Being pregnant is a time in your life when many decisions will have to be made. One of the first, and most important, will be what type of healthcare provider you will see to make sure both you and the baby are healthy throughout the pregnancy. If you plan to deliver in a hospital, you will generally be deciding between an obstetrician and a certified nurse midwife. In order to make the decision that is right for you, it is important to be educated on these different types of healthcare providers and exactly what their roles entail.
The most common option is an obstetrician, otherwise known as an OB/GYN. An obstetrician is a physician who has successfully completed four years of medical school and a four year residency in obstetrics and gynecology. Advantages to using an obstetrician for your prenatal care include direct access to medical technology such as ultrasound and genetic testing, their surgical expertise should a cesarean section become necessary, as well as their ability to manage high-risk situations. However, the American Pregnancy Association estimates that approximately 60-80% of women experience a low-risk, complication free pregnancy. Using an obstetrician may be a disadvantage if you desire a more natural, hands off approach to pregnancy and childbirth. While most babies in North America are delivered by obstetricians, you do have other options.
In certain hospitals, especially those in rural areas where obstetricians are not readily available, family practice physicians attend deliveries. The skill set and experience of family practice doctors varies widely, so if you are considering receiving care from one, be sure to ask about this. Some will perform cesarean sections and operative vaginal deliveries, as well as manage certain pregnancy complications while others will always refer to an obstetrician should complications arise.
If your pregnancy becomes high-risk, you may be referred to a perinatologist (also known as a Maternal-Fetal Medicine physician). These physicians have completed a residency in OB/GYN as well as a 3-year fellowship in the management and treatment of pregnancy complications. Women may be referred to a perinatologist for complications such as severe pre-eclampsia, an incompetent cervix, preterm labor or high order multiples.
Another option besides a physician is a certified nurse midwife. The midwifery model of care is based on the fact that pregnancy and birth are normal life processes. The scope of practice for a midwife varies depending on what state you will be delivering in, but as long as your pregnancy remains low-risk and you do not need a cesarean section, your midwife should be able to care for you for the duration of your pregnancy as well as your labor and delivery. Benefits to having a midwife include lower intervention rates, higher rates of breastfeeding and increased patient satisfaction. However, certified nurse midwives are only usually qualified to care for low-risk pregnancies, meaning that if a complication were to arise, your care would most likely need to be transferred to a physician.
Choosing a healthcare provider is perhaps the most important decision that you will make during your pregnancy. No matter what healthcare provider you choose to see during your pregnancy, the most important thing is that you feel comfortable with him or her and trust in their ability to safely manage your pregnancy.