What types of care providers provide maternity care?
Several types of midwives and physicians provide prenatal care, attend births and care for women after birth in the United States.
Most childbearing women in the United States are healthy and can choose from the full range of maternity care providers. If you have a serious medical condition or are at high risk for developing such a condition, you will probably want to be in the care of a doctor who has completed a residency and is board-certified in obstetrics and you will probably want to give birth in a hospital. Your maternity care provider can give you more information on situations that require specialized care.
How do care providers differ?
Different kinds of care providers have different beliefs and views about childbearing. Two contrasting perspectives are often called the “Midwifery Model of Care” and the “Medical Model of Care.” While the midwifery model usually describes how midwives practice and the medical model usually describes how doctors practice, many providers combine elements of both models.
Here are some contrasts between the two models:
Midwifery Model of Care
- Focus on health, wellness and prevention.
- View labor/birth as normal physiological processes.
- Use interventions at lower rates, when needed.
- Emphasize that “mother gives birth.”
- Provide individualized care.
Medical Model of Care
- Focus on managing problems and complications.
- View labor/birth as dependent on technology.
- Use interventions at higher rates, including routinely.
- Emphasize that “doctor delivers baby.”
- Provide similar care for everyone.
It’s important for you to think about your own values and ideas about pregnancy and birth so you can choose a care provider who shares your values and will meet your needs.
What should I think about when choosing my maternity care provider?
The following are signs of an excellent choice of maternity care provider:
- His/her practices are consistent with the best available research about safe and effective care.
- His/her practices work with the physiology of pregnancy and birth. After all, your body is finely tuned to do this work and you want a care provider who will take actions that support this work, not interfere with it.
- The two of you are able to develop a strong relationship with good communication and mutual trust and respect.
- His/her personal style is compatible with your needs, preferences and values.
Try to avoid choosing a care provider solely based on location, a friend’s recommendation, the care provider’s gender, your previous experience with that person for well-woman check-ups, or because your health insurance covers that person. While these things may factor into your final decision, you will want to learn about that person’s maternity philosophy and style of practice before making your final decision.
Equally important in the choice of care provider is finding out where that person attends births. The specific policies and practices of your birth setting can have a big impact on your care, experiences and outcomes, so choosing a place of birth is also a major pregnancy decision. This website also covers choosing where to give birth in depth.
Is my choice of maternity care provider related to the birth setting I choose?
Yes. Where you give birth and who provides your maternity care are closely connected. You will want to choose a birth setting that has care providers who will meet your needs in pregnancy, during labor and birth, and after birth.
For example, if you decide to give birth in a hospital, your care provider will be a physician or, if available, a midwife who practices there. Midwives usually provide care in out-of-hospital birth centers or home births, while physicians occasionally attend births in these settings. Read the Choosing a Place of Birth section for more details about what the best available research says about different types of birth settings.
What will my insurance cover?
It’s important to understand your options early on. To avoid extra bills, most women will want to choose a maternity care provider who is covered by their health insurance. Health plan provider directories often lack information that pregnant women need to identify possible maternity care providers. Commonly, directories list OB-GYNs and family doctors without clarifying whether they currently provide maternity care. Midwives may not be included in a provider directory at all (for example, if they are employed in a physician practice). And the directory list of participating providers may be out of date.