Choosing your obstetrical care provider carefully

Pregnancy is a wonderful journey and it lasts nine months, so you want to choose your traveling companions carefully. Select your obstetrical care provider before you become pregnant, if possible.

Many women schedule a pre-pregnancy appointment to detect problems and receive instruction on how to achieve optimal health. This is also a good time to consider a midwife.

Find out more, read: Choosing a midwife: Some things to consider.

One way to be certain that a provider of maternity care has professional qualifications is to call the county medical society in your area. Certification means that the provider is board-certified and is a member of the specialty group for which he or she has been examined. You may ask your provider if he or she is board-certified or if he or she is a member of any women's health organizations.

Medical practices vary widely

You may feel comfortable seeking out a small medical practice with a solo practitioner or one or two partners. Today, many doctors, either obstetricians or family physicians, work in what is called a collaborative practice. This means that when you go for your prenatal visits you may be seen by different healthcare professionals, such as:

A certified nurse midwife (CNM) provides care for women during pregnancy and childbirth. Nurse midwives have had an extra 12 to 18 months of education and training after graduating from an accredited nursing program. After passing board-certification examinations, CNMs can receive admission privileges at a hospital in conjunction with an ob/gyn physician.
A nurse (RN or LPN)
A nurse practitioner (a nurse who has received advanced education)
A childbirth educator
A social worker
A physician assistant (a health care provider who has completed a two-year program after college)

How to choose

A good place to start is with the recommendations of friends. Most women who have had babies have opinions about their care, and many are willing to share their experiences. You can also call the American College of Obstetricians and Gynecologists in Washington, D.C., at (202) 638-5577, or the American Academy of Family Physicians at (800) 274-2237 to get names of board-certified doctors in your area.

It's also a good idea to choose a hospital in advance and tour it. Not all doctors have privileges at all hospitals. It can be disappointing to choose the doctor and then find out midway through your pregnancy that you can't be admitted to the hospital of your choice because the doctor doesn't practice there.

Questions to ask doctors

You might interview several doctors before making your decision. Here are some things to find out during your visit:

What are the doctor's policies about labor and birth? For example, if you want to have an epidural and/or pain medication, you'll want to have a doctor who encourages you to choose the best method of pain relief available based on your choice. You'll also want to find out when the doctor is willing to order an epidural. If you choose not to have medication, is the doctor supportive?
Find out how to get in touch with your doctor during an emergency. Who provides coverage when your doctor is away? What happens if you have an after-hours emergency? How quickly can you count on talking with the doctor?
If you have a chronic medical condition such as diabetes or high blood pressure, how experienced is the doctor with pregnancy under those conditions?
Does your doctor have privileges at the hospital where you want to give birth?
Check your insurance plan. Is the doctor covered by your insurance?

Finally, trust yourself. A doctor may have the highest recommendations from friends and may be very well qualified. But if you don't feel really comfortable, pursue another choice. Having a baby is an intensely personal experience, and you want to make a choice that feels right.

Date last reviewed: October 2002.

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