Choosing a Doctor
A positive attitude and lifestyle
are very important aspects of a healthy pregnancy, but it also takes good prenatal
care and the help of a health care professional. It’s important to be well
informed about your options and decide on a birthing plan that fits your needs.
Primary Care Physician
If you experience any symptoms
associated with pregnancy, your first step should be to consult your
doctor. Your doctor will confirm the pregnancy and advise you on choosing
specialists to help monitor your pregnancy. Some family practice doctors
provide prenatal care and attend deliveries. You may also decide to see an obstetrician/gynecologist
(OB/GYN) or a nurse-midwife.
An OB/GYN is a doctor specializing
in the care of women and their reproductive health. Obstetrics deals
specifically with pregnancy and birth and gynecology involves care of the female
reproductive system outside of pregnancy. Your obstetrician will guide you
through the entire pregnancy. It’s possible that the doctor you have seen for
your reproductive health needs may only practice gynecology, as some OB/GYNs
stop practicing obstetrics. In this case, you will be referred to an OB/GYN
with an active obstetrics practice.
A midwife offers similar
services as an obstetrician, but in a nonsurgical environment. Midwives are
usually nurse practitioners who have additional training in midwifery. Some don’t
have nursing degrees but are certified midwives.
A midwife can be an excellent option as your
primary guide for a low-risk pregnancy. You may need to see an obstetrician if
there are any complications that arise during pregnancy, labor, or delivery. Midwifery
and obstetrics can very often be complementary. Many midwives practice in
diverse settings and can assist in deliveries that happen in hospitals, homes,
or at special birthing centers.
A doula is a person who is
trained as a labor companion. Their primary role is to offer emotional and
physical support during labor. Doulas can be involved throughout an entire
pregnancy or just for labor and delivery. Doulas also offer support and advice after
the birth (postpartum).
A birthing partner can offer
support and comfort throughout labor and delivery. They can be anyone from your
spouse or partner to a good friend.
It’s becoming more and more
possible for a woman to choose how and where she will give birth. Although most
birthing decisions can’t be finalized until the delivery itself, it’s important
to understand your options and have an idea of what feels right for you.
Most babies born in the
United States are delivered in a hospital setting. There may be several
hospitals in your area; you and your doctor can determine the appropriate
hospital for your delivery. Hospitals have labor and delivery suites and
operating rooms for cesarean sections (C-sections). Most hospitals have
labor/delivery/recovery (LDR) suites, which are large rooms that are set up to
allow women to stay in one room from labor through recovery. Many hospitals
give tours of the maternity ward for parents who are expecting.
These are free standing
centers that advocate natural childbirth for women at low risk of pregnancy
complications who are delivering at term (37-42 weeks). Birthing centers often
have more of a home birth-like atmosphere. The medical care is administered by
nurse midwives or certified midwives. There
is no obstetrician or anesthesiologist on site and no capabilities to perform C-sections.
Water births are not widely
used in the obstetric community, but are more accepted among midwives. Most
water births are done at home, but some hospitals and birthing centers offer
water birthing services. Advocates of water births suggest that the water
relaxes the mother and eases labor and delivery. There’s little risk of
drowning since a newborn doesn’t take its first breath until it is exposed to
air. There is no evidence of increased adverse effects to babies who have
undergone a water birth.
Water births are not advised
for women who are at risk for complications or premature delivery and need
A hospital birth isn’t for
everyone. Having a baby in the comfort of your own home may be the best option
for you. The downside is that emergency care is not immediately available if
complications should arise during labor or delivery. Professionals attending
women in home births are trained to provide some limited medical care like the
administration of oxygen.
Birth plans are becoming more
common as more women and their partners become actively involved in their
pregnancy and childbirth decisions. Expecting parents should fill out a birth
plan before their delivery date and discuss options and preferences with their doctor.
A birth plan may include subjects
- pain relief during labor
- delivery positions
- assisted delivery preferences
- timeline for holding the baby
- having the partner cut the umbilical cord
Birth plans are not set in
stone. They may need to change during labor and delivery if complications
Enrolling in a childbirth
class is a great way to prepare for labor and delivery, and gives you the
opportunity to ask any questions or voice any concerns to a trained childbirth
instructor. Most hospitals offer classes that aim to provide information about
labor and techniques to help you relax during delivery.