The nine months of pregnancy are all about choices. These include everything from the best exercise and the most comfortable shoes to your prenatal care provider and birth location. Pregnancy and the birth of a child are ranked as one of the most memorable experiences for women, so being well informed of all your options can help ensure a gratifying experience for you and your family. Two things you will make decisions about early in pregnancy are your health care provider and your birth location. These decisions often go hand in hand because most health care providers have chosen birth locations. Most women base their choices on health histories, preferences, finances, and well informed opinions.
Obstetricians are medical doctors who specialize in the management of pregnancy, labor and birth. They also receive specialized education in the health of the female reproductive system and surgical care. Much of their education focuses on the detection and management of obstetrical and gynecological problems. Many women who have had complicated pregnancies in the past or who have certain medical conditions will choose an obstetrician for their pregnancy care to ensure that any problems that develop can be handled effectively. Obstetricians normally do deliveries in a hospital setting.
These physicians have completed schooling and training in various fields of medicine including obstetrics, pediatrics, surgery, and internal medicine. During their residency, they gain experience in treating the whole family. Family practitioners normally handle low risk pregnancies, and most do deliveries in hospitals.
These health care providers can have a wide spectrum of training. Certified nurse-midwives have a nursing degree plus additional training in midwifery. Direct-entry midwives or certified professional midwives have extensive training in midwifery, although they do not have a nursing degree. Most midwives offer care that is flexible and individualized with little medical intervention; therefore, they usually care only for low risk pregnancies. Many midwives offer deliveries in homes, birthing centers, or hospitals.
If you have chosen an obstetrician or family practitioner as your health care provider, you are most likely making plans for a hospital birth. The number of births attended by midwives in the hospital setting is also increasing. Some families feel more comfortable having access to technology and skilled professionals in case of an emergency. There may be more restrictions during labor and birth. Make sure to tour your hospital before your birth and learn about all the guidelines and policies regarding laboring techniques, routine interventions, use of cameras or video, and newborn care.
The first free standing birth center was opened in 1974 in an effort to give women a more relaxed setting. Midwives are often the sole health care providers at free standing birthing centers, but there are some obstetricians who will do deliveries at birthing centers located inside hospitals. Birthing centers usually have fewer restrictions and guidelines and allow for more freedom in making decisions about labor. Birthing centers are often recommended for pregnancies that are considered low risk and for women who are seeking to have a birth with few interventions. If you have particular requests for your birth, be sure to talk with a birth center representative beforehand to discuss policies and guidelines.
For centuries women have been having babies at home. Many women feel more comfortable and relaxed when birthing in their own environment, however, with this freedom also comes extra responsibilities. For instance, families wanting to birth at home need to be well educated about possible concerns that can arise and be open to the option of transporting to a hospital in case of a complication. Midwives are the main health care providers for home births. Home births are recommended for women with low risk pregnancies. Many women who want no interventions and a very family-centered birth experience choose to have a home birth.
Compiled using information from the following sources:
Pregnancy, Childbirth and the Newborn: The Complete Guide. Simkin, Penny, P.T., et al, Ch. 1.
Childbirth Connection, http://www.childbirthconnection.org/
American Pregnancy Association, http://www.americanpregnancy.org