Preparing for the birth of your baby is exciting but can also be overwhelming. One of the most important decisions you can make is who will be your primary health care provider for pregnancy, labor and birth.
Lamaze International (www.lamaze.org) lists one of their philosophies of birth as:
“Women’s confidence and ability to give birth is either enhanced or diminished by the care provider and place of birth.”
It’s never too soon to start researching maternity care providers, and here is a short breakdown to help you with the process:
An “OB” is a physician who has completed specialized training in the management of pregnancy, labor and birth. OBs are surgeons trained to deal with complications and they can perform a cesarean section when necessary. OBs typically practice in the hospital setting, although a few may attend homebirths or provide backup to homebirth midwives. Many OBs work within a group practice of doctors with similar philosophies, while some have a private/sole practice. Most births in American are attended by OBs in the hospital setting.
Certified nurse-midwives (CNMs) are licensed, registered nurses with advanced training in midwifery. CNMs care for women during pregnancy, labor and birth and also provide well-women care. While CNMs cannot perform cesareans, they work closely with OBs (sometimes in the same practice) so if a mother becomes high-risk she can work in tandem with her midwife and a physician. According to the American College of Nurse-Midwives, CNMs attend almost 10% of births in America, and 98% of these births happen in a hospital. Some CNMs also attend homebirths.
A CPM is a trained midwife who has met the certification standards required by the North American Registry of Midwives. CPMs typically practice in out-of-hospital settings and specialize in homebirth.
You can ask potential providers to give you a copy of the most recent statistics for their practice such as rates of cesarean section, epidurals, and induction of labor to name a few. The same information is available from local hospitals. Homebirth midwife practices can also provide these stats, as well as their “transfer rate” of moms who begin labor at home but need to move to the hospital if complications cannot be addressed in the home environment.
Think about how much thought you put into buying a car or a house. Giving birth is a once-in-a-lifetime experience and the relationship you’ll build with your doctor or midwife is of utmost importance.
Sometimes you may have to choose a certain practice based on insurance requirements; it’s rare, though, to only have the choice of one doctor or midwife.
All too often, when I mention the importance of supportive practitioners in my Lamaze classes, I see at least one mom-to-be with a worried look on her face. During a break, she may tell me how she “knows” her provider isn’t on board with what she wants, and she feels it’s too late to change. It’s always sad when I talk to these moms after they’ve given birth and they feel their experience may have been different if they’d had a different provider. Many were unaware they could actually interview different practices or switch if they felt it wasn’t a good fit.
Don’t let that be you! Start thinking, planning, interviewing early in your pregnancy (or even before) so that you can choose the provider whom you feel with best help you welcome your new baby to the world.