Topic Overview

It’s important to find a doctor or midwife who can work closely with you and share in decision making. This partnership is key to getting the care that is best for you. And it will help you have the pregnancy and childbirth that you want.

Options for your care

Several types of health professionals are trained to provide medical care or support before, during, and after the birth. These include:

• Obstetricians.
• Perinatologists. (These are doctors who specialize in maternal-fetal health medicine.)
• Family medicine physicians who provide obstetric care. (You may choose to have this type of doctor go on to be your child’s doctor.)
• Certified nurse-midwives.
• Certified professional midwives.

Choosing a doctor or midwife

Choosing a doctor or midwife depends on where you want to give birth. Certain providers usually deliver in certain birth settings. Most medical doctors (MDs) deliver only at hospitals. If you work with a midwife, you may be able to have an out-of-hospital birth.

And your choice affects the options you may have during both your pregnancy and the birth. If you work with a midwife, you may have more options for natural management of pain during labor. But you may not be able to get certain medicines for pain relief.

Doctors and midwives also have different training and skills.

• Doctors have more medical training than midwives. They are trained to handle more serious problems. Doctors can do medical tests, such as amniocentesis. They can do surgery, such as a Cesarean delivery.
• Midwives usually have a more natural approach to pregnancy and childbirth. They may not do as many medical tests. And they often teach natural ways to manage pain during labor.

Doctors and midwives share the same goal. They both want you and your baby to be healthy. But sometimes their approaches may be different. When you choose your health professional, ask questions about his or her philosophy and approach. Do the answers match your preferences and values?

Some clinics and hospitals offer a group-practice approach. You get to choose a primary caregiver. But you will also see each of the other doctors or midwives at least once while you are pregnant. If your primary caregiver isn’t available when you go into labor, you will be familiar with the doctor or midwife who delivers your baby.

Along with a trained medical professional, you may also want to use:

• A lay midwife, who delivers babies at home. Lay midwives are not licensed. They aren’t required to have professional medical training. They may not have the medical training for handling a complicated labor or emergencies. If you plan to give birth at home, make sure ahead of time that you have medical backup and a hospital nearby in case of an emergency.
• A doula. Doulas give physical and emotional support before, during, and after the birth. Many women work with a doula along with a doctor or midwife.