Prenatal Care-Pregnancy
Choosing A Care Provider
One of the most popular strategies for choosing a care provider is to ask friends who have had babies in the last couple of years. Another approach is to decide where you want to deliver: a hospital, a free standing birthing center, or at home. Hospitals and birthing centers will usually have a list of care providers that deliver with them. Other options include asking a physician you know for a referral or finding a care provider through professional organizations with internet sites.
In the US, most prenatal care is provided by physicians, midwives deliver about 10 percent of babies. In low risk women, choosing between a physician and a midwife is a personal decision rather than a medical one.
Physician care Physicians may view birth as uncomplicated for most women, but are more likely than midwives to be sensitized to the development of potential medical problems, this focus on the medical aspects of pregnancy has pros and cons for women over the age of 35. If you prefer to be cared for by a physician, you can choose between an obstetrician and a family practitioner who specializes in pregnancy care.
Midwife care Midwives view pregnancy and birth as an uncomplicated fact of everyday life. Usually they only look after low risk patients, but most midwives will not consider you to be high risk just because you are over the age of 35. If you are having more than one baby, have a significant medical problem, or have had a prior cesarean delivery you may not be a good candidate for midwife care. Many midwives work with physician groups. Regardless of where you deliver, it is important that your midwife has easily available physician backup in case you do need it cesarean delivery, especially because cesarean deliveries are more common in women over 35.
Birthing center or home birth
If you are having a normal, healthy pregnancy, the risk to you and your baby of delivering in an alternative setting is low. For women who have strong preferences about the use of oxytocin or continuous fetal monitoring delivery at a birthing center may increase their chances of avoiding these interventions, In addition, because epidural analgesia is not usually available you are likely to receive more intensive labor support for your pain. While some believe that delivering in a frec standing birthing center will reduce your likelihood of a cesarean delivery or episiotomy, your care giver's practice style is probably a more important determinant than where you deliver.
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