You just took a pregnancy test and you see two lines. You're pregnant! Congratulations!!! But... now what? The first things women do when they find out they are pregnant are to take prenatal vitamins and skip alcohol, drugs and cigarettes. But an even more important step is to find out who will be taking care of you during your pregnancy (unless you are choosing unassisted birth which we'll talk about another day).
There are three types of care providers for pregnant women. And with each type of provider there are the very good and the very bad so interviewing potential care providers is vitally important. Most couples will do extensive research when buying a new car, a new computer or even planning their landscaping but when it comes to the most important day of their lives they may blindly accept the first place they step foot in without researching any other options or physicians.
Here's a little information on the three care providers:
1). Obstetrician (most likely also your gynecologist A.K.A. OBGYNs)
Most women default to their OBGYN because they've been with them for years and just don't think anything of it. But it is so very important to realize that you need to find a care provider with the same birth philosophies as your own. Your OBGYN may be great at giving a pap smear but what is their cesarean rate? episiotomy rate? natural birth rate? Remember that their bedside manner will translate to the delivery room so if they make you feel uncomfortable it's time to interview other OBGYNs or other types of care providers. This is the same for ANY type of care provider that you don't click with. Trust is vital in your provider!
OBGYNs will see you in their office, many of which are at the hospital they deliver at. They tend to do the most testing and screenings on pregnant women regardless if the woman needs them or not. The average amount of time your OBGYN will spend with you during a routine prenatal visit is 3-5 minutes. (Remember these are averages; I realize there are some awesome, attentive OBs out there.)
OBGYNs, on average, have the highest cesarean rates, highest episiotomy rates and highest induction rates. Going with an OBGYN may result in a very medicalized birth (though not always). They are not trained in natural birth but in augmenting labor (causing labor to go as they want it to go) which often results in a cascade of interventions that cause the mother and baby serious complications. Which is often why many women say, "Why write a birth plan? It will never go as you plan". I'm excited to share more on birth plans very, very shortly!
2). Midwives:
Certified Nurse Midwives - CNMs have gone to nursing school and have had an ADDITIONAL two years of study in midwifery. About 3% of CNMs attend home births and many practice in hospitals under physicians.
Certified Professional Midwives - A midwife who has passed rigorous competency testing by the North American Registry of Midwives (NARM) is awarded a CPM certificate. These midwives are independent practitioners who attend births at home or freestanding birth centers.
Direct Entry Midwives - An independent practitioner who has learned midwifery through study, apprenticeship, a midwifery school, or a college program that is not a nursing program.
Licensed Midwives - Midwives licensed to practice midwifery in a particular area. Normally a state.
As you can see there are many types of midwives. Most states require a midwife to be a CNM or CPM for a home delivery. A midwife who delivers at the hospital will spend an average of 30 minutes with you at a prenatal visit. A midwife at a freestanding birth center or one who attends home birth will spend an average of 1-2 hours with you during a routine prenatal visit, spending time to get to know you and your entire family. She becomes "part of the family".
I stated above that if an OBGYN makes you uncomfortable to drop them and move on. The same is for midwives. Not all midwives are created equal and some can be jokingly referred to as "medwives" and have very bad bedside manner and horrible statistics. Best way to find someone is word-of-mouth or by using rating sites like ratemds.com. Remember to *interview* and find someone you click with!
3). Family Care Physician (the person who takes care of you and your family's health)
This third option is probably not one you were aware of and to be honest I didn't know a family physician delivered babies but they do! Many women have grown up with their family physician and love them and trust them. This is a very valid option that you should check into when deciding who will deliver your baby.
INTERVIEW QUESTIONS will be coming up next time!
POLL: Now that you've learned a little more about the different care providers who will you want present at your birth?