As soon as that pregnancy test indicates a baby is on board, you\u2019re faced with so many decisions! But before you delve into picking baby names, nursery decor, constructing birth plans, and interviewing pediatricians, you\u2019ll need to figure out who\u2019s going to take care of you during your pregnancy. After all, regular prenatal care with someone you trust improves your chances of a healthy pregnancy\u2014and a healthy baby.<\/p>\n
While it\u2019s true that most parents-to-be choose an OB\/GYN for prenatal care, many don\u2019t have that option. (Approximately half of all counties in the U.S. have exactly zero obstetricians working there, notes a 2020 report from the March of Dimes.) And still others simply choose to see a non-OB\/GYN provider for their prenatal care. For help deciding which is the best prenatal care practitioner for you, check out our guide to finding the best maternity care.<\/p>\n
How to Choose the Right Prenatal Care Provider
\nFirst and foremost, you want to select a healthcare provider who\u2019s qualified to handle your specific pregnancy. That means, if you\u2019re gearing up for, say, a VBAC (vaginal birth after a C-section), you want a provider with lots of experience in that area. If you\u2019ve a history of complications from previous pregnancies, a homebirth with a midwife is not ideal. Beyond that, remember that you\u2019re deciding on a person to guide you through your pregnancy, not just an expert. You want to gel with your prenatal care provider and feel comfortable asking any question that may arise. In fact, research in the journal BMC Pregnancy and Childbirth found that fostering a meaningful relationship between a pregnant individual and their provider was key to experiencing \u201cquality care.\u201d For more help selecting your maternal health provider, consider asking your contenders some questions beyond Do you take my insurance? And Where do you deliver? To get a better sense of their bedside manner and general philosophy on pregnancy and childbirth, such as\u2026<\/p>\n
What\u2019s your role during labor and delivery?
\nHow much time do you allot for each prenatal visit?
\nAre you available by phone, email, or Telehealth for questions between visits or after-hours?
\nHow do you feel about birth plans?
\nWhat are your views about pain relief during labor?
\nDo you perform episiotomies as a matter of course?
\nAre you comfortable working with a doula?
\nWhat are your philosophies on \u201calternative\u201d birthing practices, like water birth?
\nWhat\u2019s your view on nutrition and weight gain during pregnancy?
\nWhat routine policies during labor do you recommend or require?
\nDo you ever recommend induction for an estimated large baby?
\nWhat do you tend to do if labor stalls or slows down?
\nIf I feel I need to see you before my 6-week postpartum checkup, will you accommodate me?
\nWhat kind of postpartum follow-up do you do?
\nTypes of Prenatal Care Providers
\nThe healthcare provider you\u2019ve been seeing for your pap tests, annual check-ups, and even pre-pregnancy planning might not be the right person to usher you through pregnancy. Before you land on your ideal prenatal care pick, you\u2019ll need to narrow the pool to the types of providers who can do the job. You can get prenatal care from a variety of providers, but they need to be:<\/p>\n
Obstetrician\/gynecologist: Also called OB\/GYN, this type of doctor has been specially trained to take care of you during pregnancy\u2014and deliver your baby. It\u2019s important to know that not all gynecologists are OB\/GYNs.<\/p>\n
Perinatologist: This type of doctor specializes in high-risk pregnancies and is also called a maternal-fetal medicine (MFM) specialist.<\/p>\n
Certified nurse-midwife: These experts have specialized education and training to not only deliver babies, but they can care for you before, during, and after pregnancy, too.<\/p>\n
Family physician: In communities where there are plenty of OB\/GYNs, family doctors may not deliver babies. But many family doctors can provide prenatal care and offer vaginal deliveries. (Some can perform C-sections, as well.) In fact, a 2021 report found that 67% of babies born in rural hospitals were delivered by family physicians.<\/p>\n
Nurse practitioner: While NPs are trained to be able to provide prenatal care, they don\u2019t deliver babies.<\/p>\n
Choosing an OB\/GYN as Your Prenatal Care Provider
\nAn obstetrician-gynecologist (OB\/GYN) is a medical doctor who\u2019s specially trained in women\u2019s reproductive health, pregnancy, childbirth, but also primary health care. That means an OB\/GYN is 100% qualified to give you a pap test, a breast exam, prescribe birth control\u2026and take care of you from preconception to delivery to postpartum. (PS: Not all gynecologists are obstetricians!) OB\/GYNs have been through four years of medical school and another four years of hands-on post-grad training as an OB-GYN-centered medical resident in a hospital setting. These maternal health care expert shepherd the vast majority of folks through pregnancy and delivery.<\/p>\n
An OB\/GYN may be a good choice for\u2026
\nVaginal deliveries
\nC-section deliveries
\nVBAC deliveries
\nLow- to (most) high-risk pregnancies
\nChoosing an Perinatologist\/Maternal-Fetal Medicine Specialist as Your Prenatal Care Provider
\nA perinatologist (also known as a maternal-fetal medicine specialist) completes four years of med school and four years of an OB\/GYN-focused residency, just like an OB\/GYN. But a perinatologist also receives three more years of training, focused on medical complications related to pregnancy, including the assessment and treatment of fetal issues. Generally speaking, an OB\/GYN, midwife, or another healthcare provider would be the one to refer you to a perinatologist. They\u2019ll do this if you have certain pre-existing medical conditions, if you develop a medical issue during pregnancy, or if your baby-to-be has an abnormality. (If it\u2019s your baby who needs the extra attention, your perinatologist will work with the pediatric care team to coordinate your little one\u2019s care.) Having a perinatologist care for you does not necessarily mean they\u2019ll replace your original prenatal provider. Oftentimes, they\u2019ll care for you together, with your primary prenatal provider usually delivering your baby.<\/p>\n
A perinatologist may be a good choice for\u2026
\nHigh-risk pregnancies due to an autoimmune disorder, diabetes, heart disease, inflammatory bowel disease, lupus, seizures, severe high blood pressure, or kidney problems
\nCertain a sexually transmitted diseases, such as syphilis or HIV
\nAbnormal prenatal screening test
\nAt risk of preterm labor
\nExpecting multiples
\nOver 40
\nMultiple prior miscarriages or stillbirths
\nPrior pregnancy complications, like preeclampsia, preterm labor, or gestational diabetes
\nChoosing a Midwife as Your Prenatal Care Provider
\nMidwives\u2014mostly certified nurse midwives (CNM)\u2014attend nearly 1 in 10 births in America. While \u201cmidwife\u201d sounds like an old-timey provider, CNMs are highly qualified registered nurses who also have a graduate degree (or higher) in midwifery. Certified nurse midwives provide comprehensive pregnancy and postpartum care, they deliver babies, and they offer well-woman checkups, routine women\u2019s health services, they can prescribe meds, order lab tests, and diagnose conditions. CNMs can work in hospitals, birth centers, and some oversee home births as well. Midwives don\u2019t perform surgery or care for moms-to-be with medically complicated pregnancies. While folks with chronic medical conditions are often considered high-risk and discouraged from midwife care, a 2021 report from Denmark found that those with certain chronic medical conditions who saw a midwife during pregnancy were more satisfied with their maternity care than those who experienced standard care with an OB\/GYN.<\/p>\n
A midwife may be a good choice for\u2026
\nVaginal deliveries
\nLow-risk pregnancies and births
\nHome births
\nWater births
\nHypnobirthing
\nMinimal intervention
\nHolistic care, focusing on wellness and emotions
\nSupport throughout labor and delivery
\nFear of childbirth (A 2022 report notes that midwives play a pivotal role in reducing fear of childbirth.)
\nChoosing a Family Physician as Your Prenatal Care Provider
\nDid you know that family medicine training in the U.S. has always included maternity care? It\u2019s true! In fact, according to the March of Dimes report mentioned above, family physicians provide the majority of maternity care in rural parts of the country. Of course, that doesn\u2019t mean that your family physician offers prenatal care or delivers babies… but it\u2019s worth the ask if you want to stick with a doctor you trust. It\u2019s also important to know if you live in a \u201cmaternity care desert,\u201d where there\u2019s limited access to prenatal care. (Approximately 10% of births nationwide occur in these deserts.) The range of prenatal care offered by family physicians varies, with some managing medical problems during pregnancy, others only handling prenatal care, and still others who offer comprehensive prenatal care for low-risk or high-risk pregnancy, including performing C-sections.<\/p>\n
A family physician may be a good choice for\u2026
\nThose with limited access to alternatives
\nVaginal deliveries
\nLow-risk pregnancies
\nOne-stop care, with primary, maternal, and pediatric care offered
\nChoosing a Nurse Practitioner as Your Prenatal Care Provider
\nWomen\u2019s health nurse practitioners (WHNP) is a registered nurse who has studied at the Master\u2019s or Doctoral level with a special focus on women\u2019s health. And they offer many of the same services as an OB\/GYN or a certified nurse midwife, including diagnosing conditions, ordering medical tests, prescribing medications, and prenatal and postnatal care\u2026but they do not deliver babies. Instead, WHNPs work collaboratively with physicians, including OB\/GYNs, who would guide you to the finish line. That said, these providers often are a solid choice to oversee your prenatal care. After all, research shows that roughly 73% of pregnant folks are more concerned about choosing the right prenatal care provider than choosing their delivery hospital.<\/p>\n
A nurse practitioner may be a good choice for\u2026
\nThose with limited access to alternatives
\nPersonalized care
\nOne-stop for prenatal and primary care beyond pregnancy<\/p>\n
More on your prenatal health:
\nPrenatal Appointment Schedule
\nWhich Prenatal Genetic Tests Do You Need?
\nThe Pregnancy Deficiency You Need to Know About
\nPregnancy Guide to Better Sleep
\nWeek-by-Week Guide to Your Pregnancy<\/p>\n
***<\/p>\n
REFERENCES<\/p>\n
Routine prenatal care visits by provider specialty in the United States, 2009-2010. NCHS data brief, no 145. March 2014
\nMarch of Dimes: Nowhere to Go: Maternity Care Deserts Across the U.S. 2020 Report
\nMarch of Dimes: Prenatal care checkups
\nThe impact of family physicians in rural maternity care. Birth Issues in Prenatal Care. September 2021
\nMichigan Health: OB-GYN, family physician, midwife, doula: Which pregnancy specialist is right for you?
\nJohns Hopkins Medicine: High-Risk Pregnancy: What You Need to Know
\nCleveland Clinic: Perinatologist
\nCleveland Clinic: Midwife
\nEffects of a Midwife-Coordinated Maternity Care Intervention (ChroPreg) vs. Standard Care in Pregnant Women with Chronic Medical Conditions: Results from a Randomized Controlled Trial. International Journal of Environmental Research and Public Health. August 2021
\nMidwives\u2019 interventions for reducing fear of childbirth in pregnant women: a scoping review. JBI Evidence Synthesis. December 2022
\nSupporting Family Physician Maternity Care Providers. Family Medicine. 2018
\nThe American Academy of Family Physicians (AAFP): Maternal\/Child Care (Obstetrics\/Perinatal Care)
\nEast Jefferson General Hospital, LCMC Health: More than catching babies: the role of NPs in obstetrics and gynecology
\nNurse Journal: Certified Nurse Midwife vs. Women’s Health Nurse Practitioner: What’s the Difference?
\nHow do pregnant women use quality measures when choosing their obstetric provider? Birth Issues in Prenatal Care. January 2017
\nWomen’s and care providers’ perspectives of quality prenatal care: a qualitative descriptive study. BMC Pregnancy and Childbirth. April 2012<\/p>\n","protected":false},"excerpt":{"rendered":"
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