The nine months of pregnancy are filled with choices and decisions. These include decisions about exercise, clothing, prenatal care providers and birth location. Pregnancy and the childbirth are regarded by most women as one of their most memorable experiences. Being well informed about your options can help provide the gratifying experience that you and your family desire. Two important early decisions will concern your choice of a health care provider and your birth location. The two decisions are often closely tied with one another because most health care providers already have a strong preference for a particular birth location. Most women will be guided in their choices by their health histories, personal preferences, financial ability, and suggestions by others.
Obstetricians are medical doctors who specialize in the management of pregnancy, labor and birth. They also receive specialized education in the female reproductive system and surgical care. The focus of much of their education has been 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 as their way of dealing with potential problems. Obstetricians normally perform deliveries in a hospital.
Family Practioners are physicians who have completed schooling and training in various fields of medicine that include 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 perform deliveries in hospitals.
Midwives can have a wide spectrum of training. Certified nurse-midwives have a nursing degree and additional training in midwifery. Direct-entry midwives or certified professional midwives have extensive training in midwifery even though they do not have a nursing degree. Most midwives offer care that is flexible and individualized with little medical intervention. Because of limited formal training, they usually limit their care to 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 will most likely be making plans for a hospital birth. The number of births attended by midwives in hospital settings is increasing. Some families feel more comfortable having access to technology and skilled professionals in case an emergency arises. 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 birthing center opened in 1974 in an effort to give women a more relaxed labor and birth experience. Midwives are often the only health care providers available at free standing birthing centers. However, some obstetricians are willing to 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 preferences for your birth, be sure to contact a birth center representative beforehand to discuss policies and guidelines.
For most of recorded history women have had their babies at home. Many women feel more comfortable and relaxed when giving birth in a familiar environment. However, this choice comes with extra responsibilities. For instance, families wanting to birth at home need to be well educated about the risks and be open to the possible need to transport the mother and or baby to a hospital in the event of an unexpected complication. Midwives are the main health care providers for home births. Home births are recommended for women with low risk pregnancies. Many women who don’t want any interventions and who want a very family-centered birth experience make the decision to have a home birth.
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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/