How to Prepare for Childbirth: Choosing a Provider and Setting
Choosing a Childbirth Care Provider
- May be a certified nurse-midwife (CNM), a certified midwife (CM), or certified professional midwife (CPM), as defined by a Journal of Midwifery & Women’s Health (JMWH) article on midwives (PDF, 135.7 KB); not all types of midwives have the same permissions and privileges in every state.
- Can work in hospitals (94%), birth centers (3.2%), or home settings (2.6%), according to an American College of Nurse-Midwives (ACNM) fact sheet on midwifery and childbirth (PDF, 71.96 KB).
- Provide care — depending on certifications — during pregnancy, labor, childbirth, and the postpartum period, as detailed in the JMWH article.
- Attend about 12% of vaginal births and 8% of all births in the United States, as noted in the ACNM fact sheet.
- Often have hospital privileges similar to physicians, if they are CNMs or CMs.
- Serve as primary care providers once credentialed, as stated in the JMWH article, though they cannot perform major surgery, such as cesareans (“C-sections”).
Obstetricians and Gynecologists
- Provide emotional support and comfort to women during labor.
- Cannot offer medical care but may advocate for a woman’s childbirth plan.
- Can lessen risk of C-section birth and complications, as cited by DONA International’s Benefits of a Doula page.
- Associated with lower incidence of Pitocin and pain medication use and cesarean delivery when doula services are present at birth, according to DONA International.
Choosing the Childbirth Setting
- Are the most common setting of childbirth options in the United States: Only 1 in 62 births occurred outside a hospital in 2017.
- May be prepared with a NICU, a surgical suite in the labor wing, or equipment for a water birth; women with choices for their hospital birth may want to research the facility ahead of time.
- Focus all efforts on ensuring the childbirth meets the parent’s expectations through a family-centered approach.
- Are a less expensive childbirth option, according to the American Association of Birth Centers, which may help families save money if the locations are covered by insurance.
- Produce a C-section rate of 6% among low-risk women, four times lower than the national rate of 27% of low-risk women.
- Provide labor and delivery services that are less likely to result in surgical interventions.
- Home births offer women a lower risk of contracting illnesses through the hospital; lower costs; and more personalization, autonomy, and privacy.
- Home births are attended by midwives who carry lifesaving medications to ensure the safety of women and newborns, as noted in the JMWH article.
- Home births are not recommended for high-risk deliveries, as explained in the American Pregnancy Association’s fact page on home birth; having access to equipment and personnel who are able to provide lifesaving interventions is essential for high-risk pregnancies.
- Births at-home typically progress according to plan (89.1%), as indicated by results of The Midwives Alliance of North America Statistics Project; most of those transported to a hospital were transported for “failure to progress.”