There’s a lot to think about when welcoming a new baby into the family.
Where you deliver your baby and who will be on your birth care team is a big decision.
Choosing a provider for your pregnancy and birth is one of your first decisions. It’s helpful to find a supportive provider before or in the early stages of pregnancy.
Robyn Lindenmeyer, RN, is a registered nurse and certified midwife at OSF HealthCare. She explained what to consider and how to choose a doctor and hospital for pregnancy and birth.
Choosing a provider
If you don’t have a gynecologist yet, you can ask your family doctor for a recommendation. Sometimes your health insurance provider will offer you a specific provider or options to choose from.
“Do your research,” Robyn said.
Think about what you want for your pregnancy, labor, and delivery and create a birth plan. What type of pain therapy do you want? Who would you like to have in the delivery room? Are there certain things you would like to be able to do in the delivery room, like listen to music or turn off the lights?
“I think it’s completely fair to interview doctors, get to know them and choose one that meets your hopes and needs,” Robyn said.
“Relaxation during labor is one of the best strategies for managing pain and having a positive birth experience. “So it’s important to find providers who can support you to keep you as relaxed as possible,” said Robyn. “You want your care team to be good advocates for you.”
There are different types of providers who may be involved in your pregnancy, labor, and delivery.
Obstetrics/Gynecology
OB/GYN stands for obstetrician and gynecologist.
An obstetrician is a doctor who specializes in childbirth. Her expertise lies in the medical and surgical care of women. This way you can be confident that they understand your specific health needs.
A gynecologist is a doctor who specializes in women’s health care. You may already have a gynecologist for things like pap smears, pelvic exams, and breast health exams. If you are pregnant, your gynecologist can confirm your pregnancy and direct you to the next step.
Obstetrician vs. gynecologist
An obstetrician is often called an obstetrician-gynecologist because he or she helps women who are pregnant or trying to become pregnant. Usually they only cover things related to pregnancy.
A gynecologist is also technically a gynecologist, but often only practices gynecology. This includes conducting cancer screenings and treating women’s health problems such as urinary tract infections and fertility problems.
Maternal-fetal specialist
A maternal-fetal specialist is an obstetrician-gynecologist who has received additional training to treat more complicated pregnancies and births. They are sometimes called perinatologists.
If you or your baby need special attention, maternal-fetal specialists are ideal. For example, if you have a chronic condition such as high blood pressure or diabetes, a maternal-fetal specialist can help you monitor your health during pregnancy and delivery.
It may seem scary to get a referral to a maternal-fetal specialist, but they can help you and your baby stay healthier if there are any particular problems.
midwife
Midwives are another option for your care team. They often use more holistic approaches to labor and delivery, such as trying different breathing techniques and contraction positions.
“Midwives are a little more active during the birth process because they have more time,” Robyn said.
A midwife is not a gynecologist because she has not completed a medical degree. However, midwives work with obstetricians and gynecologists to provide a healthy and relaxing birth experience. They are best used when your pregnancy is low-risk and uncomplicated.
If you want to have a midwife on your pregnancy and birth care team, look for a certified midwife (CNM). These are midwives with formal medical training. You have completed nursing school and a master’s degree in midwifery. They are specially trained to care for mothers and babies to keep them healthy and safe. CNMs can also provide more services than a non-certified midwife.
Doula
A doula is an optional member of your care team. They provide emotional and mental support during labor and delivery. Unlike a certified midwife, a doula is not a medical professional. They can help you understand your hopes and needs so you can develop a birth plan. During labor, they will be your advocate and help you make decisions based on your birth plan.
They can help you relieve pain during labor through massage, breathing techniques, or administering painkillers.
Questions to ask your care team
When looking for providers for your pregnancy and delivery, start with an open conversation. Asking questions will help you choose the best provider for you and your baby.
Here are some examples of questions to ask your care team before birth:
- What pain management options support you?
- Is the care covered by my insurance?
- Which hospitals do you deliver to?
- What happens if I go into labor when you are not on call?
- Do you perform episiotomy? (These are small cuts in the skin between the vagina and anus to prevent tearing during childbirth.)
- How often do you perform a cesarean section?
- How can you support my birth plan?
- Does the hospital allow babies to stay with you after birth?
- How do you support my decisions before, during and after birth?
- How much input can I have?
- Can I be mobile during labor?
This is how you decide where you want to give birth to your baby
When you’re looking for options for where to deliver your baby, there are many things to consider. If you are well prepared and have as much information as possible, it will be easier for you to decide where to give birth.
hospital
Many factors can influence your decision to give birth in a hospital. Your insurance company may tell you which hospital to give birth at. The hospital may be closest to your home or your care provider may be employed by the hospital.
“I encourage everyone to tour the hospital first,” Robyn said.
Many obstetricians/gynecologists provide their services only in hospitals because of the resources available there, including the most advanced technology. When you give birth in a hospital, you have access to many emergency services in case something happens. Hospitals also offer the most options for pain management – both medical and non-medical.
“Many mothers are able to go home within 24 hours of giving birth as long as everything goes normally,” Robyn said. “After a C-section, you’ll probably stay two to three days.”
Hospitals are staffed full-time by medically trained professionals such as physicians, advanced practice providers, and nurses. Hospitals also have other specialists on staff who can help if needed, such as neonatologists and lactation consultants.
If you have a high-risk pregnancy or a planned cesarean section, you should plan for a hospital birth.
Birthplace
A birth center is a place outside of a hospital where babies are born.
A birthing center may have a gynecologist, but often there are midwives and nurses. These facilities usually rely on natural and holistic approaches without medical or pain therapy interventions.
If you choose to give birth at a birthing center, research them to make sure it has certified midwives and is close enough to a hospital so you can get emergency care quickly if needed.
A birth center should only be used if the pregnancy is low-risk and has no complications. You should not go to a birthing center if you have already had a cesarean section.
Home birth
Not many providers deliver babies at home.
Giving birth outside of a medical facility carries many risks. Even a normal labor experience can quickly turn into a life-threatening situation. Things like an increase in your baby’s heart rate, an increase in your blood pressure, or your baby’s position being in a bad position can cause a serious emergency.
If complications arise, it can take a long time to get to a hospital for emergency care. Many providers recommend giving birth in a medical facility.
Questions to ask when choosing a place to give birth
As you tour hospitals and meet with care teams, here are some helpful questions to help you make your decision.
- How often are cesarean sections performed?
- Are labor and delivery rooms private or are they shared?
- What high-risk services are available if problems arise?
- Where can I contact if I go into labor?
- What breastfeeding support is available?
- Which birth preparation courses are offered?
- What amenities are available?
- Can I do skin-to-skin treatment, delayed cable clamping or other special requests?
- How many carers are allowed to be in the room?
- Are visitors allowed?
Ultimately, Robyn says, flexibility is key. Even if you have a plan for where you’ll be born, who will be there, and how everything will work, it’s important to keep expectations realistic.
“You have to be a little flexible because if you come in with really rigid expectations and something doesn’t go the way you want it to, you’re probably going to be disappointed.”