The first step to prepare for a natural birth is to select the best OBGYN or midwife to support you in the journey. This goes hand-in-hand with finding the best maternity hospital or birth center. Remember, this is your birth, and you’re in the driver’s seat. It’s in your best interest to surround yourself with a birth team that is supportive of your plans for a natural birth.
Estimated reading time: 11 minutes
Table of contents
- What Makes the Best OBGYN or Midwife?
- STEP #1: Choose the Type of Caregiver You Want to Assist Your Birth
- Step #2: Choose Where You Want to Give Birth
- Step #3: Select Your Specific Doctor or Midwife
What Makes the Best OBGYN or Midwife?
The best OBGYN isn’t a title to be won by one specific doctor. The answer is as individual as you are. What you’re looking for is the best OBGYN or midwife for you. You need to trust the caregiver that you invite to your birth. You want to be sure that you share the same birth philosophies. His or her attitudes about birth will, inevitably, affect your labor experience.
If you choose a doctor or midwife who is known to push labor inductions, epidurals, and c-sections, your chance of having a natural birth has just plummeted. On the other hand, if you choose a caregiver that encourages non-pharmacologic pain management and believes that birth is safe and normal, your chances for a natural birth are much higher.
So before you pick up the phone and schedule your first prenatal appointment, there’s an order I want you to follow to help you find the best caregiver:
- Choose the TYPE of caregiver you want to assist your birth
- Choose WHERE you want to give birth
- Select your SPECIFIC doctor or midwife
STEP #1: Choose the Type of Caregiver You Want to Assist Your Birth
Doctor or midwife?
Your options for labor support are either a doctor or a midwife. Let’s discuss the most common types of doctors and midwives you can choose from.
Family Practice Doctors (FPs): FPs specialize in the care of the entire family. Some choose to provide maternity care as well, in which case they tend to focus on healthy, low-risk pregnancies. Some of them can perform a cesarean birth, but (for better or for worse) they don’t have as much experience doing them as other types of doctors.
Obstetrician, or OB/GYN: Most women in the US will give birth with an OBGYN, which stands for obstetrician/gynecologist. They spend 4 years after medical school studying pregnancy and childbirth. They can treat both low and high-risk moms and can perform a cesarean section if need be.
Certified Nurse Midwife (CNM): CNMs are registered nurses who have earned a master’s degree specializing in pregnancy and birth. They focus on healthy, low-risk pregnancies and consult with doctors as needed. They do not perform cesarean births but can do many other procedures.
In this guide, I’ve only touched on the most common doctors and midwives in a hospital birth. But there are other types of caregivers, including:
- Perinatologist (specialist for high-risk pregnancies)
- Lay Midwife
- Certified Midwife
Are you interested in learning more about the best OBGYN or midwife options for a home birth or birth center? Or want to take a deeper dive into the difference between physicians and midwives?
Is a doctor or midwife better for natural birth?
Throughout the world, midwives are the primary source of prenatal care. In the United States, obstetricians are the norm.
Less medical interventions with a midwife
Studies of women who gave birth in a hospital under the care of licensed midwives were less likely to experience episiotomies and assisted deliveries, and were less likely to use pain medication in labor. They were also more likely to have a spontaneous vaginal birth — one that starts on its own without a labor induction.
Midwives are not as accessible as an OBGYN
Yet, not every woman is a good candidate for a midwife. Women who are pregnant with twins or triplets, who have medical complications, or whose babies have medical complications may be safer with an OBGYN who specializes in high-risk care. Additionally, midwives are much less common than OBGYNs. You may not have one within a reasonable distance from your home, or one that is in-network with your insurance.
Midwives #1 for natural birth, but don’t rule out an OBGYN
Statistically, a midwife is your best choice if you want to have a natural birth. But if a midwife is not an option for you, don’t feel like it’s a lost cause! In my 7 births, I’ve used both doctors and midwives. You can have a great natural birth with an OBGYN or a midwife, or a highly-medicalized birth with an OBGYN or a midwife. It really depends on the individual doctor or midwife that you choose. We’ll discuss this later on.
Step #2: Choose Where You Want to Give Birth
Now that you know what TYPE of caregiver you want to invite to your birth, you next need to narrow down WHERE you want to give birth.
Birth in a maternity hospital is most common
In the United States, over 98% of women give birth in a maternity hospital. Less than .1% of women give birth at home. And less than .4% give birth in a birth center. Since the vast majority of women are giving birth in a maternity hospital, that’s where we’re going to focus our time in this guide. But home birth and birth centers are also great options for natural birth. Compare all of your options!
Natural birth in a maternity hospital
Hospital caregiver options:
Family Practice Doctor, OBGYN, Perinatologist, Certified Nurse Midwife (CNM)
Main pros of hospital birth:
- Work with moms with both low and high-risk pregnancies
- All forms of pain relief are available
- Medical technology and Neonatal Intensive Care Units (NICU) are available
- Covered by insurance
- Available in most communities
Main cons of hospital birth:
- High-tech environment puts you at greater risk of receiving unwanted medical interventions
- Choices such as movement and eating are more limited
- Cesarean rates are growing for healthy, low-risk moms
- Less continuity of care — doctors and nursing staff rotate shifts
Your choice of maternity hospital will influence your birth
An unfortunate truth is that cesarean rates vary widely from hospital to hospital. This suggests that giving birth at a particular hospital may put you at greater risk for a cesarean birth. This is true even if you’re having a healthy, low-risk pregnancy.
Research the standard of care
Hospital policies in regard to labor, known as the “standard of care,” also vary widely from hospital to hospital. While most require an IV hep-lock at admission, some do not. One maternity hospital may require continuous fetal monitoring while the norm at another is intermittent fetal monitoring. Some hospitals allow water birth, while others discourage moms from even entering the tub.
Because all hospital labor & delivery units function differently, it’s important to ask questions about the standard of care at the hospitals you’re considering.
How to research maternity hospitals near me
Now it’s time for you to do some research into your local options. Your goal is to find a hospital that has a good reputation for supporting natural birth and has a lower-than-average cesarean rate. Here are some suggestions to find a hospital that’s friendly to natural birth:
- Contact your state’s department of health to view data about the cesarean section birth rates at each of your local hospitals.
- Call the hospital you’re interested in and see if they can supply you with any additional information about cesarean rates.
- Reach out to local natural childbirth educators and doulas. Ask for their recommendations about hospitals that are supportive of natural birth. Believe me…they know. And if you ask, most will be happy to tell you.
- Talk to your friends who have had natural births about their experiences with different maternity hospitals.
- Search online to read hospital reviews from people who have given birth there.
Questions to ask on a maternity hospital tour
All hospitals offer tours of their facilities. A tour of a Labor & Delivery unit is often guided by one of the nurses that works on the L&D unit. This is a great opportunity to ask questions about the hospital and its policies. Here is a list of possible questions you could ask on your maternity hospital tour:
- How many patients does each nurse typically have at once?
- Do you use intermittent or continuous fetal monitoring? Do you offer telemetry?
- Is an epidural available throughout the day and night if I want one?
- How many people can be in the room as my support team?
- Does each room have a bathtub? How often do women use them?
- Do you welcome doulas?
- Do you encourage birth plans?
- What level NICU do you have?
- Can I expect skin-to-skin contact with my baby directly after birth?
- What are the standard procedures you do to the baby after birth?
- Are there lactation consultants available to help me breastfeed?
As you do your homework, you’re setting yourself up for the best chance for a successful natural birth.
Please remember that giving birth in a hospital doesn’t mean that medical interventions will be forced on you. I’ve personally had 6 awesome natural births in hospitals. However, it does require you to be a bit more prepared for labor than the average Jane.
Read more: Learn all you need to prepare for a natural hospital birth in the KOPA® PREPARED Online Childbirth Class
Step #3: Select Your Specific Doctor or Midwife
Once you know where you want to give birth, or have it narrowed down to a few locations, it’s time to identify and select the best OBGYN or midwife near you.
Privileges & practices
There are 2 key pieces of information that you need to help you make your decision:
- Doctors and midwives only have privileges, or the ability to practice medicine, at specific hospitals. If you have a particular maternity hospital in mind, make sure to find a caregiver that has privileges at that hospital.
- Doctors and midwives don’t typically work solo. Most work alongside other caregivers in a group known as a practice. You aren’t just hiring the one best OBGYN or midwife they have working there — you’re hiring the entire practice.
How OBGYN & midwife practices work
Some practices are composed entirely of OBGYNs. Some are all midwives. And others offer a combination of both OBGYNs and midwives. You may find that you have one doctor or midwife that you prefer in a practice, and decide that he or she is the one you want at your birth. However, it doesn’t usually work that way.
Most practices rotate the on-call caregiver at the hospital for deliveries, so you’ll likely get whoever is on call when you go into labor. For that reason, it’s important to rotate your prenatal visits with each provider in the practice and build rapport with each of them. If the general vibe of the practice doesn’t mesh with your birth philosophy, it’s likely not the best fit for you, even if you really like one of the doctors.
Interview your OBGYN or midwife candidates
In order to make the most informed choice and find the best OBGYN or midwife, it’s a good idea to perform an interview. In the medical world, this is called a consultation. Most doctors and midwives offer brief, free consultations as a way to sample the practice before signing up for prenatal care. Here is a list of questions you might consider asking at the interview or consultation:
- How many births do you attend each month?
- How many of those births are vaginal vs cesarean?
- Are there specific ways you support moms who want a natural birth?
- How many of your clients attempt natural birth (no epidural or pain meds)?
- How do you feel about birth plans?
- Do you recommend taking childbirth classes? Do you have any childbirth classes you recommend?
- How do you feel about doulas? Do you have any that you recommend?
- What is your policy on labor induction? Why are most inductions scheduled in your practice?
This is just a small sample of the types of questions you could ask at a consultation. Read the article below to find a more comprehensive list of questions, and to learn what to do if you want to switch to a new OBGYN or midwife later in pregnancy.
Read more: Interview Questions to Ask OB GYN or Midwife
Now it’s time for you to get to work! First, determine the type of healthcare provider you want to assist at your birth. Next, decide where you want to give birth, whether it be a hospital, birth center, or home. And if possible, narrow down the exact location. Finally, select the specific doctor or midwife, or practice, that you’d like to support your labor and delivery. As you do so, you’re taking an important first step to prepare for a positive, empowering natural birth. Good luck, mama!
Kopa Birth’s online birthing classes allow you to prepare for a natural hospital birth from the comfort of your own home, 24/7. Enroll today in our free online childbirth class and start preparing for your natural birth!