Building Your Birth Team: Choosing a Doctor or Midwife

Your care provider during your pregnancy and birth will have a huge impact on what your birth looks like and how you feel about it later. Here’s how to choose the right doctor or midwife for you.

Asking for recommendations

One good way to try to find the best provider for you is to ask people who have had babies in your area. Be sure to ask whether they felt like their care provider supported their choices or whether they felt pressured into making decisions they regretted later.

Sticking with your gynecologist

If you have a great relationship with your gynecologist and they also provide pregnancy care, you may simply want to stay with that provider. However, it is extremely important to still talk to them about your birth preferences. As wonderful as they are at providing gynecological care in the office, they may not support the kind of birth you are hoping to have.

Considering a midwife

A midwife might be a good option for you if you hope to have an unmedicated birth with as few medical interventions as possible. Midwives often practice what is called “expectant management” of labor, which involves waiting and observing instead of taking action to make labor progress or change. In most places, you can have midwifery care for either a home or hospital birth.

Considering an OB/GYN

OB/GYNs attend births in the hospital. They provide medical care for both vaginal births and surgical births (Cesarean sections), as well as for pregnancies and births that involve complications for the pregnant parent, baby, or both. You may want to consider an OB/GYN if you have underlying health conditions, have a complicated pregnancy, or if you just feel more comfortable with medical interventions, such as medical pain relief, induction, or surgical birth.

Choosing a provider

Whether you choose to have an OB/GYN or a midwife, you’ll want to choose the specific provider who is right for you. It’s important to find out whether a provider has specific policies that would be at odds with your birth preferences. Here are some questions to consider.

For a doctor or hospital-based midwife:

• Do they have the policy to induce you once you hit your due date?
• What percentage of their patients who want an unmedicated birth end up having one?
• What is their practice’s Cesarean birth rate?
• If your provider has agreed to your birth plan, will other providers respect that if they are on call for your birth?

For a home birth midwife:

• Do they have a backup? Will you get to meet them?
• Under what circumstances would they transfer you to hospital care?
• What is their “risk out” rate? How many of their patients end up needing to transfer to hospital care?

You should also consider practical issues, such as which hospital your provider delivers at, whether your provider is covered by insurance, or how far away a home birth midwife lives.