Choosing a doctor and hospital for pregnancy and birth

There’s a lot to think about when welcoming a new baby to the family.

Where you choose to have your baby and who is going to be on your birthing health care team is a big decision.

Choosing a provider for your pregnancy and birth is one of the first decisions you make. Finding a supportive provider before or in the early stages of pregnancy is helpful.

Robyn Lindenmeyer, RN, is a registered nurse and certified nurse midwife at OSF HealthCare. She explained what to consider and how to choose a doctor and hospital for pregnancy and birth.

Choosing a provider

If you don’t have a gynecologist yet, you can ask your primary care provider for a recommendation. Sometimes your health insurance will give you a specific provider or options to choose from.

“Do your research,” Robyn said.

Think about what you hope for your pregnancy, labor and delivery and come up with a birth plan. What kind of pain management do you want? Who do you want in the delivery room? Are there certain things you want to be able to do in the delivery room, like listen to music or turn off lights?

“I think it’s totally fair to interview doctors, get to know them and pick one that fits your hopes and needs,” Robyn said.

“Relaxing through the contractions is one of the best strategies to manage pain and have a positive birth experience, so finding providers who support you in a way that is going to keep you as relaxed as possible is important,” Robyn said. “You want your care team to be good advocates for you.”

There are several different types of providers that may be involved in your pregnancy, labor and delivery.

OB/GYN

OB/GYN stands for obstetrician and gynecologist.

An obstetrician is a doctor who specializes in birth. Their expertise is in women’s medical and surgical care. So, you can be sure that they know your specific health needs.

A gynecologist is a doctor who specializes in women’s health care. You may already have a gynecologist for things like Pap smears, pelvic exams and breast health checks. When you’re pregnant, your gynecologist can confirm your pregnancy and get you connected to the next best step.

Obstetrician vs. gynecologist

An obstetrician is often called an OB/GYN because they help women who are pregnant or want to become pregnant. They usually only treat things that are related to pregnancy.

A gynecologist is also technically an OB/GYN, but they often just practice gynecology. That includes performing cancer screenings and treating women’s health issues, like urinary tract infections and fertility concerns.

Maternal-fetal specialist

A maternal-fetal specialist is an OB/GYN who received extra training to treat more complicated pregnancies and births. They are sometimes called perinatologists.

Maternal-fetal specialists are great if you or your baby needs special attention. For example, if you have a chronic health condition, like high blood pressure or diabetes, a maternal-fetal specialist can help monitor your health throughout pregnancy and during delivery.

It may seem frightening to get a referral to a maternal-fetal specialist, but they can help keep you and your baby healthier if there are any unique issues.

Midwife

Midwives are another option to have on your care team. They often use more holistic approaches for labor and delivery, like trying different breathing techniques and labor positions.

“Midwives are a little bit more hands on during the birthing process because they have more time,” Robyn said.

A midwife isn’t an OB/GYN because they haven’t completed medical school. However, midwives work alongside OB/GYNs to help create a healthy and relaxed birth experience. They are best used when your pregnancy is low risk and uncomplicated.

If you would like a midwife on your pregnancy and birth care team, look for one who is a certified nurse midwife (CNM). These are midwives who have formal medical training. They have completed nursing school and have a master’s degree in midwifery. They are specially trained to care for moms and babies to keep them healthy and safe. CNMs can also offer more services than a midwife who isn’t certified can.

Doula

A doula is an optional member of your care team. They offer emotional and mental support during labor and delivery. Unlike a certified nurse midwife, a doula is not a medical professional. They can help you understand your hopes and needs so you can come up with a birth plan. During labor, they’ll be an advocate to help you make decisions with your birth plan in mind.

They can help you manage pain during labor through massage, breathing techniques or getting you connected with pain medication.

Questions to ask your care team

When you’re searching for providers for your pregnancy and delivery, start with an open conversation. Asking questions will help you to choose the best provider for you and your baby.

Here are some examples of questions to ask your care team before birth:

• What pain management options do you support?
• Is care covered by my insurance?
• What hospitals do you deliver at?
• What happens if I go into labor when you’re not on call?
• Do you perform episiotomies? (These are small cuts to the skin between the vagina and anus to reduce tearing during birth)
• How often do you perform C-sections?
• How can you support my birth plan?
• Does the hospital allow babies to stay with you after birth?
• How do you support my decisions before, during and after birth?
• How much input can I have?
• Do I have the ability to be mobile during labor?

How to choose where to have your baby

If you’re exploring options for where to have your baby, you have many things to consider. Being prepared and having as much information as possible makes it easier to choose where to give birth.

Hospital

Many factors can influence your decision to give birth at a hospital. Your insurance may tell you which hospital to deliver at, the hospital might be the closest to your home or your provider is employed at the hospital.

“I encourage everyone to start by touring the hospital,” Robyn said.

Many OB/GYNs only deliver in hospitals because of the resources available right there, including the most advanced technology. If you’re giving birth in a hospital, you’ll have access to many emergency services in case something happens. Hospitals also offer the most options to manage pain – both medically and non-medically.

“A lot of moms can go home within 24 hours after delivery, as long as everything has been normal,” Robyn said. “After a caesarean, you will probably stay for two or three days.”

Hospitals are staffed full time with medically trained professionals, like doctors, advanced practice providers and nurses. Hospitals also have other specialists on staff that can help if needed, like neonatologists and lactation consultants.

If you have a high-risk pregnancy or a planned C-section, you should plan on a hospital birth.

Birthing center

A birthing center is a place outside of a hospital where babies are delivered.

A birth center may have an OB/GYN on staff, but they often are staffed by midwives and nurses. These facilities usually rely on natural and holistic approaches without medical or pain management interventions.

If you choose to give birth in a birth center, research the center to make sure it is staffed by certified nurse midwives and is close enough to a hospital that you can get emergency services quickly if needed.

A birth center should only be used if you have a low risk, uncomplicated pregnancy. You shouldn’t use a birth center if you’ve already had a C-section previously.

Home birth

Not many providers deliver babies at home.

There are many risks involved in delivering outside of a medical facility. Even a normal labor experience can turn into a life-threatening situation very quickly. Things like a spike in your baby’s heart rate, a spike in your blood pressure or a bad position of your baby could cause a severe emergency.

It can take a long time to get to a hospital for emergency care once complications arise. Many providers encourage delivering at a medical facility.

Questions to ask when choosing where to give birth

When touring hospitals and meeting with care teams, here are some helpful questions that will guide you in your decision.

• How often are C-sections performed?
• Are labor and delivery rooms private or shared?
• What high risk services are available in case any issues come up?
• Where do I check in when I go into labor?
• What breastfeeding support is available?
• What prenatal classes are offered?
• What amenities are available?
• Will I get to do skin-to-skin, delayed cord clamping or any other special requests?
• How many support people are allowed in the room?
• Are visitors allowed?

Ultimately, Robyn said, flexibility is key. Even if you have a plan for where you give birth, who’s there and how everything goes, it’s important to keep expectations realistic.

“You have to be a little flexible, because if you come in with really rigid expectations and something doesn’t go the way you want it to, you’re likely to be disappointed.”