When it comes to pregnancy and childbirth, families have more options than ever. Whether you are considering a traditional hospital birth or are interested in a home birth, doing your research can help you choose a provider who best fits the needs of you and your baby.
But understanding your options can sometimes feel overwhelming. What is the difference between an OB/GYN and a midwife? What role does a doula play? And what other specialists might be helpful along the way? Knowing who does what, and the type of care and support each provider offers, can help you build a birth team that fits your pregnancy, preferences and plans.
Obstetricians and Gynecologists (OB-GYN)
An OB-GYN offers a range of services throughout pregnancy, from routine prenatal visits and monitoring fetal development to providing guidance on nutrition and lifestyle and managing high-risk pregnancies. These physicians work out of a clinic or hospital setting and also assist with labor and delivery, perform cesarean sections if needed and offer postpartum care.
“When it comes to pregnancy, it is a personal decision, and you want the right fit,” said Dr. TreChelle Carson, an OB-GYN with Mary Washington Healthcare in Stafford. “You want someone who you feel comfortable talking to and asking the embarrassing questions, the hard questions.”
Some points to consider when choosing an OB-GYN may be what the doctor’s stance is on anesthesia, as well as what interventions are available should complications arise.
“You also want to think about whether you want an OB-GYN that is a part of a practice, or if seeing a sole doctor the whole time is important to you,” Carson said. “Pregnancies vary and you want to know how you’ll be specifically monitored. We are happy to provide you with the accommodations you desire, as long as those accommodations are available.”
Midwives: CNM and CPM
In addition to OB-GYNS, expectant mothers can opt to utilize the services of a midwife. In Virginia, two common types of midwives are certified nurse midwives (CNMs) and certified professional midwives (CPMs), according to Madison Orme, director of operations at Tree of Life Midwifery and Birth Center in Fredericksburg.
“Both certifications prepare a midwife to provide care to a woman or birthing person during the childbearing year,” Orme said. “This can include preconception counseling, prenatal care, labor and delivery and postpartum care for the mother and for the baby for the first six weeks. CNMs also have prescriptive authority, while CPMs are still working to get legislation passed allowing them to support their clients’ prescriptive needs.”
During the postpartum period, the midwives at Tree of Life Midwifery and Birth Center monitor a mother’s recovery, look for signs of emotional distress, provide breastfeeding support and check that her newborn is gaining an appropriate amount of weight. Developing a relationship with your midwife is a vital part of the process.
“There’s nothing like sitting down together and chatting about how everything works,” said Rebecka Ockay, a CPM with Open Arms Midwifery & Massage in Fredericksburg. “I love talking about God’s design of the body and how a couple can personalize their experience of birth, with the wisdom and support of their midwife. No one should have to try to figure out the myriad intricacies of this journey all on their own. Midwives love to help navigate that.”
Ockay suggests keeping communication open and expressing any specific desires and birth plans with your midwife, including whether you wish to have a home birth.
“It’s very personal to have a home birth, so the couple and midwife need to be a great match,” said Ockay. “Each practitioner is unique, whether a home birth midwife, hospital midwife, or obstetrician. Learning about your provider’s birth philosophy can impact your journey in a big way.”
Doulas
A doula, meanwhile, can provide additional support throughout your pregnancy. A doula is a trained professional who offers emotional and physical support and education before, during and after childbirth, but does not provide medical care.
“The largest part of my support as a birth doula is physical, emotional, mental and spiritual hands-on support throughout childbirth from early labor until the first few hours postpartum,” said Ariel Groft, a certified DONA birth doula, childbirth educator and lactation counselor with Rooted In Love (RIL) Doula Services Inc. in Stafford. “In my postpartum visits, I support my mamas by talking through the birth stories, assisting with resource referrals for maternal and infant care needs such as pelvic floor or tongue ties as well as by providing hands-on care for mom and her family.”
Other Specialists to Consider
Other specialists women may want to add to their care team include chiropractors, who can help alleviate pain in the back, hips or pelvis as pregnancy progresses, and pelvic floor specialists, who can assess and treat pelvic floor muscle dysfunction. Prenatal massage therapists and nutritionists can also be helpful resources during pregnancy and postpartum.
For higher-risk pregnancies, you may also be referred to a perinatologist, also known as a maternal-fetal medicine (MFM) specialist. These specialists are ob/gyns who are specifically trained to handle high-risk pregnancies.
No matter what type of provider you choose, thoroughly researching and vetting your options is an important first step.
“Don’t rely on Google or TikTok,” Carson said. “Make sure you get confirmation so you aren’t relying on false information. Talk to others about their birth plans.”
Ockay couldn’t agree more.
“Educate yourself. Do a deep dive into your options. Even with all the articles, videos, social media posts and books that modern parents have access to, there is still a massive lack of knowledge about women’s health, fertility health, options for care providers and birth locations, and breastfeeding,” she said.
Ultimately, regardless of which type of provider a family chooses, safety and health of both mother and baby remains the priority.
“Whether it is a doctor or a midwife, every provider just wants to keep the mother and the baby safe,” Carson said. “That is the ultimate goal.”
