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Choosing a Prenatal Health Care Provider

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By now you may have thought a lot about finding a health care provider for your pregnancy and the birth of your child. Perhaps you've already made an appointment or seen someone. Whatever the case, you want to be in good hands. This is the person with whom, for the next several months, you will be making some of the most important decisions of your (and your baby's) life. How do you go about finding someone you trust and feel comfortable with?

First, think about the type of delivery you'd like to have. Do you want to give birth at home or in a hospital? Do you want your provider to speed your labor with drugs or let it progress naturally? Do you want pain relief available to you? The answers to these questions can help you determine which of the three types of prenatal provider you'd like to work with: a physician (also called a medical doctor, or M.D.), a nurse practitioner (N.P.), or a certified nurse midwife (C.N.M.).


Medical doctors are the most popular choice in the United States. Nine out of 10 women choose an M.D.— either an obstetrician or a family physician — for prenatal care and delivery. Obstetricians have at least four years of specialized training after medical school, and they deal only with gynecology (women's health) and obstetrics (pregnancy and childbirth). Obstetricians are trained to handle any emergency that might arise during labor, including the need for a cesarean section. Family physicians have at least three years of special training after medical school, but they treat the entire family for all medical needs, including pregnancy and birth. Most M.D.s deliver babies in hospitals.

For more information on obstetricians, you can go to the American College of Obstetricians and Gynecologists Web site, To find out more about family physicians, visit the site for the American Academy of Family Physicians at

Certified Nurse-Midwives

About 7 percent of women in the United States use certified nurse-midwives (C.N.M.s), who are specially trained in women's health, prenatal care, and birth. C.N.M.s are nurses with either a master's or doctoral degree. A C.N.M. not only provides prenatal care but also delivers the baby. Why would you choose a C.N.M. over an M.D.? Mostly because of the difference in birthing philosophies. C.N.M.s generally believe that because pregnancy and birth are normal events in a woman's life, pregnant and laboring women don't need many, if any, medical interventions. C.N.M.s do not use drugs to induce labor, do not generally feel that intravenous fluids are necessary during labor, encourage women to use any position they want for labor and birth, and support the participation of family members in the birth. If complications arise, they refer their patient to a physician (all C.N.M.s have referral arrangements with M.D.s). C.N.M.s work in hospitals and in birthing centers, and some assist with home births. For more information, visit the American College of Nurse-Midwives Web site at

Nurse Practitioners

Nurse practitioners (N.P.s) are specially trained in women's health and usually have a master's or doctoral degree. They are licensed to provide prenatal care and well-woman care, but they do not deliver babies. N.P.s usually work in clinics with an M.D. or a C.N.M., one of whom would attend the birth. You can learn more about N.P.s on the American Association of Nurse Practitioners Web site,



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