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Choosing a Caregiver
Why is choosing a caregiver one of the most important maternity decisions I will make?
How will my choice of caregiver influence where I can give birth?
What are important considerations when choosing a maternity caregiver?
What are some insufficient reasons for choosing a caregiver?
How do types of caregivers differ from one another?
What if I change my mind and want to switch to another caregiver?
Early
in your pregnancy, it is important to make thoughtful decisions about
who will be your caregiver and where you plan to give birth. These
major decisions can influence:
- the care that you receive and the effects of that care
- the quality of your relationship with your main and other caregivers
- the amount of information you receive
- the choices and options you will have, particularly during your labor and birth
- the degree to which you are involved with decisions about your care.
If
you are a well and healthy childbearing woman (as are most pregnant
women in the U.S.), you can choose a midwife or a doctor as your
maternity caregiver. Options: Caregiver
will help you learn about the midwifery model of care and the medical
model of care, as well as different kinds of midwives and doctors who
provide maternity care. This and other pages in this section can help
you find the right caregiver for you.
It may take some time
and energy to find the right caregiver and birth setting. These
important decisions are well worth the effort.
How will my choice of caregiver influence where I can give birth?
Caregivers and birth settings usually go hand in
hand. As you explore your different options, you will want to decide on
a caregiver who practices in a birth setting that will meet your needs.
For example, if you decide that you would like to work with a
physician, you will probably be limited to giving birth at a hospital.
If you choose to work with a midwife, you may have more options since
midwives practice in hospitals, birth centers, and homes. Moreover,
there may be important differences among hospitals and among birth
centers. When choosing a caregiver, it is also important to think about
choosing a birth setting that is right for you.
The following are signs of an excellent choice of maternity caregiver:
- caregiver's practices are consistent with the best available research about safe and effective care
- caregiver's practices work with the physiology of pregnancy and
birth — your body is finely tuned to do this work; some actions support
this work, while others interfere with it
- the two of you are able to develop a strong relationship with good communication and mutual trust and respect
- the caregiver's personal style is compatible with your needs, preferences, and values.
It is not wise to select a caregiver solely because:
- that person practices near your home or workplace — convenience is
nice, but you may need to travel further to find the right person
- you know someone who worked with that person — even if recommended
by a friend or relative, you will want to be sure that a maternity
caregiver's style will meet your needs and values and reflects the best
available research
- that person is a woman, or a man — if you have a preference for
caregiver gender, you will want to be sure that that person's maternity
philosophy and style of practice match well with your needs and values
and with the best available research
- that person has been your provider for well-woman or primary care —
you will want to learn about that person's maternity philosophy and
style of practice before making your decision.
In making your decision, keep in mind that caregivers vary in important ways:
- philosophy of birth and model of care
- style of practice — this includes the amount of time spent with
you, interest in sharing information and involving you in
decision-making, and preferences for use of interventions
- birth settings — most
caregivers work at one or two sites, and few offer the full range of
hospital, out-of-hospital birth center, and home birth.
- whether specific types of caregivers are available in your area
- whether your insurance will cover their services.
As
time goes on, you will learn more about your needs and about the
caregiver and birth setting that you have chosen. If you have concerns
and have not been able to resolve them through open and respectful
communication, you may begin to wonder if you have made the right
choice(s). Do not hesitate to explore other options. Even if it is late
in your pregnancy, you can switch if:
- you have enough time to explore options and find a situation that you believe will work better for you
- the new caregiver or setting has no policies that prevent you from making this change at that time in your pregnancy
- your insurance will cover the new arrangements, or you are willing and able to pay out of pocket.
You may have to change your caregiver and/or birth setting to get what you want.
Most recent page update: 2/21/2006
© 2010 Childbirth Connection. All rights reserved.
Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.
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News and Features
"2020 Vision" and "Blueprint for Action" Reports Available
Leaders from across the U.S. health care system have prepared several reports for improving the maternity care system.
Learn about Transforming Maternity Care project 
Read the "2020 Vision"
Read the "Blueprint for Action"
Read the Consumer Workgroup report
Help implement Blueprint recommendations
Rising Maternal Mortality
Analysis of maternal mortality data for the state of California, with 14% of the nation's births, strongly suggests that maternal mortality is increasing in tandem with rising rates of cesarean section and obesity.
Read article about maternal mortality in California
Read companion Q&A
Maternity Care Fact Sheet Available
A new fact sheet (12/09) summarizes U.S. maternity care trends and figures from the latest federal reports. The fact sheet updates background information in the 2008 Milbank Report on Evidence-Based Maternity Care.
Get the fact sheet
Read Evidence-Based Maternity Care
US Cochrane Center (USCC)/Consumers United for Evidence-based Healthcare (CUE)
Visit the USCC/CUE website for the latest pregnancy and childbirth systematic reviews.
Maternity Care, a Major Segment of Health Industry, Must Be Overhauled for Health Care Reform to Succeed
As competing interests work out the particulars of health care reform, Childbirth Connection reminds the nation that rapid gains in the quality, cost, and value of maternity care are achievable.
Read the press release (PDF)
National Policy Symposium Honors Childbirth Connection's 90th Anniversary
Nearly 250 leaders deliberated about Transforming Maternity Care in Washington DC in April 2009.
Learn about symposium, next steps 
See 90 years of milestones for women and families (PDF)
Seton Family of Hospitals Receives First Maternity Quality Matters Award
Childbirth Connection presented its inaugural Maternity Quality Matters Award to an organization that is achieving significant gains for women and newborns.
Learn more about award winner
Maternity Care Priorities in Health Care Reform
Childbirth Connection has issued a statement about health care reform priorities for a high quality, high value maternity care system.
Read the statement (PDF)
Evidence-Based Maternity Care Report Released
A major new report takes stock of the U.S. maternity care system and finds great opportunities for improvement. Childbirth Connection collaborated with the Reforming States Group and the Milbank Memorial Fund to develop the report.
Learn more, get the report
Read companion USA Today article
Read the USA Today article
Read the Consumer Reports story
Take the Consumer Reports quiz
Read Our Bodies Our Blog entry
Help Transform Maternity Care! Please join our efforts to make quality maternity care a top national priority. Your support will help make the transformation possible. View 2009 Supporter Roster
New Mothers Speak Out National Report ReleasedThe latest report in Childbirth Connection's Listening to Mothers series is now available. Get an eye-opening look at the reality of life as a mother of young children in the United States, based on national surveys conducted by Harris Interactive. Learn more, get the report Read the Wall Street Journal story and listen to the podcast Download Quick Facts (PDF)
"I had a very easy pregnancy, labor & delivery. All were normal. I really enjoyed being pregnant and I love being a mother, but it is very hard and stressful."
-Listening to Mothers® survey participant
Every woman has the right to decide collaboratively with caregivers when she and her baby will leave the birth site for home, based on their condition and circumstances.
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