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Choosing the right health care provider for pregnancy and childbirth

Prenatal care - health care provider; Pregnancy care - health care provider

You have many decisions to make when you are expecting a baby. One of the first is to decide what kind of health care provider you want for your pregnancy care and the birth of your baby. You may choose an:

• Obstetrician
• Family practice doctor
• Certified nurse-midwife

Each of these providers is described below. Each has different training, skills, and outlooks on pregnancy and childbirth. Your choice will depend on your health and the type of birth experience you want. The choices available to you may differ depending on your local resources.

Here are some things you need to consider when you decide on the type of provider you want:

• Risk factors you may have for problems during pregnancy and childbirth
• Where you would like to deliver your baby
• Your beliefs and desires about natural childbirth

I Would Like to Learn About:

Obstetricians

An obstetrician (OB) is a doctor who has special training in women's health and pregnancy.

OB doctors specialize in both caring for women during pregnancy and labor and delivering their babies.

Some OBs have advanced training in caring for high-risk pregnancies. They are called maternal-fetal medicine specialists, or perinatologists. Women may be advised to see an OB specialist if they:

• Had a previous complicated pregnancy
• Are expecting twins, triplets, or more
• Have a preexisting medical condition
• Need to have a cesarean delivery (C-section), or had one in the past

Family Physicians

The family physician (FP) is a doctor who has studied family medicine. This doctor can treat many illnesses and conditions, and treats men and women of all ages.

Some family doctors also take care of women who are pregnant.

• Many will care for you during your pregnancy and when you deliver your baby.
• Others provide prenatal care only and have an OB or midwife care for you during the birth of your baby.

Family medicine doctors may also be trained to take care of your newborn after delivery.

Certified Nurse-Midwives (CNM)

Certified nurse-midwives (CNM) are trained in nursing and midwifery. Most CNMs:

• Have a bachelor's degree in nursing
• Have a master's degree in midwifery
• Are certified by the American College of Nurse-Midwives

Nurse midwives care for women during pregnancy, labor, and delivery.

Women who want to have as natural a childbirth as possible may choose a CNM. Midwives view pregnancy and childbirth as normal processes, and they help women safely deliver without treatments or minimize their use. They are trained to be the primary care person during labor and delivery. Treatments may include:

• Pain medicines
• Vacuum or forceps to aid the delivery
• C-sections

Most nurse midwives work with OBs. If complications or medical conditions develop during pregnancy, the woman will be referred to an OB for a consult or to take over her care.

References

American College of Obstetricians and Gynecologists website. Joint statement of practice relations between obstetrician-gynecologists and certified nurse-midwives/certified midwives. www.acog.org/clinical-information/policy-and-position-statements/statements-of-policy/2018/joint-statement-of-practice-relations-between-ob-gyns-and-cnms. Updated November 2022. Accessed March 1, 2023.

Gregory KD, Ramos DE, Jauniaux ERM. Preconception and prenatal care. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 5.

Williams DE, Pridjian G. Obstetrics. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 20.

Review Date: 11/21/2022  

Reviewed By: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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