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Choosing Your Birth Team

Though your due date may seem years away instead of mere months, now is the time to start investigating whom you'd like to deliver your baby and where you'd like the happy event to occur.

Obstetricians. In the United States, most pregnant women choose obstetricians. Obstetricians are physicians who have completed four-year residencies in obstetrics and gynecology after medical school. If you have a serious chronic illness, are carrying more than one baby, are an older mother, or anticipate other potential complications, you will certainly want to consider working with an obstetrician. You may also want to consider a perinatologist; a perinatologist is an obstetrician who specializes in the care of women with high-risk pregnancies.

Family practitioners. These physicians do obstetric training as part of their residency and may do prenatal care and low-risk deliveries.

Nurse-midwife. If yours is a relatively low-risk pregnancy, you might prefer a nurse-midwife. In most parts of the world, obstetricians deliver babies only during emergencies, and midwives handle the rest. That's increasingly true in the United States too, where nationwide about 10 percent of all pregnant women now choose midwives over obstetricians.

Certified nurse-midwives complete two years of graduate work in midwifery after nursing school. Certified nurse-midwives don't accept high-risk pregnancies, and they always have a doctor on call, even for seemingly uncomplicated deliveries. In general, certified nurse-midwives use fewer medical interventions than obstetricians, though this depends on your particular provider. Several research studies in the United States show that healthy women with normal pregnancies who choose certified nurse-midwives are just as likely to have healthy births as those who choose obstetricians.

Communication is key. No matter who guides you through pregnancy and birth, it will be an essential partnership. You're going to be feeling excited, overwhelmed, joyful, anxious, and unsure -- often all at once -- so a good practitioner can be a welcome guide on your journey to motherhood.

Experts say that miscommunication is the reason for most conflicts between patients and their health care providers, so this is a good time in your life to learn to speak up, both for your own good and for your baby's. Prepare questions for each visit, taking notes on what your provider says so that you don't forget her answers. Answer your provider's questions honestly, get your partner involved, and speak up whenever you're unsure about a provider's advice or when your expectations have not been met.


Originally published in You & Your Baby: Pregnancy.

All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.