You do have some choice about who attends your labor-it’s not simply a matter of opting for hospital expertise or a home midwife. Wherever you decide to have your baby. the system can usually be tailored to suit your individual needs. Most women like to have their partner or a friend with them during childbirth, and hospitals now welcome this. You may find it reassuring to have abirth coach, too- someone who’s been through it before and knows what to do.
Obstetrician
An obstetrician is a doctor who specializes in pregnancy and childbirth. This doctor will provide your prenatal care, and the hospital you go to will depend upon his or her affiliation. Many doctors in a city will have privileges at more than one hospital, but doctors in the suburbs may practice at only one hospital. You may choose a doctor recommended by a friend or family member, or you could check your insurance company’s list of providers in your area. You may decide you’d prefer a female doctor over a male one.
Midwives
The modern, professional midwife is a specialist in childbirth. She can care for you throughout your pregnancy and during labor and delivery, and knows when to call for extra advice and assistance. Unlike the obstetrician, her focus is the normal, not the abnormal. She’s interested in your general well-being, not just your uterus and how it may malfunction. Although midwifery is traditionally a female profession, there are now some male midwives as well.
Certified nurse-midwives (CNM) These midwives are registered nurses whose specialty is taking care of pregnant women and delivering babies. Like nurse-practitioners, they may also be able to diagnose and treat common illnesses in adults. In the US, they are graduates of programs that are accredited by the American College of Nurse-Midwives, they have passed a national certification exam, and they are licensed in all 50 states according to the relevant state laws. Certified nurse-midwives may work in a group practice with other midwives or with obstetricians, in a birthing center, or in a hospital. Rarely, they may deliver a child at home. Wherever midwives practice, they must have an obstetrician on call for assistance in case the pregnancy turns out to be high-risk or something goes wrong. Many insurance plans and HMOs are required by law to allow a woman to choose between an obstetrician and a nurse-midwife, but you should check your medical insurance carrier to make sure this is the case.
Certified midwives (CM) Some midwives do not obtain a general nursing degree before going into midwifery, although they do start with a degree in another health-related field. They go through the same educational and licensing system that was set up by the American College of Nurse-Midwives. This level of certification was started in 2000 and, therefore, is not yet common across the US.
Direct-entry midwives These midwives go directly into midwifery, obtaining their expertise through a combination of self-study, apprenticeship with other midwives, or a private midwifery program rather than going through the formal educational and licensing system set up by the American College of Nurse-Midwives. They are not legally recognized in 15 of the 50 states, and their fees are reimbursed by Medicaid in only ten of these.
Nursing Staff
You may encounter a variety of nurses during your labor and delivery because each has a different role. Labor and delivery nurses help care for both mother and baby during delivery, postpartum nurses help the mother immediately after birth, and neonatal nurses take care of the new baby. Nurse-practitioners may provide additional support during your pregnancy because they are qualifed to diagnose and prescribe medicine.