Birthing Choices: Care Providers & Labor Locations

tiny baby feetThe nine months of pregnancy are all about choices. Everything from the best exercise, to the most comfortable shoes to more important things like your prenatal care provider and place to give birth. Pregnancy and the birth of a child are ranked as one the most memorable experiences for a woman, so being well informed of all your pregnancy options can help ensure you have the most gratifying experience for you and your family. Two things you will make decisions about early in pregnancy are who will provide your care and where you will birth your baby. These decisions often go hand in hand since most care providers have a certain place they do deliveries. Most women base their choices on health histories, preference, finances and well informed opinions.

Care Providers

Obstetrician
These physicians have completed schooling and training in the specialized field of women's reproductive health known as Obstetrics and Gynecology. Obstetricians have the skills, knowledge, and means to deal with any type of complication that may arise in pregnancy and childbirth. Many women who have had complicated pregnancies in the past or who have certain medical conditions will choose an Obstetrician for their pregnancy care to ensure that any problems that develop can be handled effectively. Obstetricians normally do all deliveries in a hospital setting.

Family Practitioners
These physicians's have completed schooling and training in various fields of medicine including obstetrics, pediatrics, surgery, and internal medicine. During their residency they gain experience in treating the whole family. This type of care provides the basis for a relationship and continuum of care from newborns to grandparents from the same physician. Family practice doctors normally handle non-risk pregnancies and most do deliveries in hospital settings.

Midwives
These care providers can have a wide spectrum of training. Certified Nurse-Midwives have nursing training plus additional training in midwifery. Direct entry midwives or Certified Professional midwives have had training in midwifery but do not have a nursing degree. Most midwives offer care that is flexible and individualized, with little medical intervention and therefore often only care for non-risk pregnancies. Many midwives offer deliveries in homes, birthing centers, or hospitals.

Locations

Hospitals
If you have chosen an obstetrician or family practitioner as your care provide, then you are most likely making plans for a hospital birth. (Although the number of births attended by midwives in the hospital setting is also increasing!) Some families feel more comfortable having the backup of technology and skilled professionals in case something were to go wrong during a delivery and the hospital is the best place to deal with any complications. But with that assurance can also come more restrictions on options during the labor and birth. Make sure to tour your hospital before your birth and learn about all the guidelines and policies regarding laboring techniques, people in the delivery room, use of cameras or video and newborn procedures.

Birthing Center
The first free standing birthing center was opened in 1974 in an effort to give women the "homelike" setting but with close proximity to a hospital facility in case of complications. Midwives often are the sole care providers at free standing birthing centers, but there are a few Obstetricians who will do deliveries at birthing centers located inside of hospitals. Birthing centers usually have fewer restrictions and guidelines for families to follow and allow for more freedom in making laboring decisions. Birthing centers are often recommended for pregnancies that are considered low risk and for women who are seeking to have a birth with little interventions. If there are particular requests you want for your birth, be sure to talk with a birth center beforehand to find out their policies and guidelines.

Home Birth
For centuries women have been having babies in their home. Many feel more comfortable and relaxed when birthing in their own environment, but with this freedom also comes extra responsibilities. Families wanting to birth at home need to be well educated on possible problems that can arise and be open to the option of transporting to the hospital in case of a complication. Midwives are the main care providers for home births. Home births are recommended for women with low risk pregnancies and no labor complications. Many women who want no interventions and a very family centered birth, choose to have a home birth.

Reprinted with permission from American Pregnancy Association.