Choosing your health care provider for pregnancy

The health care provider you choose for pregnancy can make a big difference in your experience. Although the nature of your pregnancy may dictate which type of health care provider is best for you, personal preferences matter, too. Before making a decision, consider all of your options.

Family physicians: Primary care for all ages

Family physicians provide care for the whole family through all stages of life, including pregnancy and birth. Training and experience qualify family physicians to manage most pregnancies, including minor surgical procedures for vaginal delivery. A few family physicians also perform C-sections, but most don't. Family physicians may work solo, or they may be part of a larger group practice that includes nurses and other medical professionals.

You might choose a family physician if:

• You have an established relationship with a family physician
• You and your doctor don't expect any problems with your pregnancy
• You want the same doctor to care for your entire family
• You want continuity in care from prenatal appointments throughout childhood and beyond

Obstetrician-gynecologists: Traditional caregivers for pregnancy and birth

Doctors who specialize in obstetrics and gynecology are commonly referred to as OB-GYNs. They're trained to handle all phases of pregnancy, from preconception planning to postpartum recovery. OB-GYNs also specialize in the prevention and treatment of other conditions affecting a woman's health. OB-GYNs often work in group practices that include nurses and other medical professionals.

You might choose an OB-GYN if:

• You have an established relationship with an OB-GYN
• You have a pre-existing medical condition, such as diabetes, high blood pressure or an autoimmune disorder
• You're at risk of developing complications — such as gestational diabetes or high blood pressure (preeclampsia) — during pregnancy
• You're carrying multiple babies
• You want the reassurance that you won't need to be transferred to a different care provider if an unanticipated problem arises, such as the need for an emergency C-section

Maternal-fetal medicine specialists: Advanced care for high-risk pregnancies

Maternal-fetal medicine specialists, also called perinatologists or high-risk obstetricians, are trained to care for women with the highest risk pregnancies. Maternal-fetal medicine specialists often work in group practices, functioning mainly as consultants rather than primary obstetric care providers.

You might consult a maternal-fetal medicine specialist if:

• You have a severe medical condition complicating your pregnancy, such as an infectious disease, heart disease, kidney disease or cancer
• You've had pregnancy complications in the past or recurrent pregnancy losses
• You're a known carrier of a severe genetic condition that may be passed on to your baby
• Your baby is diagnosed before birth with a serious medical condition, such as spina bifida

Midwives: Attentive caregivers in low-risk pregnancies

Midwives provide preconception, maternity and postpartum care for women at low risk of complications during pregnancy. Guided by the principle that pregnancy and birth are natural events, midwives generally offer a low-tech approach to the birthing process. Midwives can't perform C-sections and may not be licensed to administer drugs or anesthesia, if the need arises.

There are many types of midwives. In the United States, the most common include:

• Certified nurse-midwives. Certified nurse-midwives are registered nurses who've completed advanced training in obstetrics and gynecology and have graduated from an accredited nurse-midwifery program and passed several certification exams. They're certified by the American College of Nurse-Midwives (ACNM).
• Certified midwives. Certified midwives don't have a nursing degree but may be trained in other areas of health care. They're certified by the ACNM after meeting the same standards required for certified nurse-midwives.

Although midwives may practice solo, many are part of a group practice — such as a team of obstetric care providers.

You might choose a midwife if:

• You're in good health and don't expect any problems with your pregnancy
• You prefer an in-depth interaction with each prenatal visit

If you're considering a midwife, make sure he or she is associated with a doctor or has a backup arrangement with a hospital in case complications arise. If you're not giving birth in a hospital, create an emergency plan with your midwife. Include details such as the name and number of your midwife's backup doctor, the hospital you'll be taken to, and how you'll get there.

Who's right for you?

In the end, it's most important to find a health care provider you can trust to safely guide you and your baby through pregnancy, labor and delivery. Ask yourself these questions:

• Does the health care provider listen to your concerns and provide helpful answers to your questions?
• Does he or she seem comfortable with your views on pregnancy, childbirth and medical care?
• Can the health care provider deliver your baby in the place you want to give birth, such as a particular hospital or birthing center?
• Who will care for you if your health care provider isn't available in an emergency or when your labor begins?

Once you've made your decision, remember that you chose your health care provider for a reason — and allow him or her to give you the best possible care.

Related

Prenatal care: What to expect during the first trimester
Fetal development: What happens during the first trimester?
Pregnancy symptoms: What to expect during the first trimester