Choosing Your Care Provider
When it comes to deciding who will provide the medical care for you and your baby during your pregnancy, the options can seem overwhelming. Most people have heard of an OB, many have heard of midwives, but did you know that there are different types of midwives? And even different types of doctors that catch babies?
Who you choose to support you during your pregnancy and birth should depend a lot on the type of birth that you are hoping to have. So, it’s important to have an idea of the type of birth you’re wanting before you choose your provider.
Let’s dig into the different types of care providers you can choose from when planning your birth.
Obstetrician (OB or OB-GYN):
If you’re planning to give birth in a hospital, a large percentage of available providers will be obstetricians (OBs). These doctors are trained in medical birth, and are well prepared for any complications that may come up during your pregnancy or birth. Some may have more experience with natural birth, but most are used to supporting birth with some form or forms of medical intervention. They are surgeons, and can perform a cesarean birth should one be necessary. You will have all prenatal visits in a doctor’s office, and the standard prenatal testing and scans will be recommended. Most OBs work in a group, so you will likely have a rotation of providers in your appointments, and whichever provider is on call at the time of your birth will be the one who catches your baby.
High-risk OB (MFM):
If you have a high-risk pregnancy, it’s likely you’ll be referred to a maternal-fetal medicine obstetrician (MFM OB). These doctors specialize in complicated pregnancy and birth, and have a wealth of knowledge and experience supporting moms and babies that may need a little (or a lot) of extra care. All of the above information about standard OBs applies here as well, with the added note that you will likely have many more tests and scans, depending on your and your baby’s particular health picture.
Hospital-based Midwife (CNM):
Many hospitals have the option of working with a certified nurse midwife (CNM) if you have a low risk or uncomplicated pregnancy. These providers have lots of experience supporting more natural pregnancy, labor and birth, and often provide more in-depth appointments than OBs. If you have a hospital birth with a midwife, you’ll still have pain medication options and emergency care close at hand, but may have an easier time having a natural birth if you so choose. Hospital midwives also often work in a group with an on-call rotation.
Family Practice Doctor:
Some family medicine or family practice doctors provide prenatal and birth care (in the hospital setting) as well as routine health care and even pediatrics. If you’re hoping to have one doctor for all of your needs, this is a possible way to do that! However, if your pregnancy or birth presents with complications, you’ll likely be referred to an OB or MFM.
Homebirth midwife (CNM):
Some certified nurse midwives choose to attend births outside the hospital setting. When you choose a homebirth CNM you’ll be getting the benefit of the midwife’s nursing education and experience as well as the chance to birth your baby in the comfort of your own home. CNMs also may be able to provide a few more interventions at home than a CPM, and that may help you avoid a transfer to the hospital in the event intervention is needed. You’ll likely have longer prenatal visits, (which may take place in your home or in an office), and ample time to ask your questions when working with a homebirth midwife. You will have much more control over the setting and experience of your birth, since you’ll be in the comfort of your own home.
Homebirth midwife (CPM):
Certified Professional Midwives are trained and certified, but usually don’t have a nursing degree. They attend birth in the home setting, and have most of the same benefits as working with a CNM, but because they aren’t nurses, may have some limits to the interventions they can provide. These women are usually very experienced in the natural process of labor and birth, and often have learned additional skills on the job from a mentor, or more experienced midwife.
Homebirth midwife (traditional):
A traditional or direct-entry midwife will usually get most, if not all, of her training on the job, shadowing and being mentored by an experienced midwife. These midwives do not have certifications, and often work in communities where midwifery is either unregulated, or they choose to work uncertified in regulated states. Traditional midwives can be very experienced or very inexperienced, but since they are not certified, it’s important to do your research when choosing a traditional midwife. It’s possible to have a safe and wonderful birth with a traditional midwife, you just need to be certain she is what you’re looking for, and has appropriate training and experience.
A few more notes:
You can always interview potential providers! If you find that you don’t connect with a provider, you can make an appointment with another to see if he or she is a better fit. Keep “shopping” until you find someone that you like, trust, and believe will support you in the way you need.
If insurance is a concern, making sure your chosen provider is in-network will be very important. Calling the provider can be a good start, but you will likely need to contact your insurance company directly to verify in-network status. Very few insurance companies cover homebirth, and even fewer homebirth midwives accept insurance.
Sometimes CNMs and CPMs catch babies in free standing birth centers, as well! So if you are looking for an out-of-hospital birth experience, but don’t want to birth at home, this could be a good fit for you!
The bottom line:
The type of birth you’re hoping for will guide you in your choice of provider. If you know you want a homebirth, you’ll need to choose a midwife. Researching the types of midwives available in your area will help you find the right fit for you! If you know you want to give birth in a hospital, you have several options, and finding a provider in alignment with the kind of birth you want will guide your choice.
What kind of birth are you hoping to have? Have you already chosen a care provider? What helped you make your decision?
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