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 closer monitoring.
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 like:
- 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 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 that aim to provide information about labor and techniques to help you relax during delivery.