Pregnancy, Babies, and Birth: Choosing a Healthcare Provider

There are several options available to pregnant women in terms of choosing a healthcare provider. ?What is most important, regardless of who you choose, is that you get adequate and regular prenatal care for you and your baby. ?Your healthcare provider will keep an eye on the health and progress of you and your baby and will be able to watch for possible complications that could prove dangerous if not detected and addressed. ?For women with low-risk pregnancies, you can usually choose between a Family Doctor, an OB/GYN (Obstetrician/Gynecologist), or a Certified Midwife. ?Here are the main differences between these three basic providers:

• Family Doctor: A family doctor is the general physician that you go to for all of your healthcare needs. Talk to your family doctor and see if he/she is qualified to deliver babies and how many babies he/she has delivered during his/her practice. ?One of the benefits of having your family doctor provide your prenatal care is that you may already have an established relationship with them before pregnancy and they will continue to provide care for you and your baby after birth; it provides some continuity of care. ?One of the cons of having a family doctor provide prenatal care is that they may not have as much experience in obstetrics as an OB/GYN or Certified Midwife.

• OB/GYN: An OB/GYN is a person that has completed medical school and then has gone on to receive 4 additional years of specialized training in obstetrics and gynecology. ?An OB/GYN may work independently, in a group practice, or at a hospital. ?They are experts in performing both complicated and uncomplicated vaginal deliveries and Cesarean sections. ?Most family doctors and midwives that provide prenatal care will have an OB/GYN that they are associated with that they can refer to if their patients develop complications that they are not able to address. ?One of the benefits of having an OB/GYN is that they have specialized knowledge and experience in prenatal care and delivery since it is the only area of medicine they practice. ?They are also able to attend to higher risk pregnancies. ?One of the cons of having an OB/GYN is that they may not always be available or able to attend the birth of your baby if they are not on call, so another OB/GYN may step in for the delivery (usually a member of their group practice or a member of hospital staff).

• Certified Midwife: There are several different classifications and certifications of midwives. ?There are Certified Nurse-Midwives (CNMs), Certified Midwives (CMs), Certified Professional Midwives (CPMs), and Direct-Entry Midwives (DEMs). ?CNMs are trained as both nurses and midwives, have at least a bachelors degree (lots have Master's degrees),?and they must pass a national certification exam from the American College of Nurse-Midwives (ACNM) and receive a state license to practice. ?CMs are college-educated and certified by the ACNM. Because this is a relatively new specialty, not every state licenses CMs. ?CPMs?are trained midwives who are certified by the North American Registry of Midwives (NARM). Not all states certify CPMs. ?DEMs?may have a college degree, or they may have trained through an apprenticeship, or learned through self-study, workshops, or other instructional programs. Most attend births in homes or birth centers. Not all states recognize DEMs. ?Most midwives prefer a more natural approach to birth and typically avoid higher-tech interventions like the use of forceps,?Cesarean sections, and pain medication. ?One of the benefits of a midwife is they act as a more active advocate for women that prefer to have a natural birthing experience and take a more personalized approach to dealing with mothers. ?One of the cons to using a midwife is that some states limit the amount of medical interventions that a midwife can perform, so if complications arise, you may need to be transferred to the care of an OB/GYN or other specialist that you are not familiar with.?

• Optional Care-Doula: A doula is not a primary healthcare provider and does not provide prenatal care. ?A doula is a birth coach that can be available to a mother during labor and during her postpartum period as a support and advocate. ?Doulas can act as a?liaison?between the laboring mother and her health care team, can provide physical support like massages to reduce labor pain, and provide emotional and informational support to both the mother and the father. ?One of the benefits of having a doula is having an additional support person in the room during delivery (or at home after birth with a Postpartum Doula), especially if the father is uncomfortable with the delivery process or doesn't want to act as a labor coach. ?One of the cons of having a doula is that they are a medically unnecessary professional that will cost you money that is not covered by your insurance.

High Risk Pregnancies. ?For women with high risk pregnancies (pregnant before age 17 or after age 35, have diabetes, cancer, a history of high blood pressure, epilepsy, are pregnant with more than one baby, have a history of 3 or more miscarriages or complications during previous pregnancies, etc.) should see a doctor that specializes in high risk pregnancies such as a maternal-fetal specialist or perinatologist. ?These are professionals that are specially trained to attend to high risk pregnancies that require more careful, frequent monitoring.

Proper Certification and Licensure. ?Regardless of who you choose, ensure that they have the proper state licensure and/or certification, and are in good standing in the state they practice in. ?Most, if not all, of this information is available online or through your local state licensing board (in the state of Utah, the Department of Professional Licensing has some of that information: www.dopl.utah.gov). ?You can also do some research on the provider that you choose online in terms of ratings previous patients have given them. ?Ratings may not be available for all practitioners, but it can't hurt to put the name of the provider in to an internet search engine (like Google) and see what comes up.

The Provider-Patient Relationship. ?Another important aspect of choosing a healthcare provider is whether or not you feel comfortable with them, you feel like they listen to you and take you seriously, and that you feel like you are in capable and competent hands. ?Don't be afraid to call the provider before choosing them and talking to them for a while on the phone. ?If you are unable to do that, don't be afraid to switch providers if you go to an appointment with the one you've chosen and you don't feel like it's a good fit. ?Remember, this person is going to be a major decision-maker and witness to one of the most vulnerable times of your life, so the better you feel about your relationship with them, the more comfortable you will be in trusting their judgment and feeling supported in your decisions. ?

Sources: wedmd.com, healthline.com

Disclaimer:?The "Pregnancy, Babies, and Birth"?blog series is meant as a source of general information?only. ?It's intended use is to encourage women to further consider and discuss reproductive and birthing decisions themselves with their partners and with their medical care providers. ?Information included in this series is not intended to be professional medical advice or a substitution for a relationship with a licensed physician or practitioner. ?Any serious questions or concerns about reproductive, prenatal, and/or perinatal health should be directed to your primary care physician or other licensed specialist. ?Women's Services and Resources does not promote any particular brand, medical provider, birthing location, or any other specific birthing decisions. ?We strongly encourage women to become as educated about their choices as possible so they are empowered to make educated decisions for themselves and their babies.

Source: http://byuwsr.blogspot.com/2012/11/pregnancy-babies-and-birth-choosing.html

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