The Confident Pregnancy, Step 2: Choose Your Care Wisely

As I discussed in part one of this series, the early weeks of pregnancy give you plenty of time to read up on what you've gotten yourself into before your first "official" doctor's appointment, around twelve weeks. Which begs the question: Who, exactly, will you be going to?

Although it may sound dramatic, I strongly believe that this is the most important decision you can make during your pregnancy. Having had two children, I have had two very different experiences - one natural birth, and one emergency cesarean. The provider who cares for you and your baby during pregnancy affects much more than who you will be seeing for the next nine months. The provider you choose also determines where you can give birth, as most facilities only allow certain providers to deliver there. Your provider's viewpoints on pregnancy and childbirth also set the tone for your own experience, so you need to make sure that your provider's views closely match your own.

If you already have a provider and you connect with him or her, this may be an easy decision. While you are waiting for that twelve-week appointment, call your provider and find out which facilities they are able to deliver at. Then, call those facilities and schedule a tour of the birth center or maternity ward. Ask questions on the tour about issues that are important to you. For instance, who is allowed to be with you during labor and deliver? What are their policies regarding visitors? Will you be allowed to breastfeed in the event of a cesarean? All of these questions will or could potentially apply to you - and when the time comes, the facility won't care that you didn't know their policies in advance. If you don't like the facility or facilities at which your provider can deliver, ask him or her about alternatives. Can they request permission to deliver at another facility? Are they even willing to? If you have a solid relationship with your provider, you'll want to do everything you can to keep that. In the end, you have to decide which is most important to you - your current provider, or your ability to choose a different facility for your child's birth.

If you don't currently have a provider, or your relationship with your provider isn't that great, then your options are wide open. And what are those options? Generally, a woman will choose either a Certified Nurse-Midwife (CNM) or an Obstetrician/Gynecologist. A Certified Nurse-Midwife is an individual who has undergone in-depth training on prenatal care, birth and the care of newborns, but is not technically a medical doctor. Certified Nurse-Midwives generally take a more natural approach to childbirth. They will usually encourage alternatives to pain medicine in childbirth, and will encourage you to view the entire process as a natural event. Obstetrician/Gynecologists are medical doctors who have undergone years of intensive training. They tend to more readily prescribe interventions such as medication or cesarean sections. Consequently, they are generally more prepared to take action if a complication does arise.

In the end, the right decision is the one that you are comfortable with after looking at all of your options. Births in the United States today range from unattended home births (yes, they do happen) to cesarean sections which are scheduled for convenience. Whatever your choice, a successful birth is one that ends with a healthy baby. Period. Follow your instincts, and you and your baby will be fine.