How to Choose a Care Provider for Pregnancy and Birth

You might already have a care team that you feel great about. You are ahead of the game! Not everyone does. A care team includes everyone who is supporting you in your pregnancy and who will be caring for you during your birth and postpartum recovery. It’s very important that these people know you, your preferences, and are ready to work with you as collaborators.

Who Is On a Care Team?

When discussing pregnancy, birth and postpartum recovery, there might be a lot of people involved in your care. You’ll probably have a primary care physician like an obstetrician or family practice doctor or a midwife, possibly a maternal/fetal medicine (MFM) specialist for high risk situations, a doula, allied health care providers like a physical therapist or acupuncturist, a birth photographer, a partner, family members, friends. Not everyone has such a big care team but many do.

Understanding Your Care Options

You might have a lot of options or fewer. Some parts of the United States are considered “maternity care deserts”. These are areas where there are no maternity care providers within a reasonable distance from where people live. Or you might not live in a maternity care desert but you might be limited by your insurance plan. There may only be one facility in the network and a handful of providers who practice there, or even just one practice. When you’re looking for a care provider, it’s a good idea to contact your insurance company to find out all your options. Ask about obstetricians, family practice doctors, MFMs, midwives, hospitals, birth centers. Find out about the supplemental health care specialties like mental health therapy, chiropractic, massage, acupuncture, pelvic floor physical therapy. Some insurance plans do provide coverage for these kinds of services, but it might be limited or there may be special provisions. It’s good to know ahead of time whether you’ll need referrals and what the coverage is.

You might also have choices about your personal team. Some people have parents, siblings, in-laws, other family members, or friends who are willing to be part of the support team. It’s very important to accept help when it’s offered, but it’s also important to choose wisely. You can probably give most anyone a “job” to do, but you might not feel comfortable inviting every person to be there for the birth (and you probably shouldn’t!). Maybe you can let certain people help take care of your pets while you’re away or help prepare food for your return or for your recovery stay at the hospital. You might ask someone else to put together your baby crib, someone to be on call to give you a ride to the hospital or birth center, and another to help with baby care after you get home. Everyone has their strengths and weaknesses. Don’t feel bad if you need to set some boundaries. It’s healthy, and your top priorities are your safety and your baby’s. When you don’t feel safe or supported, it’s harder to ensure that things go smoothly.

How to Choose a Good Match

Finding a care provider might be easy and take no time at all, but you might also need to do a lot of digging. Checking with your insurance carrier is a great place to start for health care. You can also ask your current care providers, friends, family, co-workers, or neighbors for referrals. Just remember that everyone is different. The provider that your sister felt most comfortable with might not be the right fit for you. That’s ok! Keep looking until you find that one that is.

You can check reviews to get a feel but that’s not always possible or even necessarily the most reliable method. Every provider is likely to have some good and some bad reviews. The best way to know is to meet each person yourself and ask some questions. The following list of questions can apply in most situations, although you might leave some out if you’re considering whether to invite a certain friend or family member to attend your birth.

• Do they work in a group practice? If so, how many providers are there?
• What are the chances my chosen provider will attend my birth?
• If they work in a group practice, do their partners practice similarly? Will I meet them? When and how?
• What is the best way to get in touch during business hours and after hours if needed?
• What is the prenatal visit schedule?
• What is the postpartum follow up schedule?
• How long is a typical prenatal/postpartum visit?
• How long is a typical wait for appointments?
• Where will I park, and is there a fee?
• What is the process for getting ultrasounds and labs? Is everything done on site or do I need to go somewhere else?
• Do you offer or can you recommend prenatal education?
• What are your cesarean rates? – both planned and emergent
• How do you feel about elective cesareans and if so, at which week of gestation do you recommend it?
• What are your episiotomy rates and under what conditions do you recommend them?
• What are your induction rates and under what conditions do you recommend them?
• How do you feel about elective inductions and if so, at which week of gestation do you recommend it?
• Which hospital do you work in?
• Can you support me in position changes during labor? What about with an epidural?
• Can you support me in position changes during PUSHING? What about with an epidural?
• How do you feel about doulas or other members of my support team being there for appointments and at the birth? What about in the OR if I need a cesarean?
• How do you feel about birth plans?
• What is your level of tolerance for time spent pushing?
• How often do you prefer to do cervical exams? Do you recommend them at any of the prenatal appointments?
• How often do you recommend AROM?
• What might you recommend I do in case of PROM?
• Do you prefer continuous fetal monitoring in every situation? Or do you support intermittent auscultation when appropriate?
• Do you like to get partners involved? Catching the baby, cutting the cord, etc.
• How often do you support VBAC?

The list above are good questions to ask to get an idea of some logistics and basic framework for health care. But it’s also important to know something about their personality and bedside manner to know if they’ll be a good fit for you. Pay attention to these things too.

• Do they ask you questions?
• Do they listen carefully to your thoughts and preferences?
• Do they openly and easily offer information about themselves, their philosophies, and how they prefer to support someone in pregnancy and birth?
• Do they willingly and openly answer your questions about their statistics and preferences?
• Do they take enough time with you at each visit, or do you feel rushed?
• Are they consistent and punctual with appointments most of the time?
• Do they give you advice for each stage of pregnancy about how to maintain good health and prepare for birth?
• Do they refer you to other support professionals to address concerns that are not in their realm of expertise? For example, would they recommend pelvic floor physical therapy or prenatal yoga if you are having some aches and pains?
• Do they willingly offer alternatives if their first recommendation does not seem right for you?
• Do your personalities blend well? If you like warmth and nurturing, is that your care provider’s style? Or maybe you prefer a very matter-of-fact and down-to-business style?
• Do they follow through on assurances and recommendations or are you finding that they change their mind later in your care without verbalized need?

The Bottom Line: Why the Right Care Provider Matters

I can’t emphasize enough how important it is to feel well-supported during your childbirth journey. The right person for you might be someone that no one else likes, and the person that EVERYONE else loves might completely turn you off. That’s not what matters. What matters is that you feel good about your choice. It matters so much that it can make a measurable difference not only in how you feel about your experience, but also in how you feel about yourself. A great care team can make you feel empowered as well as supported. This can go a very long way in keeping your stress levels down, your risks down, and your outcomes great.