As soon as you find out that you’re pregnant, many questions may come your way. Will you give birth in a hospital or at home? Will you opt for pain relief in labor? What kind of healthcare provider will help you birth your baby? How can you choose a pregnancy care provider who supports your goals? Knowing what options are available is an essential step in selecting a pregnancy caregiver.

Pregnancy Care Providers

There are all types of pregnancy care providers, including certified nurse-midwives, obstetricians (OB), family practice doctors, advanced practice nurses, and so forth. Most births are attended by obstetricians or certified nurse midwives in the U.S.

The most notable difference between midwives and obstetricians is the years of medical training. An OB must complete four years of undergraduate school, four years of medical school, and three-to-four years as a resident doctor rotating throughout OBGYN office visits, surgery, and working in a hospital Labor & Delivery unit.

To become a certified nurse-midwife (CNM), you must first be a registered nurse, work two years in Labor & Delivery unit, complete a graduate education program in midwifery, and pass a national certification exam.

A certified professional midwife must have a previous background as a doula or  and Labor & Delivery health professional, complete a direct-entry program for three years, and pass a national certification exam.

Although all three practitioners are trained and experienced in Labor & Delivery, nurse midwives and professional midwives have a different scope of practice and provide care in different birth environments. Obstetricians provide birthing care to women in hospitals, where medical interventions and surgery can take place. Certified nurse-midwives also work in hospitals, birth centers, or attend home births. Professional Midwives only support home births and provide holistic health care.

Asking questions will help you make an informed choice about your provider with the comfort of knowing their practices align with your goals and expectations. When interviewing providers, ask:

  • What is your approach to prenatal care?
  • If we have a difference in opinion, is their opportunity for shared decision making, or will I be asked to leave the practice if we disagree?
  • Will you allow me the autonomy to have input in how I birth my baby, including my preferences, and positions for birth?
  • What if my baby isn’t ideally positioned for birth, will you encourage a cesarean birth or recommend alternatives (such as chiropractic care, spinning babies, etc.)?
  • What is your approach to labor and birth?
  • If I desire a natural birth, will you patiently support me and provide resources to optimize my birth experience?
  • How will you communicate with me if an urgent issue arises during birth? Are you proactive with communication or will you wait to explain your actions later?
  • Do you have a formalized plan for communicating any kind of birth trauma or emergency that may occur in my birth process? Can I count on you or someone in your practice to personally brief me on what happened afterwards?
  • Will you allow me to make my own choices without bias?
  • Will you discharge me from your practice if I don’t agree with your professional opinion or recommendations?
  • What is your approach to postpartum recovery?
  • If I experience abnormal pain or bleeding after birth, will you address it in a timely manner?

How Do I Choose My Pregnancy Care Provider?

Use these questions to help you determine the best type of pregnancy care provider based on the birthing experience you desire:

  • Is my pregnancy considered low-risk or high-risk?
  • Do I want to birth naturally?
  • Do I want freedom to birth as I feel?

Once you know how you desire to birth your baby, begin your search for providers convenient to where you live:

  • Schedule interviews or consultations before selecting a provider
  • Bring a list of questions to your initial visit
  • Ask about whether the provider would support the presence of a doula during labor and birth

Hiring a Doula

Doulas are pregnancy support persons who can provide you with evidence-based education, care, and support throughout your pregnancy, birth, and postpartum recovery. Ask if the hospital or facility where you will give birth has doulas available for support.

Many of these questions may not be scenarios you experience in your birth experience, but by having a real open, honest, and transparent conversation with your provider, you can truly optimize your ideal experience.

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Nikita Johnson is a midwifery student, doula and doula trainer in Baltimore Md. She is the Founder of DMV Birth Doulas, LLC and the Black Doula Training.

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