There’s a lot to think about when welcoming a new baby to the family.
Where you choose to have your baby and who is going to be on your birthing health care team is a big decision.
Choosing a provider for your pregnancy and birth is one of the first decisions you make. Finding a supportive provider before or in the early stages of pregnancy is helpful.
Sarah Shoemaker, DNP, CNM, is a certified nurse midwife with OSF HealthCare. She explained what to consider and how to choose a provider and birth location for your upcoming delivery.
Choosing a provider
If you don’t have an OB/GYN or midwife yet, you can ask your primary care provider for a recommendation. Sometimes your health insurance will give you a specific provider or options to choose from.
“Do your research,” Sarah said.
Think about what you hope for your pregnancy, labor and delivery and come up with a birth plan. What kind of pain management do you want? Who do you want in the delivery room? Are there certain things you want to be able to do in the delivery room, like listen to music or turn off lights?
“Once you know what your goals are for the pregnancy and birth, that can help guide your decision-making. Do not be afraid to advocate for yourself, interview providers, get to know them and pick one that fits your needs,” Sarah said.
“The key to coping well through contractions is feeling relaxed and safe. What makes one patient feel safe may be completely different than what another patient needs. It’s important to find health care providers who listen to you,” Sarah said. “Your care team should be strong advocates for your needs.”
Several different types of providers may be involved in your pregnancy, labor and delivery.
Looking for a doctor?
OB/GYN
OB/GYN stands for obstetrician and gynecologist.
An obstetrician is a doctor who specializes in birth. Their expertise is in women’s medical and surgical care. So, you can be sure that they know your specific health needs.
A gynecologist is a doctor who specializes in women’s health care. You may already have a gynecologist for things like Pap smears, pelvic exams and breast health checks. When you’re pregnant, your gynecologist can confirm your pregnancy and get you connected to the next best step.
Obstetrician vs. gynecologist
An obstetrician is often called an OB/GYN because they help women who are pregnant or want to become pregnant. They usually only treat things that are related to pregnancy.
A gynecologist is also technically an OB/GYN, but they often just practice gynecology. That includes performing cancer screenings and treating women’s health issues, like urinary tract infections and fertility concerns.
Maternal-fetal specialist
A maternal-fetal specialist is an OB/GYN who received extra training to treat more complicated pregnancies and births. They are sometimes called perinatologists.
Maternal-fetal specialists are great if you or your baby needs special attention. For example, if you have a chronic health condition, like high blood pressure or diabetes, a maternal-fetal specialist can help monitor your health throughout pregnancy and during delivery.
Getting a referral to a maternal-fetal specialist may seem frightening, but they can help keep you and your baby healthier if there are any unique issues.
Midwife
Midwives are another option to have as your provider. They often use more holistic approaches for labor and delivery, like trying different breathing techniques and labor positions. It is a myth, however, that midwives only support labor without an epidural.
“Midwives very often have time built into their schedule devoted to labor support so they can be more involved in the labor process. If this is important to you, no matter what pain management you choose, a midwife may be the right provider for you,” Sarah said.
A nurse midwife differs from an OB/GYN because midwives are not surgeons. They are registered nurses who went on to get master’s or doctoral degrees in midwifery, specializing in low-risk vaginal birth and women’s health care.
Doula
A doula is an optional care team member that you can hire. They offer emotional and physical support during pregnancy, labor and delivery. While doulas are very helpful to the birthing process, they are not medical professionals like OB/GYNs or midwives. They can help you understand your hopes and needs so you can come up with a birth plan. During labor, they’ll be an advocate to help you make decisions with your birth plan in mind.
They can help you manage pain through massage, position changes and breathing techniques.
Questions to ask your care team
When you’re searching for providers for your pregnancy and delivery, start with an open conversation. Asking questions will help you to choose the best provider for you and your baby.
Here are some examples of questions to ask your care team before birth:
- What pain management options do you support?
- Is care covered by my insurance?
- What hospitals do you deliver at?
- What happens if I go into labor when you’re not on call?
- Do you perform episiotomies? (These are small cuts to the skin between the vagina and anus to reduce tearing during birth)
- How often do you perform C-sections?
- How can you support my birth plan?
- Does the hospital allow babies to stay with you after birth?
- How do you support my decisions before, during and after birth?
- How much input can I have?
- Do I have the ability to be mobile during labor?
How to choose where to have your baby
If you’re exploring options for where to have your baby, you have many things to consider. Being prepared and having as much information as possible makes it easier to choose where to give birth.
Hospital
Many factors can influence your decision to give birth at a hospital. Your insurance may tell you which hospital to deliver at, the hospital might be the closest to your home or your provider is employed at the hospital.
“I encourage everyone to start their journey by touring the hospital,” Sarah said.
Many OB/GYNs only deliver in hospitals because of the resources available right there, including the most advanced technology. If you’re giving birth in a hospital, you’ll have access to many emergency services in case something happens. Hospitals also offer the most options to manage pain, including nitrous oxide, IV pain medication and epidurals.
“For patients with uncomplicated deliveries, many choose to go home the next day,” Sarah said. “If you have a cesarean, or C-section, you will probably stay for two or three days.”
Hospitals are staffed full time with medically trained professionals, like doctors, advanced practice providers and nurses. Hospitals also have other specialists on staff that can help if needed, like neonatologists and lactation consultants.
If you have a high-risk pregnancy or a planned C-section, you should plan on a hospital birth.
Birthing center
A birthing center is a place outside of a hospital where babies are delivered.
A birthing center may have an OB/GYN who consults, but midwives and nurses usually provide care for patients. These facilities rely on natural, holistic approaches to childbirth. Many also have nitrous oxide available for patients, and water birth is usually an option.
Birthing centers are designed for low-risk patients, so contact them if you aren’t sure if you qualify.
Because birthing centers are designed for low-risk patients and do not have access to epidurals/IV pain medication, you need to be mentally and physically prepared for unmedicated childbirth.
Home birth
Not many providers deliver babies at home.
There are many risks involved in delivering outside of a medical facility. Even a normal labor experience can turn into a life-threatening situation very quickly. Things like a spike in your baby’s heart rate, a spike in your blood pressure or a bad position of your baby could cause a severe emergency.
It can take a long time to get to a hospital for emergency care once complications arise. Many providers encourage delivering at a medical facility.
Questions to ask when choosing where to give birth
When touring hospitals and meeting with care teams, here are some helpful questions that will guide you in your decision.
- How often are C-sections performed?
- Are labor and delivery rooms private or shared?
- What high risk services are available in case any issues come up?
- Where do I check in when I go into labor?
- What breastfeeding support is available?
- What prenatal classes are offered?
- What amenities are available?
- Will I get to do skin-to-skin, delayed cord clamping or any other special requests?
- How many support people are allowed in the room?
- Are visitors allowed?
Sarah said that flexibility is key. Even if you have a plan for where you give birth, who’s there and how everything goes, it’s important to keep expectations realistic.
“Working with your provider to come up with a plan, as well as contingency plans during birth, helps to prevent birth trauma. Birth and pregnancy can be unpredictable, and it’s important that your choices and needs are supported. It’s important to have a team you trust so you can work together for the best outcomes for you and your baby.”
Last Updated: October 10, 2024