Picking your healthcare provider is much more than just choosing a midwife or an obstetrician—when, where and how you want to birth your baby are important factors.
Philosophy & Model of Care
When selecting a provider, question the provider’s or practice’s philosophy of care to see if it is how you want to receive care. Is it a large practice where clients wait significant time to be seen, to then spend only 10 minutes with their provider? Is it a smaller boutique practice where clients can take up to an hour for their initial visit and have at least 30 minutes at return visits with a provider? Question what additional services the practice has to support you through pregnancy, labor, birth and recovery. Do they provide birthing, postpartum, newborn, and lactation education? Do they offer group prenatal care visits, like the Centering Pregnancy program, to boost education during pregnancy and access to pregnant peers? Do they offer maternal mental health services, or do they refer to other practices?
Type of Practice
Consider the type of practice your ideal provider is affiliated with. Is it a solo-practice, physician-led practice, midwifery-led practice, or a collaborative practice? OB/GYNs are surgeons who take a medical approach to your care. Midwives are primary care providers who support pregnancy as a normal state of health and give care based on an individual’s needs. If the practice has multiple providers, are patients assigned to each provider, or do you see all the providers? How are urgent problems handled? Who will attend your birth? Do they have a shared call rotation? If so, you may have built a relationship with a provider throughout pregnancy only to have an unfamiliar provider attend the birth.
Run the Numbers
Statistics are important; ask about the following:
- Induction rates and timing of inductions. For example, does your provider schedule post-term inductions at 40, 41, or 42 weeks?
- What is the provider’s caesarean birth rate? The national primary cesarean section rate is around31%, with a goal to decrease it to 23.6%. The lower their rate the more likely your baby will have a vaginal birth
- What are the breastfeeding rates of the facility where you will birth? “Baby friendly” designated hospitals have trained breastfeeding support staff
Maternal Healthcare Crisis
The U.S. may be one of the most developed countries in the world, but it has one of the highest rates of maternal death among American women within 12 months of birthing. Black and Indigenous women die during the postpartum year at rates up to 4 times more than birthing moms of other races or ethnicities. Ask your provider:
- What practice changes have you made to reduce the maternal healthcare crisis?
- What specific actions does your practice take to improve the outcomes for Black and Indigenous birthing persons?
- Will they welcome a doula at your labor and birth for additional advocacy and support?
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