit for you.
Each choice can come at a price though. For a woman choosing a midwife it can be very difficult if the midwife finds an actual problem with the pregnancy or birth. The pregnant or birthing woman may have a hard time switching gears to focus on the problem in order to address it. Here is what Dr. Wagner says about the price the woman choosing a doctor pays, "In prenatal care they [doctors] take the same approach, focusing on what can go wrong and ordering numerous tests and screening procedures. This attitude casts a shadow over the maternity care a woman receives. When an obstetrician runs a test or gives a preemptive treatment, it is an unspoken vote of no confidence in the woman’s body.” I know women often feel each prenatal visit is like a pass/fail test. This is especially stressful on women who are high achievers. If they run into a perceived “failure”, at an office visit it can shake their confidence to their core and they may become obsessed with their fear of failure. This can lead to a rise in stress hormones which can spiral into more “failed” tests.