Choosing a Caregiver and a Place to Give Birth

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Finding the caregiver who is right for you . Choosing the birth environment that's right for you . Setting up your first prenatal appointment . What to expect from the prenatal workup

Choosing a Caregiver and a Place to Give Birth

Now that you've had a chance to get used to the idea of being pregnant, you need to start making some important decisions about your pregnancy—such as finding a caregiver and deciding where you would like to give birth.

You have three basic options when it comes to choosing a caregiver: an obstetrician (a general obstetrician or one who has specialized training in high-risk pregnancy), a family physician (your family doctor), or a midwife (a certified nurse-midwife, a certified midwife, or a lay midwife). Although 80% of American women continue to turn to obstetricians for care during pregnancy, a growing number are using the services of certified nurse-midwives (CNMs). In fact, according to the U.S. Department of Health and Human Services, the number of CNM-attended births has grown from 19,686 in 1975 to 196,977 in 1994.

The growing interest in midwifery reflects a new view of birth as a natural process rather than an illness requiring a lot of medical intervention. In recent years, even the medical establishment itself has changed its way of managing low-risk pregnancy, recognizing that pregnant women and their partners want to play a more active role than ever before in planning the births of their babies.

Some women are choosing to give birth in places other than hospitals—the setting of choice since the end of World War II. Some are seeking birth centers (family-friendly facilities designed to meet the needs of laboring women and their families); others are choosing to give birth at home (the norm in America prior to World War II, but something that was almost unheard of during the years after the war).

In this chapter, we talk about the pros and cons of each of these options and give you the inside track on choosing both a caregiver and a birthing environment that are right for you. Then we tell you what to expect from your first prenatal appointment.

Unofficially…
Midwives attend 5% of births in the United States and 75% of births in Europe.

Finding the caregiver who is right for you

There are three basic options when it comes to caregivers: family physicians, obstetricians, and midwives.

Family physician
A family physician is a medical doctor who has had several years of specialized training in primary care, including obstetrics. He is interested in all aspects of your health and well-being, not just your obstetrical health.

Obstetrician
An obstetrician is a medical doctor who has received specialized training in obstetrics. Obstetricians typically handle high-risk pregnancies but are also the caregiver of choice for many women who are having low-risk pregnancies.