Finding the right care provider for you isn't a choice that should be made lightly. The attitude your care provider brings to your birth will greatly affect your experience.
- Where will YOU feel most comfortable to have your baby (at home, in a birth center, or in a hospital).
- Would you prefer a midwife or an OB for your maternity care and follow-up appointments after birth.
Before you pick your care provider, think about what you would like for your birth: how do you want to labour, which positions would you like to try, how do you want the baby to be handled after they are born. Think about all these questions and write down what you would like. Write down where you are flexible and where you aren't.
Bring this list to the meet and greet appointment with your care provider and ask them about their views. You will quickly grasp their openness to your ideas. If they aren't open for a dialogue, it is best find someone else.
Shopping around for a care provider is a healthy part of your birth story and choice. You CAN change care providers at any time during your pregnancy. You don't have to feel guilty about it- it's your body, your pregnancy and your birth! No matter what, it will be a life altering experience for you and your baby. Prepare for it and surround yourself with the best support system possible. You don't want to find yourself untrusting in the midst of labor.
Feeling confident and having an open and trusting relationship with your midwife or OB is infinitely most important!
More about HOME BIRTH:
Midwifery in the United States
*Fact Sheet Courtesy Midwife Alliance of North America
Crises of maternity care spending and poor maternal-infant health outcomes in the U.S.
- The United States spends more than any other nation on health care, using almost half of all of the worldʼs health care dollars
- $98 billion of health care spending in the U.S. goes towards the provision of maternity care
- Despite large spending, the U.S. currently ranks 50th in the world for maternal mortality and 46th for infant mortality occurring during the first year of life
Midwifery care leads to improved health outcomes and cost-savings
- Studies consistently demonstrate reduced maternal morbidity, equivalent perinatal mortality, decreased technological intervention at birth, enormous cost savings, and high client satisfaction rates associated with midwifery care
Improving maternal-child health outcomes: a comparison
- Current U.S. cesarean rate is 32.8%
- Midwifery cesarean rates range on average from 2.3% – 6.4%
- Current. U.S. prematurity rate is 11.99%
- Midwifery prematurity rates range on average from 1.4% to 1.7%
- Current. U.S. low birth weight (<2500 grams) rate is 8.5%
- Midwifery low birth weight rates range on average from 0.8% to 1.1%
- Low birth weight and prematurity are the two leading factors in infant mortality
- Significant health disparities exist in the U.S. among racial/ethnic minorities, low socioeconomic families, and other marginalized populations
- Midwifery care can has demonstrated potential in improving health outcomes for vulnerable and disenfranchised populations.
Public health organizations recognize and support
midwifery care for low-risk women, including:
- American Public Health Association
- World Health Organization
- American College of Nurse Midwives
- National Perinatal Association
The Midwives Model of Care™
- The Midwives Model of Care is based on the fact that pregnancy and birth are normal life processes.
The Midwives Model of Care includes:
- Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle
- Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
- Minimizing technological interventions
- Identifying and referring women who require obstetrical attention
The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section.
Copyright (c) 1996-2008, Midwifery Task Force, Inc., All Rights Reserved.
- Number of homebirths in the United States: 29,650 (0.72% of all births in the U.S.)
- Homebirth trends: 29% increase in homebirths from 2004 – 2009
- Highest Rates of Homebirth by State: Montana (2.55%); Oregon (1.96%); Vermont (1.91%)
- Homebirths by Attendant Type: Direct-entry Midwives (42.9%); Certified Nurse Midwives (19.5%); Physicians (4.9%); Other Attendant (32.9%)
- Low Risk Profile for Homebirths: Preterm delivery (5.8%); Low Birth Weight (4.2%); Multiple deliveries (0.9%)
- Central Intelligence Agency, 2011. CIA world factook. Central Intelligence Agency, Washington, D.C.
- de Jonge, A., van der Goes, B., Ravelli, A., Amelink-Verburg, M., Mol, B., Nijhuis, J., Bennebroek Gravenhorst, J., Buitendijk, S., 2009. Perinatal mortality and morbidity in a nationwide cohort of 529,688 low-risk planned home and hospital births. International Journal of Obstetrics and Gynecology 116(9), 1177-1184.
- Fullerton, J., Navarro, A., Young, S., 2007. Outcomes of planned home births: An integrative review. Journal of Midwifery and Womenʼs Health 52(4), 323-333.
- Hamilton, B., Martin, J., Ventura, S., 2012. Births: Preliminary Data for 2010. National Vital Statistics Reports 60(2):1-25.
- Health Management Systems, 2007. Midwifery licensure and discipline program in Washington State: economic costs and benefits. Health Management Associates, Washington D.C.
- Janssen, P., Lee, S., Ryan, E., Etches, D., Farquharson, D., Peacock, D., Klein, M., 2002. Outcomes of planned home births versus planned hospital births after regulation of midwifery in British Columbia. Canadian Medical Association Journal 166(3), 315-323.
- Johnson, K.C., Daviss, B.A., 2005. Outcomes of planned home births with Certified Professional Midwives: large prospective study in North America. British Medical Journal 330(7505), 1416-1422.
- MacDorman, M.F., Matthews, T.J., Declercq, E., 2011. Homebirths in the United States: 1990 – 2009. NCHS Data Brief, 84, 1-9.
- Murphy, P., Fullerton, J., 1998. Outcomes of intended home births in Nurse-Midwifery practice: A prospective descriptive study. Obstetrics and Gynecology 92(3), 461-470.
- Schroeder, E., Petrou, S., Patel, N., Hollowell, J., Puddicombe, D., Redshaw, M., Brocklehurst, P., 2012. Cost effectiveness of alternative planned places of birth in woman at low risk of complications: evidence from the Birthplace in England national prospective cohort study. British Medical Journal 344(e2292), 1-13.
- World Health Organization, 2010. Trends in maternal mortality: 1990 to 2008. World Health Organization, Geneva.
More about BIRTH CENTER BIRTH:
More about HOSPITAL BIRTH:
More about having a DOULA:
Ten Reasons to Hire a Birth Doula
- Birth Doulas Enhance the Birth Experience:
You may forget what it felt like to take your first “legal” drink, but you’ll never forget the birth of your children. The birth doula’s role in labor and delivery is to anticipate your needs and help carry out your wishes. The birth doula is there to provide continual physical and emotional support.
- Assistance with Creating and Maintaining a “Birth Plan”:
A birth plan is a document that spells out in writing your wishes for your labor and delivery. If you’re planning a hospital birth, the birth plan would be shown to your doctor, hopefully before you would go into labor. Most doctors and hospitals adhere to expectant mother’s birth plans, as long as it does not compromise the mother's or expectant child’s health. A birth doula can help an expectant mother create her birth plan. Once the woman is in labor, the birth doula would be there to support and encourage the woman, according to her wishes. The birth doula, however, is not in the position to make demands on your behalf. The birth doula also can not force you to adhere to your birth plan or withhold pain medication. The birth doula’s role is to encourage you the best they can, to follow your wishes.
- Enhance the Birth Experience for Expectant Partners:
A birth doula is not there to take the place of the partner. With the doula’s experience, they are better able to assist the partner and guide them on ways to better assist the laboring mother. The doula and the partner’s roles compliment each other.
- Full One on One Care/Support:
Many people believe they will receive all the care and attention they will need from their doctors and nurses. If you’re planning a hospital birth, chances are, you will not be the only patient. Doctors and nurses are there to monitor your health and labor progress along with every other laboring mom. The birth doula is there solely for you. They do not work with other moms while you’re in labor. Doulas also do not work in shifts. You will have the same doula at your side for the entire birth experience.
- Decrease in Incidence of Use of Pain Medication:
Many expectant moms choose to forego the use of pain medication during childbirth. The doula’s role is to assist and encourage the birthing mother the best they can to adhere to those wishes. The continual physical and emotional support offered helps laboring moms cope with the pain and discomfort, making labor pain management much more likely without the use of drugs.
- Assists with Breast Feeding:
For those who choose to breast feed, research has indicated that women who choose birth doulas have a better success rate with breast feeding then those who do not. The doula is there to offer guidance and support with breast feeding per their training and education.
- Increases Better Bonding:
Part of a certified birth doula’s training places emphasis on maternal/paternal/infant bonding. The birth doula recognizes the importance of those first few minutes/hours after birth with bonding. Research indicates families who have used birth doulas have a higher recorded incidence of maternal/paternal bonding then those who have not. This does not mean that you have to use a birth doula in order to bond with your baby; it just shows that the birth doula’s presence is a factor in bonding success for all parties.
- Decreased Incidence of Post Partum Depression:
Women who use birth doulas appear to have more confidence and feel empowered by their birth experience. A common complaint from women who have/had suffered from post partum depression is unsatisfactory or complicated births. We already know that birth doulas can play a role in overall childbirth satisfaction.
- Birth Doulas Assist with Communication:
While birth doula can not give medical advice, perform diagnostic tests or diagnose problems, they can, however, promote positive communication between you, your partner and the hospital staff. Many women feel overwhelmed or helpless during labor. The birth doula’s role is to help be your advocate.
- Birth Doulas are Relatively Low Cost and Recommended:
Clinical researches as well as major health organizations such as The WHO recommend continual labor support. Birth doulas are shown to reduce labor times and improve the overall satisfaction of the birth experience. Many insurance plans also cover birth doula services.
Doulas are certified by Doulas of North America. To find a doula near you and assistance with choosing a doula, visit www.DONA.org
More about GIVING BIRTH:
find/create registry lists
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- Bottle Stories
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- Bathing Baby
- How to Swaddle
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- Greening Your Pregnancy
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