You've just received exciting news--you're pregnant! Now what? The first step most women make, besides telling their partner, is calling their OB/GYN office, and setting up an initial appointment. Many women continue to see the same provider that they use for well woman check ups, throughout their pregnancy. Some women decide to switch providers. Why might this be? Well, for one, all care providers are not the same. Whether you see a midwife or an obstetrician (OB), there are certain things to look for in the way they treat their patients.
If you choose to see an obstetrician, you'll give birth in a hospital. Keep this in mind when choosing your obstetrician. Most OB's only deliver at one hospital. Is the hospital they deliver at one that you would like to be in? Are there any major policies at that hospital that disagree with your birth plan? Perhaps you're planning to have a doula. Does your hospital have any policies concerning doula support? Maybe you plan to have your placenta encapsulated. Does your hospital have any policies about taking your placenta home? As a doula, I'm heartbroken for clients who find a care provider they love, only to realize the hospital they will be birthing at has policies that directly conflict with their birth plan. Consider both your care provider, and the hospital they have privileges with.
If you choose to see a midwife, you may give birth at a hospital, birth center, or at home, depending on where they work. Here in Hampton Roads, we have midwives who deliver at a variety of places. Just like with an obstetrician, make sure you know where your midwife delivers. If your midwife only delivers at the hospital, ask yourself the same questions we ran through above: does this hospital support my birth plan?
If your midwife serves in a birth center, it's equally important to find out their policies. Does the birth center have certain requirements? Can you decline any of the standard procedures? What are the birth center's medical capabilities? How far away is the nearest hospital, in case of a medical emergency?
If your midwife offers homebirth, you'll want to know slightly different things. What are your midwife's policies? What would "risk you out" of a homebirth? Do they support your birth plan? What does their prenatal and postpartum care look like? How far is your home from a hospital, in case of a medical emergency? Are you comfortable giving birth in your home, and is your home suitable for a home birth?
These are all great questions to ask your care provider about the place you are going to give birth. But what about the person who will be attending your birth? Different care providers have different qualifications, but that doesn't mean one is "better" than the other. Consider your view of birth.
Would you prefer that your pregnancy is managed closely by a doctor, or would you rather have someone guide you through it with less strict direction? This is one of the primary differences between an obstetrician and a midwife. An obstetrician is a physician and will manage your pregnancy care, just like they would manage, for lack of a better comparison, an illness. This isn't necessarily a bad thing. If you prefer that your pregnancy is managed, and want to give birth in a closely monitored setting, or if you require high-risk care, an obstetrician will serve your birth wishes best.
If you prefer to be a little more gently guided in your pregnancy, a midwife may be a great fit. Midwifery care is a little harder to define, since every midwife has a slightly different idea of how to care for pregnant and birthing women. The basis of their philosophy, is to provide evidence based care. Midwives believe that pregnancy and birth are normal life events that don't usually require intervention. Midwives' model of care includes prenatal care, assistance during childbirth, and postpartum support. They strive to reduce technological interventions and are able to identify and refer women who may need obstetrical attention.
Wherever you give birth, and whoever you choose to attend it should treat you with respect, compassion, and individualized care. Your care provider may see dozens of births per week, but that doesn't mean you should be treated as if you are a product on an assembly line. You only give birth to this baby once, so choose your care provider wisely.
We cover this extensively in my childbirth education class, Hypnobabies, but most of my students are already in their third trimester, and for better or worse, have already chosen a provider. Hopefully this post encourages women to find the right doctor or midwife earlier on. Please contact me by email at firstname.lastname@example.org if you'd like a list of recommended care providers.