Which Birth Provider is Right for You?
When women get pregnant they are faced with many big decisions including which type of provider to use for their prenatal care and delivery of their baby. Part of this decision is based on where women would choose to have their babies, hospital, birth center or home. Also playing into the decision is whether or not the woman would like to have the option of pain medication in labor. In the United States there are a number of different providers all with different educational backgrounds and philosophical approaches to pregnancy and childbirth.
The different birth attendants in the United States include Obstetrician/Gynecologists (OBGYNs), certified nurse-midwives (CNMs), or certified professional midwives (CPMs). These different types of providers have very different types of education and tend to differ philosophically. There are differences in their scope of practice and the legal issues surrounding their practices in different states. Although, this article will not be going into it, there are a few other options out there for birth attendants, including family practice MDs and lay midwives.
Choosing to deliver at the hospital, may mean choosing to have an obstetrician deliver your baby. These are doctors who have done a special residency in obstetrics and have specialized knowledge in both the normal pregnancy and higher risk conditions of pregnancy. They are also surgeons who can perform a cesarean section in case of an emergency or problem in labor. If you are delivering in the hospital with a physician you will have the option of pain medication. Obstetricians usually will have the nurses they work with give the labor support for women choosing natural childbirth and will tend to come to the hospital at the time of actual delivery.
Certified Nurse-midwives have a masters degree in nurse-midwifery. They are certified by the American College of Nurse Midwifery. They tend to mostly practice in the hospital, but also practice in home and birth center settings. They specialize in normal healthy pregnancy, but when they have relationships with Obstetricians they can manage higher risk pregnancies in the hospital. Pain medication is an option with nurse-midwives, however they will also stay with a patient and support her to have natural childbirth if that is what she desires. Many nurse-midwives assist in cesarean sections, so if a patient needs to have one an obstetrician and the nurse-midwife will perform the surgery together.
There are many different midwives who perform home birth deliveries. Most commonly these midwives are certified professional midwives. They are educated through a structured school program or through self study and then through apprenticeships with other midwives. They are required to meet certain standards and take an certifying exam by the North American Midwifery Alliance. They only deliver in out of hospital settings and can not offer pain medication for labor. They do offer lots of labor support and approach pregnancy and normal healthy physiologic state.
These types of providers are the three most popular options women choose from for care during their pregnancy. Based on what preference a woman has for birth setting, pain management, and pregnancy philosophy, the decision of which provider to use is very personal. Most important is that the woman is comfortable with the setting and finds a provider she can trust. It is worthwhile to look into the laws in the state where she is living as some states have very different regulations when it comes to home birth. Meeting the OB/GYNs, nurse-midwives, and certified professional midwives in the community, is the best way to find the best match for each individual pregnant woman.
Pregnant and looking for prenatal care in Portland Oregon? You can find an experienced midwife in Portland or a Portland OB/Gyn at Laurelhurst Women’s Center, located at Providence Hospital in SE Portland.