Choosing a pregnancy provider is one of the most important decisions you make in your early pregnancy. This person is going to be the one guiding you through one of the most transformative and life-changing experiences you will ever have, and you want to make sure they are guiding you in a direction that aligns with your pregnancy and birth desires. Finding a provider who shares those beliefs will be better equipped to help you achieve your goals and support you in the decisions you make.
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For example, if you are interested in a more natural and unmedicated birth without the use of medical interventions, it is important to seek out a provider who supports that approach (read our post on medical procedures you can say no to for an empowered birth). This type of provider will most likely also support many natural remedies and a holistic lifestyle during your pregnancy. They may also have resources that a traditional medical doctor may not have.
[*Hey, mama… Have you downloaded our FREE guide yet? “The Ultimate Guide to Natural Pregnancy Remedies” It’s jam-packed with awesome tips and advice to help you tackle those pesky pregnancy discomforts using natural remedies.*]
Similarly, if you are looking for that more traditional, medicalized birth experience – perhaps you are hoping to get an epidural or scheduled c-section – then it is important to find a provider who is comfortable with and experienced in those methods. Choosing a provider who aligns with your values and desires can help ensure that you feel heard and respected throughout your pregnancy and birth.
Choosing the right provider can also reduce stress and anxiety during pregnancy. Pregnancy is a time of great change and uncertainty, and having a provider who understands and supports your choices can help provide a sense of comfort and reassurance. The last thing you want to add to your already full plate is uncomfortable pressure from your provider or feeling unsafe and unheard at prenatal appointments. When you trust and respect your provider, you are more likely to feel comfortable sharing your concerns and asking questions, which can lead to better communication and ultimately, better outcomes for both you and your baby.
[Related post: How to Handle Pregnancy Cravings]
Just don’t forget that all pregnancy providers (no matter what kind you choose) are medical professionals and are legally responsible for ensuring the health and safety of both you and your baby. Even if you are planning on an unmedicated birth, you should ensure there is a certified person present who can legally and medically assist you in the unfortunate case of any unexpected emergencies.
There are two primary types of providers you can choose from during your pregnancy:
obstetricians (OBs) also known as physicians and midwives. Both play a crucial role in maternal healthcare, but they approach pregnancy and childbirth from different perspectives.
It’s important to note that both midwives and obstetricians can provide excellent care during pregnancy and childbirth, and the choice of healthcare provider depends on your unique individual needs and preferences. You also do not have to settle on the first provider you meet! Typically your insurance covers a variety of providers. There is nothing wrong with making an appointment, asking some questions to find out if that provider will be a good fit, and then moving on to a different care team. The provider you choose for your first prenatal appointment does not have to be the one you are stuck with your entire pregnancy!
What is a Midwife?
Midwives are healthcare professionals who specialize in supporting women through a healthy pregnancy, labor, and delivery. They often work with women who are at low risk of complications and focus on natural childbirth methods. Midwives typically have a background in nursing or midwifery, and undergo specialized training in pregnancy and childbirth. They are trained to support women through a low-risk pregnancy and delivery, and may opt for more natural methods to manage pain, such as breathing techniques, massage, or hydrotherapy.
Midwives typically take a holistic approach to pregnancy care, focusing on the whole person rather than just the pregnancy. They often emphasize the importance of a healthy lifestyle, including nutrition, exercise, and stress management, and may recommend natural remedies to manage common pregnancy discomforts.
Pros of Working with a Nurse Midwife
- Personalized care focused on individual needs of mother and baby
- More time spent with patients to build relationship of trust and understanding
- Holistic and attentive approach to care
- Natural and low-intervention approach to childbirth
- Skilled at identifying potential issues before they become problematic
- Prioritize non-pharmacological pain management techniques
- Continuity of care throughout pregnancy, childbirth, and postpartum period
- Results in better birth outcomes, fewer interventions, and higher levels of satisfaction with birth experience
Cons of Working with a Midwife
- Choosing a midwife may not be the best fit for every woman as midwives cannot perform medical interventions like epidurals or cesarean sections.
- Midwifery care may not be the best choice for those who want these options available during labor.
- Consider looking for a midwife who teams with an OB if you want to work with a midwife but want to ensure these options are available.
- Midwives often work in birth centers or in homes, which may not feel like the safest environment for some people.
- Hospital birth with an obstetrician may be the safer choice for those with high-risk pregnancies or concerns about potential complications.
- Some midwives do work in a hospital setting, and this is a question you can ask at your first visit.
- Not all midwives are created equal, and it’s important to do your research and work with a qualified midwife.
What is an Obstetrician
Obstetricians are medical doctors who have completed medical school and a residency in obstetrics and gynecology and who specialize in the care of pregnant women and their babies. They are trained to handle high-risk pregnancies and complicated deliveries with the use of more traditional and modern medical interventions. They tend to take a more medicalized approach to prenatal care, focusing on monitoring the health of the mother and baby and identifying and managing any potential complications.
Obstetricians are legally allowed to and trained to perform medical interventions such as epidurals, assisted delivery, and cesarean sections. They primarily opt for medical pain relief and feel more comfortable with medical interventions over holistic and natural remedies.
Pros of Working With an OB
- Obstetricians, or OBs, are highly trained medical doctors specializing in pregnancy, childbirth, and postpartum care.
- OBs undergo four years of medical school and four years of residency training in obstetrics and gynecology.
- They have the knowledge and expertise to handle a wide range of pregnancy-related complications and emergencies.
- Most OBs have hospital privileges and can admit and care for their patients in a hospital setting.
- Working with an OB can provide women with peace of mind, advanced medical technology, and hospital resources if needed.
Cons of working with an OB
- OBs may prioritize medical interventions over natural approaches, which may not align with the goals of some pregnant women.
- OBs may have a high patient load, leading to a lack of personalized care and support and less time spent with you as an individual.
- Alternative pain management techniques may not be as encouraged by OBs.
- Hospital policies and regulations may limit a patient’s options for labor and delivery like eating, drinking, and moving during labor, which can be frustrating for those who want more freedom and flexibility.
- More likely to recommend medical interventions like inductions, epidurals, and cesarean sections, which can interfere with the natural process of childbirth.
- Your personal care can be generalized and impersonal which often leads to unnecessary medical procedures and interventions.
Not every OB is money motivated, but unfortunately we live in a world where money still drives most people. A 2018 study published in the journal Health Affairs found that Medicare payments to OB-GYNs for vaginal deliveries were on average $1067 compared to $1621 for C-sections. Private insurance payments for C-sections were also found to be higher than those for vaginal deliveries. They can also make more money quicker – a C-section surgery takes about 45-60 minutes to perform. A woman laboring naturally and delivering vaginally on average takes 12-14 hours.
Bottom line, OB’s make more money for a C-section than they do from a vaginal birth and they can get in and out of the hospital quicker. There are some absolutely wonderful OB’s out there who are not money motivated, but unfortunately those doctors are not the norm in the industry. Be wary of any OB who has a C-section rate higher than 15%. The World Health Organization recommends a C-section rate of no more than 10-15%.
So, which should you choose, Obstetrician or Midwife?
Regardless of which provider is the best fit for your unique pregnancy, it is essential to choose one that aligns with your values and desires and is willing to communicate with you as an equal, and not as simply a case file. Physicians and midwives each have their own set of pros and cons, and every woman has different priorities and needs in her unique pregnancy. However, effective communication between you and your provider is key to ensuring that your needs are being met throughout your pregnancy and childbirth.
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Questions To Ask at Your First Pregnancy Appointment
Take in this list of questions to your first prenatal appointment to help determine if the provider will be a good fit for your pregnancy goals. Treat it like an interview! You are in control of your pregnancy, and the provider is there to help you achieve the empowered birth you desire, not to tell you what to do.
- What is your approach to prenatal care?
- Can you explain your philosophy on childbirth and the role of the mother in the process?
- What is your view on pain management during labor, and how do you support unmedicated births?
- How do you feel about the use of interventions such as induction or episiotomy?
- How often do you perform ultrasounds, and what is your opinion on their frequency and necessity?
- How do you feel about natural methods of pain relief, such as hydrotherapy or hypnobirthing?
- What is your policy on allowing the mother to eat and drink during labor?
- How often do you encourage movement and position changes during labor?
- How do you support breastfeeding and provide resources for new mothers?
- How do you handle postpartum care, including mental health support?
- What is your stance on the use of forceps or vacuum extraction during delivery?
- How do you handle emergencies or complications during childbirth?
- Can you describe your experience and training in supporting natural childbirth?
- How do you involve the partner or support person during labor and delivery?
- What is your policy on informed consent and involving the mother in decision-making throughout pregnancy and childbirth?
- Can you give me your birth statistics from last year on the following:
- Total births
- Percent over 40 weeks
- Percent primary cesarean
- Percent vacuum forceps
- Percent successful VBAC
- Percent unmedicated
- Percent with 1st degree tears, 2nd degree tears, 3rd degree tears, 4th degree tears
- Percent that were medically induced
- Percent that received an episiotomy
- Percent with shoulder dystocia
- Percent with postpartum hemorrhage
Choosing a pregnancy provider that supports your birth plan can also help you feel more empowered and confident throughout your pregnancy and childbirth. When you have a provider who understands and respects your wishes, you’re more likely to feel comfortable asking questions and advocating for yourself. This can help you feel more confident in your ability to make informed decisions about your care and more prepared for the challenges of childbirth.
Studies have shown that women who have a supportive provider and a birth plan that aligns with their values and desires are more likely to have a positive childbirth experience. A positive childbirth experience can have long-term benefits for both you and your baby, including increased satisfaction with your birth experience and better maternal-infant bonding.
Good luck, mama.
Jess
