Pregnant? Here Are 4 Things to Think About When Choosing a Doctor or Midwife

If you’re thinking about starting a family or are newly pregnant, you have an exciting journey ahead of you. One of the most important people on that voyage will be the health care provider who takes care of you during pregnancy.

Most women in the United States choose to have their babies delivered by an obstetrician-gynecologist (OB-GYN) or a family medicine physician, but some women with low-risk pregnancies choose a midwife as an alternative to a physician for pregnancy and birth health care.

Here are four tips for choosing a practitioner to help you move through the different phases of your pregnancy and prepare to meet your little one.

1. Determine what type of practitioner you want.

Decide if you want an OB-GYN, a family medicine provider or a midwife to care for you.

OB-GYNs are specialists in women’s reproductive health, pregnancy and childbirth. Family medicine doctors also can care for women during pregnancy and delivery and for the baby afterward.

Midwives focus on partnering with patients, educating women during pregnancy and creating continuity of care through a group practice. They are specialists in low-risk, normal pregnancies, so if you have a high-risk pregnancy, this may not be an option for you. If you have a chronic medical problem, such as diabetes or high blood pressure, or have had previous pregnancy complications, you may be considered high risk.

When you choose a midwifery practice that operates in a hospital, you have the benefits of being in a hospital system with physician support that can be called on if needed.

Also decide if you want the support of a doula during your delivery. Doulas are trained professionals who offer physical, emotional and informational support to women before, during and shortly after childbirth. Doulas work closely with the labor and delivery team to help women have a positive birthing experience.

2. Check with your insurance provider.

Find out which area hospitals and providers are in your insurance plan’s network. That means you will receive your care at a lower price. Going out of network is often costly.

“Better yet, plan during open enrollment (when you’re signing up for coverage) and select an insurance option that provides in-network benefits for the practice and delivery facility of your choosing,” says Philip Deibel, MD, an obstetrician who delivers babies at UNC REX Healthcare.

Also talk to your insurance company about what is covered related to prenatal care, labor and delivery, and care for you and your baby after birth. This could include anesthesia, lactation services, a hospital-grade breast pump and other options.

3. Do your research and ask around.

Ask friends, co-workers and your primary care provider for their recommendations, and then make sure those providers are in-network. If you are new to town, visit each doctor’s website to read up on his or her credentials, services and treatment philosophy and check out reviews and comments from patients.

When considering providers, find out where they have privileges to deliver babies. If you prefer a particular hospital, you’ll want to make sure the provider can take care of you there. If you need more information about local hospitals’ labor and delivery and after-birth care, that’s another good time to seek out friends’ advice and online reviews. Make sure the providers you choose are in-network.

Be sure to consider the location of both your provider’s office and the hospital, and decide if you need those to be close to home or work. If the provider’s gender or credentials are important to you, keep that in mind as well.

4. Set up an interview.

Once you’ve narrowed down your list of providers, call their practices and ask if they are accepting new patients. If they are, set up an introductory appointment to learn more.

“Go in for a preconception consult to talk about preparing for pregnancy while also finding out if that practice seems like it will be a good fit,” Dr. Deibel says.

Bring a list of questions. Ask about their on-call coverage arrangement; if your provider is not on call when you go into labor, you’ll probably have a different provider deliver your baby.

“Find a group that is small enough where you know everybody, but big enough where the doctors aren’t exhausted,” Dr. Deibel says.

For example, if you go to a practice with one provider, they’re on call every day and every night, so they’re also probably covering the office while they’re covering the hospital.

“And either you’re going to be a patient waiting (in the office) because they’re at the hospital delivering, or they may not be around a lot during your labor because they’re seeing patients in the office,” Dr. Deibel says.

If it’s important to you to know the doctor who ends up delivering your baby, choose a practice where you can meet everyone.

During your interview, ask about the practice’s philosophies on issues that are important to you, such as pain management, honoring your birth plan, having a doula present at delivery and after-hours availability. If you have questions during your pregnancy, urgent or not, how can you reach a provider during and after office hours?

Finally, trust your gut. As with any relationship, sometimes things don’t click, and that’s OK. You should feel comfortable and have confidence in your provider’s ability to see you through this special journey to motherhood.

If you need a primary care provider, obstetrician or midwife, you can find one near you.