1.If the fit is not right, make a change

There is plenty of time in pregnancy to find the provider that best fits your pregnancy goals. An expectant mother can often change her provider during her pregnancy. Healthcare providers are consultants; they make recommendations but are not ‘in charge’ of their patients. Patients can choose to ‘fire’ their medical providers and seek care elsewhere. Some providers are great in the office and not so great during delivery. Prenatal care leads to the ultimate experience of childbirth, which is one of extreme vulnerability, and likely exhaustion, for women. During childbirth, you may want to trust that your provider has your best interest at heart and will be faithful to help achieve your desired pregnancy experience. So start getting care early, but if you do not like your provider, find someone else who you like and have confidence in.

2. Where you deliver matters

Not only does your prenatal provider matter, so does the place where you will deliver your baby or babies. Did you know that there are safety rank lists for hospitals that provide maternity care? Some labor locations are safer for mothers and some are safer for newborns; the goal is to find one that is safe for both mothers and newborns. Look for hospitals that have good statistics. Sometimes the safest location may not be the newest, have the biggest maternity rooms, the best decor or wall art or have staff that look most like you. Make safety your priority! Talk to your prenatal provider about where to deliver. If you want to deliver at a specific place, you can sometimes work backward and look for providers that deliver at that location.

3. Ask a labor and delivery nurse for a referral

Want the real inside scoop on Obstetricians, Prenatal Nurse Practitioners or midwives? Ask a labor and delivery nurse. You can visit your preferred hospital or birthing center early—maybe even in the first trimester or before pregnancy–to interview a labor and delivery nurse. Review your birth plan or labor preferences with the nurse and ask who she would recommend for you. Labor and delivery nurses work with many providers. They know who works well under pressure, who is skillful, who does too many cesareans, who is safe, who is reckless. Ask a labor and delivery nurse for her insider opinion.

4. Have a detailed delivery plan

Do you have a very detailed birth plan? If so, you should review it early on with your prenatal care provider. It is helpful for a mother to be flexible when drafting a birth plan. Some initially included items may not be safe or may make your provider uncomfortable. You and your provider should be able to discuss your desires and come to agreements on the most important items in the plan. However, if your provider dismisses your birth plan without trying to find common ground with you, that is a red flag.

If your provider is not aligned with your birth plan, ask if they have a partner they can refer you to or maybe a midwife that you can work with. Many women who have a detailed birth plan may prefer the experience of delivering with a midwife, compared to an Obstetrician. Do not wait until labor to realize that your provider does not support your birth plan.

5. Know your provider options

There are different types of providers for prenatal care: Obstetricians, Family physicians, Nurse Practitioners, and Midwives. Different providers have different styles. Understanding the difference between provider types will help avoid disappointment based on misunderstandings & misconceptions. Physicians often oversee the care provided by Nurse Practitioners and Midwives. Physicians are also more likely, than midwives, to manage labor with medications. If you want minimal labor interventions you may want to get prenatal care from a midwife. On the other hand, complicated pregnancies are best managed by Obstetricians. Doulas can offer a host of support in preparation for delivery, during childbirth and postpartum. A doula may be a nice additional resource to care provided by your main prenatal practitioner.

This article was written by: Kia Lannaman, MD