While it takes good prenatal care and a positive lifestyle to help ensure a healthy pregnancy, it takes the help of a health care professional to make the transition from fertilized egg to delivered baby a safe and successful one. It’s important to be aware of your options and choose a doctor or midwife and birthing plan that suits your needs.
Primary Care Physician
If you are experiencing any of the symptoms of pregnancy, your first step should be to consult your regular doctor. He or she will help you confirm pregnancy and then advise you on choosing specialists to help monitor your pregnancy. Some family practice doctors provide prenatal care and attend deliveries or you may need to see an 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 all the reproductive needs outside of pregnancy. Your obstetrician will guide you through the entire pregnancy. It is possible that the doctor you have seen for your reproductive needs may only practice gynecology, as some OB/GYNs do stop practicing obstetrics. In this scenario, you will be referred to an OB/GYN with an active obstetrics practice.
A midwife offers similar services as an obstetrician, but in a non-surgical environment. Midwives are usually nurse practitioners who have additional training in midwifery (Certified Nurse-Midwives). Some do not have nursing degrees but are certified midwives (Certified Professional midwives).
A midwife can be an excellent option as your primary guide for a low-risk pregnancy. However, if there are any complications that arise or surgeries that become necessary during pregnancy, you may need to see an obstetrician. The two professions (midwifery and obstetrics) can very often be complementary. Many midwives practice in diverse settings and can assist in deliveries that happen in hospitals, in homes, or at special birthing centers.
A doula is a woman who is trained as a labor companion. Her 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, and some offer support and advice postpartum. Studies have suggested that women who are supported by doulas during labor are less likely to require medical intervention, including pain relief or cesareans. It’s also been suggested that births attended by doulas are shorter, with less complications.
A birthing partner, like a doula, can offer support and comfort throughout labor and delivery. It 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. While most birthing decisions can’t be finalized until the delivery itself, it’s important to understand the options and have an idea of what feels right for you.
Most babies in the United States are delivered in a hospital setting. There may be several hospitals in your area, or your doctor may determine which hospital you will deliver at. Hospitals will have labor and delivery suites and operating rooms for cesareans (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 obstetrical community, but are more accepted among midwives. There is some medical evidence suggesting that water immersion during the first stage of labor reduces the use of epidural anesthesia although limited information in the medical literature for other outcomes. Advocates of water births suggest that the water relaxes the mother, easing labor and delivery. Since a newborn doesn’t take its first breath until they are exposed to air, there is little risk of drowning. There is no evidence of increased adverse effects to the baby with laboring in water or a water birth. Water births are offered at some hospitals, but are often done at home.
Water births are not advised for women who are at risk for complications and need closer monitoring, or for those women delivering prematurely.
A hospital birth isn’t for everyone and having a baby in the comfort of your own home may be the best option. The downside is that if complications should arise during labor, emergency care is not immediately available. Professionals attending women in home births, usually midwives, are trained to provide some limited medical care, such as the administration of oxygen. Approximately 12 percent of women who attempt to deliver at home will require transfer to a hospital, so for those planning on a home delivery, a transportation plan in case that scenario arises is essential.
The safety of home birth has been a subject of controversy, especially among professional physicians groups. The World Health Organization (WHO) supports the right of women to choose where they give birth, but state that women should have low-risk pregnancies and receive appropriate support and formulate contingency plans if they are to give birth at home.
As more women and their partners become actively involved in their pregnancies and childbirth decisions, birth plans are becoming increasingly common. Some doctors encourage patients to fill out a birth plan before their delivery date, while others are willing to discuss options and preferences with their patients.
A birth plan may include issues such as pain relief in labor, delivery positions, assisted delivery preferences, holding the baby immediately after birth, and having the father or partner cut the cord. Birth plans are not set in stone, and may need to change during labor and delivery if complications occur.
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, which aim to provide information about labor and techniques to help you relax during delivery.