Read the options below. Discuss them with your health insurance carrier. Do this before you get pregnant. Who you choose will partly depend on:
* Your health insurance coverage.
* You may need to choose from a certain list. Find out who is on it. Ask if there is a waiting period for maternity coverage.
* The health care providers in your area
Your personal wishes are important, too. For example, do you prefer a female or a male provider? Do you want a provider who works alone? Or do you want one in a group practice?
Where You Can Give Birth
Where do you want to have your baby? These are places to think about:
* Hospitals. There may also be choices within hospitals. These could be:
– Regular delivery room. Your family may be able to be with you here.
– Birthing center or birthing room. Your family can be with you here.
– Special high-risk pregnancy section. Sometimes mothers and newborns need high-risk care. Some hospitals offer high-risk care. Find out what services local hospitals can offer.
* Birthing centers not inside hospitals. These are sometimes called alternative birthing centers. They are for low-risk pregnancies. Find out what hospital is used when special needs arise.
{Note: Your special needs during pregnancy may determine where you can have your baby. Do not plan a home birth. It is not safe for you and your baby.}
Types of Providers
* OB/GYN (obstetrician/gynecologist). This doctor gives prenatal and delivery care. That care ends 6 weeks after delivery. The OB/GYN treats women when they’re not pregnant, too. You may already have an OB/GYN. If you do, you could choose this provider for your pregnancy. Most women choose an OB/GYN. If you belong to an HMO, you may need a referral for an OB/GYN. A referral is when your primary care provider says you need a special doctor. You don’t need a referral if the OB/GYN is your primary care provider. You also don’t need a referral if your HMO lets you pick an OB/GYN plus a primary care provider.
* Family practice doctor. A family practice doctor can act as an OB/GYN, an internist, and a pediatrician. That means the provider can give you prenatal care and deliver your baby. You and your child can both go on seeing this same provider afterward. But if you need a cesarean section (c-section), you will need an OB/GYN.
* Maternal and fetal medicine specialist. This provider may be needed to help with high-risk pregnancies. Your primary care doctor or your OB/GYN would give you a referral if he or she can’t provide the care needed for your high-risk problems.
* Infertility specialist. This provider helps persons who want to get pregnant, but haven’t been able to after trying for a year. You may want to see this doctor if your regular OB/GYN cannot help you with your needs.
* Certified nurse-midwife. This provider cares for women with low-risk pregnancies. The nurse-midwife is trained to handle low-risk births. Be sure he or she works with a medical doctor. A lay midwife cannot provide total care. Find out if your insurance will pay for a nurse-midwife. Be sure the midwife is certified. Call the American Midwifery Certification Board (AMCB) at 866.366.9632 or go to its Web site:www.amcbmidwife.org.
How to Find a Provider
There are a lot of ways to find providers who might suit you:
* Look in the directory of providers from your health insurance carrier.
* Ask your regular doctor or specialist.
* Do you have any friends who had a baby recently? Are their ideas about having babies like yours? Ask them.
* Call information at the hospital you want. Ask for the name and phone number of the nurse in charge of the maternity section. Ask for the name and phone number of a resident in obstetrics who works at that hospital. A resident is a doctor who is in training. Ask for the “Physician Referral Service.” Call any or all of them and ask what doctor(s) they recommend.
* Call the medical school closest to you. Ask which obstetricians it recommends.
* Ask your county medical society.
* Look in the Directory of the American Medical Association. Ask for this at your doctor’s office or library.
* Look in the Directory of Medical Specialties for OB/GYNs. Your doctor’s office or library should have this, too.
* Look for a doctor who can take care of special needs you may have.
* Do you want a doctor with a high interest in prepared childbirth? Prepared childbirth is a special approach. The pregnant mother goes to classes. Her partner or other childbirth “coach” goes with her. They both learn ways of helping the birth happen, like special breathing. The doctor works with the mother in this approach to childbirth.
How to Follow Up with a Provider
Have you found some likely prospects? Now you can:
* Call the American Board of Medical Specialties at 866.275.2267 or go to its Web site:www.abms.org. Find out if the provider is properly trained and licensed.
* Ask yourself some questions.
– Do you think you could work well with the provider?
– Does the provider’s office seem to be managed well?
* Ask the provider some questions. You may be able to do this on the phone. (You may be charged an office visit for the phone call.) Or you may need to make a date to meet in person. Here are some questions to ask. You will think of others.
– Does the provider accept your health insurance? What do services cost? How must payment be made? How much do you have to pay?
– What hospital(s) does the provider use?
– Is the hospital accredited? The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) does this.
– Does the hospital have a birthing center or birthing room?
– Does it have a Level III neonatal intensive care unit (NICU)?
– Can fathers and other persons be with you in the delivery room? In the operating room?
– Will the provider be the one who delivers your baby?
– Does the provider have partners who share the practice? If so, what would their roles be?
– Would a resident deliver your baby? A resident is a doctor in training.
– How would you reach your OB/GYN or health care provider? Would this differ at certain times of day or night? For emergencies?
– Who would take care of you when your health care provider is away?
– What is the provider’s Cesarean section (C-section) rate? If the rate is more than 35%, ask why.
– For what reasons does the provider do a C-section?
– Does the provider prefer a certain form of pain relief? If so, what and why?
– At the place you will deliver, can you get anesthetics for an epidural any time of the day or night? An epidural is an anesthesia that can block most of the pain during labor and delivery.
– What else can be given for pain?
You can talk to two or more providers. Compare the answers you get. Then you can decide who will give you care and deliver your baby.
