Choosing Your Birth Team

Choosing Your Birth Team

Choosing the members of your birth team is one of the most important decisions that you’ll make during your pregnancy. This person or group of providers will support you emotionally and physically throughout your pregnancy, advocate (and hopefully pursue) your wishes during labor, and check in on you during your postpartum period. This person is helping you start a new, exciting, and extremely vulnerable chapter in your life.

Trust and intuition are important factors in making this decision. You, your partner and potential providers will discuss the best option for your family, but ultimately this is your very personal decision.

Think about big decisions you’ve made in your life, like choosing a college or a wedding venue. I’d like you to consider the idea that choosing a birth provider is an equally big decision. A big, very special decision that you’ll remember for the rest of your life. One that can significantly change the trajectory and outcome of your pregnancy.

When you’re overwhelmed during the first few days of pregnancy and want to see a practitioner ASAP, it’s tempting to choose the first provider you find or one based off a referral from a friend or your primary care physician. However, that quick decision may not lead you down the most ideal path for your specific situation. Please take some time to sit with this information, do your research, interview a few providers, and make an empowered decision instead of choosing the first provider you find. I promise you’ll thank me later.

And as a voice of experience, keep in mind that even if you do select the wrong provider to begin with, you CAN switch to someone else once you find the right provider. I switched with baby #3 at 8 months along because my original provider tried to force me into an unnecessary c-section.

A close-up of a pregnant woman having her blood sugar/ glucose checked.

Four Questions to Ask Before You Choose a Provider

While you’re considering potential providers, keep the following three factors in mind:

What options do I have in my area?
What type of birth do you envision having? (Medicated, Un-medicated, Assisted, Unassisted, etc)
Where do you plan on giving birth? (Home, Birth Center, or at a Hospital)
What do I want my birth to look like? This will determine the setting, types of interventions, people in attendance, and options for alternative treatments. Keep an open mind about this question.
Does it matter to me who is in the delivery room? (For example, if your physician works in a group care setting, you may see multiple caregivers throughout your pregnancy. The one who attends your pregnancy may be the one who is on call.)

Once you answer these questions you will have a better idea of your vision for your birth and you will be able to narrow down who all you want on your team. I would suggest interviewing multiple birth professionals before making your final decision and know it is NEVER too late to change if your decide they are not working out for some reason in the future. Tour different facilities so you know if they have the right feeling you are looking for for your birth. Ask questions! No one in the birth industry should make you feel uneducated, unintelligent, or uncared for – so ask all of the questions you want. If they are not given suitable answers, move on to your next option.

Having your husband/partner, extended family, and friends in the delivery room can be a great experience as long as they provide you with a positive-stress free environment. If this is not the case you have every right to not invite them into this intimate space.

Understanding the Types of Providers

Your caregiver’s approach is going to depend on their training, experience, birth philosophy, and the policies of the hospital and state they practice in. If you’re looking to have a birth with minimal interventions, you’ll want to choose a provider and birth setting that welcomes a more physiological (natural) birth and is comfortable supporting a woman with alternative options. Otherwise, you could receive routine care, which may include interventions when the provider feels it is necessary or facility policy calls for it.

It’s important to understand that not all hospitals have the same policies and procedures when it comes to birth. You’ll want to tour multiple hospitals; work with a doula or childbirth educator in your area that is familiar with local hospital policies; and ask lots of questions. For example, some hospitals and physicians are comfortable with VBACs (vaginal birth after cesarean) while others are not. This could significantly impact your decision.

Also keep in mind that some midwives are not comfortable with VBACs done at home. I know that until the last year or so, we did not have an option for an assisted at home VBAC. With my first child, born in 2010, we didn’t even have an option for an assisted home birth. With baby #4, we were lucky enough to locate a local-ish midwife (she was 30-45 minutes away depending on traffic) but she didn’t support at home VBACs because of the risk of uterine rupture. Finally, this year, with baby #5, we were lucky enough to find a midwife here in town that supports it all being done at home as long as you’ve proven that you can have a successful VBAC. As this will be my 3rd vaginal birth after my cesarean in 2013, she said that I have definitely proved my body can do it.

You’ll also want to take into consideration your state of health and how your pregnancy is progressing. If you’re healthy and the pregnancy is going well, you can safely choose any provider. If your pregnancy is complicated or if your caregiver anticipates any issues, you may want to work with an obstetrician alone or as a consultant along with your family physician or midwife.

Common Providers in the USA

Obstetricians/gynecologists (OB-GYNs):

The most common choice for births in the USA, accounting for ~85% of the maternity care in the US
Education: A minimum of medical school or a school of osteopathic medicine and three or more years of additional training in obstetrics and gynecology
Their education focuses on detection and treatment of problems and they are trained to be surgical doctors
They may work in a private practice or as part of a group
Insurance is more likely to cover an OB/GYN over other birth care providers
Many couples feel safer being under their eye and in a hospital setting.

Family Physician:

Education: A minimum of medical school or a school of osteopathic medicine and two or more years of additional training in family medicine, including maternity and pediatric care
Their education focuses on the health care needs of the entire family

Midwife:

The typical maternity caregivers in most countries. They are becoming increasingly popular in the United States.
Education and practices are based on the Midwifery Model of Care
All midwives are trained to support and aid pregnancies as a normal and natural part of life, instead of treating problems.
Certified Nurse-Midwife (CNM): A minimum of nursing school and one or more years of additional training in midwifery. Typically, a CNM works in a hospital setting and alongside an OB/GYN, but not always.
Licensed Midwife (LM): A minimum of three years of formal training according to their state’s requirement. Most work in birth centers or attend home births
Certified Professional Midwife (CPM): The only midwife credential that requires knowledge and experience in out-of-hospital settings. A CPM handles normal, healthy pregnancies outside of a hospital, at free-standing birth centers and home births. CPMs carry a small client load and provide a very personal and attentive relationship. They support, guide, and educate women to make informed decisions, and provide little medical intervention to pregnancy, labor, and birth.
Midwife Assistant: Attending the birth, a MA provides assistance to the midwife.

Additional Team Members to Consider (Doula, Acupuncturist, Chiropractor, Homeopath, etc.):

Doula: A doula does not replace your husband/partner or other main support person. A doula can aid in every birth situation, no matter the environment or birth style you choose. She gives support emotionally, mentally, and physically. She can calm you through relaxation techniques, movements, and positions. Having a well-educated doula is like have a really good guide to direct you through all things related to pregnancy, labor, birth, and beyond. She is comforting to both the laboring mother and the partner, ensuring that the partner has an active role in the birth. She will encourage your to advocate for yourself throughout labor. A doula is not a medical professional. She cannot diagnose or give medical advice. She also cannot legally deliver your baby. That being said, research greatly supports having a doula present at your birth. It has been proven that births with a doula present has:

50% less chance of an unnecessary c-section 25% shorter labor time
60% less chance of an unplanned epidural
30% less chance in needed an instrumental-assisted delivery
40% less chance of needing Pitocin

While these team members may not attend your birth, they are great to add to your lineup. You may even be able to have an acupuncturist, chiropractor, or homeopath at your side throughout your labor. They can play a significant role throughout pregnancy and labor – and after:

Chiropractor
Acupuncturist
Natural path
Nutritionist
Massage Therapist
Pelvic Floor Specialist

Choosing your birth team wisely is very important and it will have a big impact of how your birth plays out. Your birth team has the responsibility to follow your wishes. Remember it is legally required that all details be presented to you for the best choices to be made. If you do not agree with something, your birth team legally must respect your wishes.

While there is still about 98% of women birthing in hospitals, more and more are choosing to give birth outside of a hospital setting. It is important that you know that you can make changes to your birth team at any point of your pregnancy. If you are not feeling supported or change your views, you may switch providers without feeling any guilt.

This is YOUR pregnancy and YOUR birth, and YOUR TEAM is working for YOU.

The information included in this post is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. Always consult your healthcare provider to determine the appropriateness of the information for your own situation, or if you have any questions regarding conception, pregnancy, or your prenatal treatment plan.This post is intended for readers in the United States, as other countries have different policies when it comes to health care providers.

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Choosing Your Birth Team

Choosing Your Birth Team