Your Childbirth Experience

Here are the basics on choices for birth locations and health care providers.

Car seat … check!
Name chosen … getting close.
Childbirth plan … don’t delay.

Your view of your childbirth experience will influence some of your most important decisions. Who will deliver your baby? Where will you give birth? Your choices should be based on both medical factors and personal concerns.

Who will provide me with prenatal care and deliver my baby?

There are several types of health care providers who are trained to provide medical care for pregnancy and birth. Interview those you are considering. Confirm they have the certification and any state licensing needed. Below are a few options to consider:

• Obstetrician. Ob-gyns are doctors who specialize in women’s health, pregnancy, labor and birth. They can deliver babies, perform Cesarean sections and diagnose pregnancy-related conditions.
• Maternal-fetal medicine subspecialist (perinatologist). Perinatologists are doctors who are trained in managing complicated, high-risk pregnancies.
• Family doctor. Family physicians are doctors  who have training and experience delivering babies, too. They typically handle low-risk pregnancies and can consult with an ob-gyn as needed. They usually do not perform C-sections.
• Midwife. Certified nurse midwives are registered nurses who have graduate degrees in midwifery. Certified midwives have a bachelor’s degree, but not a nursing degree. Both provide care for women with low-risk pregnancies and their babies. Their care is from early pregnancy through labor, delivery and the weeks after birth. Midwives generally work with a qualified doctor who will provide backup support. Midwives do not perform C-sections.

Some women and their partners have a doula present for labor and delivery. A doula is a trained, experienced professional. He or she provides  labor coaching and support to the mother before, during and just after giving birth. Doulas don’t perform medical tasks. Instead, they provide physical comfort and emotional support for the mother and her partner. 

Where should I give birth?

Choices for delivery include birth centers, at home or in the hospital. Check with your insurance provider about coverage for your choice of location. Tour the facility and ask about its policies before you decide. Each setting has its pluses and minuses. Your preferences, your health, your baby’s health and your traveling distance from specialty care can all affect where you deliver. Where your health care provider practices can also help you choose.

• Hospital
  A hospital, hospital-based birthing center or accredited freestanding birthing center is generally the safest place for you and your baby during labor and delivery. Hospitals often have special home-like birthing rooms. They may provide practice privileges for nurse-midwives. They typically conduct extensive childbirth education programs and offer some flexibility for families to participate.
  
  If you have a high-risk pregnancy, it’s best to give birth in a hospital. Hospitals have advanced technology and trained specialists. They deal with emergencies every day. Being in a hospital may put your mind at ease even if your pregnancy is not high-risk. Many hospitals also have neonatal intensive care units in case a newborn needs special care.

• Birth centers
  These centers provide home-like surroundings and are considered more cost-effective. Birth centers are often located within a hospital or are freestanding nearby. Some women choose this location if they have a low-risk pregnancy. If changes during your labor require more extensive intervention or a C-section, you will most likely be transferred to the hospital.

• Home delivery
  Some women choose to give birth at home. They are assisted by a doctor or midwife. A woman may choose this location because she wishes to give birth in a familiar, relaxing environment. Or she may want to forgo medical intervention, or have cultural or religious norms or concerns. However, a home birth isn’t right for everyone. The American College of Obstetricians and  Gynecologiest recommend women make an informed decision about home delivery. Women considering home delivery should  understand the benefits and risks with associated home birth.

Your health care provider might caution against a planned home birth if you have a chronic medical condition, like diabetes, had a previous C-section or have a pregnancy complication, such as preterm labor. Make sure your midwife has a backup doctor in case of an emergency.

By Mary Small, Contributing Writer

Sources
American College of Obstetricians and Gynecologists. Your Pregnancy and Childbirth. 6th ed. Washington, DC: ACOG; 2015.
Womenshealth.gov. Prenatal care and tests. Accessed: June 15, 2016.
American Association of Birth Centers. What is a birth center? Accessed: June 15, 2016.
UpToDate. Planned home birth. Accessed: June 15, 2016.

Last Updated: June 16, 2016