Written by: Holly Figueroa

When you find out that you’re pregnant, one of the biggest and most important decisions you’ll be faced with is which healthcare provider to see throughout your pregnancy.  There are several different types of providers that you can choose from depending on the type of care you’re looking for.  For some a traditional obstetrician (OB) is the right fit, others seek the more natural approach taken by midwives.  

The first step is to evaluate whether you are considered a “high-risk” pregnancy or not.  If so, you’ll probably see a perinatologist, a doctor specializing in high-risk pregnancies, such as having a medical condition such as diabetes, high blood pressure or genetic disorder, or who have had complications during previous pregnancies.

For women who are having a low-risk, or routine pregnancy, most consider either an obstetrician (OB) or a midwife.  According to the American Board of Obstetrics and Gynecology an OB is a specially trained medical doctor who specializes in the care and surgery of women, specifically related to pregnancy.  Obstetricians follow a more medical course of action throughout the pregnancy and always deliver in a hospital setting.  

Advantages to using an OB:

  • Trained to handle medical complications that may arise during pregnancy such as preeclampsia, placenta previa and preterm labor
  • Have undergone specialized surgical training and therefore have the ability to perform a cesarean section of necessary

Disadvantages to using an OB:

  • Increased risk of medical interventions such as an episiotomy, induction, epidural and cesarean birth
  • Must give birth in a hospital rather than a birth center or at home

According to Midwives Alliance of North America, a midwife is a “trained professional with expertise and skills in supporting women to maintain healthy pregnancies and have optimal births and recoveries during the postpartum period. Midwives provide women with individualized care uniquely suited to their physical, mental, emotional, spiritual and cultural needs. Midwifery is a woman-centered empowering model of maternity care.”

Advantages to using a midwife:

  • Decreased risk of medical interventions such as an episiotomy, induction, epidural and cesarean birth
  • Decreased risk of preterm birth, infant mortality and perineal tearing
  • Increased satisfaction with quality of care

Disadvantages to using a midwife:

  • Some midwives aren’t permitted to deliver in a hospital setting (but some are!)
  • Unable to treat some complications so a transfer to an OB may be necessary
This graphic was included in the 1st and 2nd editions of the Iowa Birth Resource booklets.

This graphic was included in the 1st and 2nd editions of the Iowa Birth Resource booklets.

Things to consider when making your decision:

  • The type of birth you desire: natural or medical interventions
  • Where you wish to deliver: home, birth center or hospital
  • Whether or not you have a preexisting medical condition that may cause complications during pregnancy
  • The provider’s philosophies in regards to pregnancy, labor and delivery and whether they fit with your own beliefs
  • Training/certifications the provider has
  • The provider’s induction and cesarean section rate
  • If the provider is in a group practice, will you have a chance to see all of the providers prior to delivery
  • Do you plan on writing a birth plan?  If so, will the provider respect and follow your wishes
  • Does the provider have professional or patient references
  • Protocol that will be followed should you go past your due date and does that plan align with your wishes

One of the most important decisions that you will make during your pregnancy is the person whom you choose to care for you and your unborn baby.  To find someone who respects your wishes, aligns their practice with your pregnancy beliefs, empowers you as a woman and mother and supports you choices in terms of your pregnancy, labor and birth experience is invaluable.

IBO Care Provider


American Pregnancy Association

Midwives Alliance of North America

American Board of Obstetrics and Gynecology

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