Women's Healthcare Topics

Choosing a Healthcare Provider for Pregnancy

Reviewed by James Brann, M.D.

Obstetrician-Gynecologist (OB/GYN)

A majority of expectant women choose an obstetrician-gynecologist (OB/GYN) for their prenatal care and delivery. An OB/GYN is a physician who specializes in obstetrics, reproductive medicine, and women's health issues. He or she undergoes a four-year residency in obstetrics and gynecology after completing a general medicine program (which is typically four years of medical school).

As a result of their extensive training, OB/GYNs are specialists that can manage both low-risk and high-risk pregnancies.


It is highly advisable that you go see an OB/GYN for your pregnancy care if:

    Learn about the different healthcare providers that can deliver your baby.
  • You have a pre-existing condition, such as a STD, diabetes, high blood pressure, and etc.

  • You are over 35 years of age.)

  • You are carrying twins or multiple babies.

  • You have a history of pregnancy problems.


An OB/GYN can handle all stages of your pregnancy, from preconception family planning to postpartum recovery. These doctors often work in group practices with nurses and other medical professionals; however, some OB/GYNs work in a private practice setting.

OB/GYNs typically deliver in a hospital setting with the latest medical technology. These doctors can perform elective and emergency cesarean sections, episiotomies, and other medical and operative interventions that may become necessary.

Over 80 percent of American women choose to see an obstetrician-gynecologist for their pregnancy and childbirth care. Between 8 to 9 percent choose midwives, and 6 to 7 percent choose family physicians.

Keep in mind that your obstetrician-gynecologist may not be available when you deliver your baby. In fact, a growing number of OB/GYNs only offer prenatal care and they do not deliver babies. Your baby may be delivered by a laborist – a board certified OB/GYN whose job is simply to deliver babies at the hospital.

Laborists, also called OB hospitalists, are responsible for inpatient hospital care of pregnant women. They are immediately available throughout the day and night, so they can monitor the progression of your labor, react to complications that can occur, and provide a safe delivery.

An advantage of having a laborist at the hospital where you are delivering is that you will not have to wait for your doctor to get to the hospital. You always have a skilled obstetrician to monitor your care. Although this doctor may be a stranger to you, you can rest assured that he or she is very knowledgably about the birthing process.

If you are concerned about a stranger delivering your baby, talk to your OB/GYN about his policy on delivering.

Perinatologist

If you're experiencing a high-risk pregnancy, your healthcare provider may refer you to a specialized OB/GYN called a perinatologist. This type of OB/GYN is sometimes referred to as a maternal-fetal medicine specialist.

A perinatologist is a physician who has extensive medical training in taking care of high-risk pregnancies. After graduating from medical school (or another general medicine program), this doctor undergoes a four-year obstetrics and gynecology residency, then another two or three years in a maternal-fetal medicine fellowship.

Perinatologists often serve as consultants for regular OB/GYNs rather than as primary obstetric care providers. In addition, they work with family physicians and certified nurse-midwives to handle pregnancy complications. In some cases, you may be referred to a perinatologist and see them regularly for the rest of your prenatal care, labor, and delivery.

These doctors are only available in a large hospital setting, such as a university hospital that is set up to take care of very ill babies. Because perinatologists are so specialized, they need access to the latest medical technology to treat any pregnancy complication that arises.

You may be referred to a perinatologist if:

  • You are under age 18 or over 35. Maternal age can sometimes play a role in causing a high-risk pregnancy.


  • You have pre-existing medical conditions, such as a sexually transmitted disease, diabetes, hypertension, immune system deficiency disease, and genetic disorders. These can complicate your pregnancy.


  • Your unborn baby has already been diagnosed with a serious medical condition, such as spina bifida.

Depending on your situation, you may see both a perinatologist and your regular obstetrician during your pregnancy. In some cases, you may see the perinatologist exclusively. If this is the case, he or she will also deliver your baby. However, if you have continued to see your regular OB/GYN, the perinatologist most likely will not be present at your baby's birth, but he or she may consult with a neonatologist (a doctor who specializes in taking care of high risk babies) before delivery to make sure that everything is in place for your baby's care.

Family Practitioner (FP)

Instead of switching to an OB/GYN, you may want to receive your pregnancy care from your existing family practitioner (FP). A FP is a medical doctor who specializes in taking care of the entire family through every stage of life, including pregnancy and birth. Your FP can even take care of your baby after delivery.

Keep in mind that you should only use a family physician if you are experiencing a low-risk pregnancy. All FPs are trained to provide normal prenatal care, but they will refer you to an OB/GYN if you start to experience pregnancy complications.

If you choose your family doctor for your pregnancy care, this doctor will also deliver your baby. However, most FPs perform only minor surgical procedures. Only a small number of family doctors perform c-sections.

A family practitioner may work alone, or in a larger group practice with nurses and other doctors. Many FPs have a close relationship with their patients because they are involved in all aspects of their care, and they may have treated them for a number of years.

Many expectant women who have a good relationship with their FP and have no high-risk issues often trust their pregnancy, labor and delivery to this doctor.

A family physician always delivers in a hospital setting.

Not all family physicians practice obstetrics. You will have to ask your individual FP for their policy.

Certified Nurse-Midwife (CNM)

For pregnant women who want a more "natural" approach to childbirth, they may choose to see a certified nurse-midwife (CNM) rather than a physician. A CNM is a registered nurse who undergoes specialized training in midwifery. CNMs are required to pass a national exam, so they can be certified by the American College of Nurse-Midwives. They are licensed in the state that they practice.

Unlike most obstetricians and family practitioners, certified nurse-midwives have very close relationships with their patients. They often provide gentler, more attentive care than most physicians.

CNMs provide care for pregnant women from their first prenatal visit through labor and delivery, and after the birth of their baby. CNMs work with obstetricians, who serve as their back up if complications arise during pregnancy, labor, or delivery.

You can only choose a certified nurse-midwife if you are healthy and have a low-risk pregnancy.

Some CNMs may be licensed to use medical interventions during labor and delivery, including electronic fetal monitoring, labor-inducing drugs, epidurals, pain medication, and episiotomies. However, a certified nurse-midwife can only use these techniques under a medical doctor's supervision. CNMs do not perform cesarean sections.

Certified nurse-midwives deliver in birth centers and/or in a hospital setting.

It is not recommended that you use a lay midwife for labor and delivery. Lay midwives do not hold nursing degrees, and most are not associated with a doctor. They do not provide care in a hospital setting. If unexpected complications occur, this can leave you and your baby in a dangerous situation.

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