First and foremost the purpose of prenatal care is to ensure the well being of the mother and baby.
It is very important that you trust the person you choose to help you have a healthy pregnancy and safe birth.
The best combination for a safe and satisfying birth is a woman who is in charge of what she does, a baby who is in charge of what he/she does and a health care provider in charge of what he/she does.
So lets talk about the options out there.
Most practitioners (OB/GYN, Midwives, Family Physicians and Osteopaths), see pregnant woman generally on the same pre-natal schedule , once a month until 32 weeks of pregnancy, then bi-monthly until 36 weeks, then weekly until birth. Many of the same procedures are done, for example blood tests, urine tests, pelvic exams, measuring the baby, determining the position of the baby, blood pressure etc.
The way the practitioner is trained greatly affects his or her philosophy and perspectives, and therefore your care.
Prenatal Healthcare Providers: (generalizations)
OB/GYN- (obstetrician/ gynecologist) –
“Obstetrician” means “one who stands by”. OBs are medical doctors trained to manage pregnancy and childbirth like a medical event and they're also trained surgeons. Most obstetricians’ mindset, as it should be, is “take no chances”. They also come from the “what if” approach. There are some obstetricians who approach pregnancy and childbirth with more of a holistic approach and will help and support women achieve natural births in a hospital. Keep in mind that a lot of obstetricians are part of a group practice, which means if your doctor is out of town or not on call, most likely you will be seeing one of their partners. It will be important for you to meet all of the doctors in the practice. A lot of women today tend to look for a doctor whose philosophy is one of informed partnership. Some OB/GYNs work with a midwife. Depending on the hospital or obstetrical practice you choose, you may be able to have the best of both worlds; a midwife and a family physician or obstetrician.
Obstetricians see patients from “low risk” to “high risk”.
For more information visit: American Congress of Obstetricians and Gynecologistsj
“Midwife” means “with woman”. Midwives are more common in Europe and other parts of the world but they are becoming increasingly more popular here in the United States. The philosophy of the majority of midwives is that they believe that pregnancy and childbirth are a natural process and that women are biologically capable of giving birth naturally. They believe that pregnancy and childbirth are a rights of passage and therefore encourage the full participation by the mother during pregnancy and birth, and support this transition, helping her grow in confidence and ability to nurture herself and baby both before and after birth. They tend to believe “fear” is enemy #1 for the pregnant or laboring woman because it increases pain and slows progress of labor.
Most modern midwives practice in hospitals and birth centers, though some attend homebirths. Some midwife work with an OB/GYN. Should a complication arise, midwives are trained to identify the complication and transfer their clients to a higher level of care when the complication requires it.
Midwives see patients who are healthy and “low risk”.
Certified nurse-midwives (CNMs) are licensed nurses who have taken 2-3 years of additional training in obstetrics and passed special certification exams. They can deliver babies in hospitals, birthing centers or at home. CNMs have to work under a physician, as a ‘just in case”.
Certified Midwife (CM)- They have a background in a health related field and graduated from a midwifery education program accredited by ACME. (Accreditation Commission for Midwifery) After graduation they take the same national certification examination as CNMs but receive the professional designation of certified midwife.
Direct Entry or Certified Professional Midwife (CPM)- Primarily attend home births but can attend some birthing centers. They have passed the certification examination of the North American Registry of midwives (NARM). Not all CPMs are legally recognized. Twenty six states now recognize direct-entry midwives in statute, 24 through licensure. They to must work with a physician in case of an emergency.
For more information go to: the National Association of Certified Professional Midwives
If you would like more clarity between the different midwives that are available please go to:
For a comparison of Certified Nurse-Midwives, Certified Midwives, and Certified Professional Midwives http://www.midwife.org/ACNM/files/ccLibraryFiles/Filename/000000001385/CNM%20CM%20CPM%20ComparisonChart%20082511.pdf
To find a midwife: American Collage of Nurse midwives; www.midwife.org
To find out whether a midwife is properly certified- American Midwifery Certification Board: www.amcbmidwife.org
To learn more about midwifery model of care go to: http://choicesinchildbirth.org/files/Midwifery_Model_of_Care.pdf
Not all Family Physicians provide obstetrical care, but some do. They too may be part of a group of doctors or any OB/GYN your doctor works with. (Most FP can not do a cesarean birth or assist you in the delivery and will need an OB/GYN backup. Make sure you are comfortable with anyone the work with.
Osteopathic Obstetricians (D.O.)-
They have gone through medical training and residency program nearly identical to an obstetrician and have the exact same privileges and rights. They can perform cesarean births and other surgeries. The difference is that part of their training integrates holistic healing with organized medicine. They view the body as an integrated unit of mind, body, and spirit, which contains a natural ability to heal itself.
For more information: Visit the American Osteopathic Association
How else can you find your healthcare provider?
Get references from friends, other healthcare provider and a really good resource are obstetrical nurses because get to see local OB’s and midwives in action. Take a list and narrow it down. Then make an appointment. It is good to interview at least 3 healthcare providers. Don't worry, you can always switch health care providers down the road if you find out you really don't match!
Depending on if you have insurance or what your insurance will cover, will ultimately help your decision. If you do not have insurance, You Have A Right To Free and Subsidized Medical Care. Prenatal care is extremely important. According to www.MaternityHealth.org about 2/3 of pregnant women need help paying for pre-natal care. Find out what benefits you can receive from Medicaid. Benefits vary from state to state so also check with your State’s Health Department.
Keep in mind that it is very important that you like and trust your healthcare provider. After your interviews with your potential healthcare provider...ask yourself, Would I leave my newborn baby with this person all day? Your answer may surprise you.
Check out Part 3 - Questions to Ask While Interviewing A Doctor or Midwife
QUESTION: Which healthcare provider are you leaning towards? Why? I would love to hear what your thoughts are. Please share your answer in the comment box below.
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