Your pregnancy involves many people in addition to you and your baby. Your family, of course, is affected. You may have a childbirth educator and an exercise instructor. And you will certainly have a doctor or a midwife to care for you during your pregnancy and at the birth of your baby. This caregiver is a partner in your pregnancy. (As used here, the term caregiver refers to a person-doctor or midwife-who cares for a woman during pregnancy and labor.) He or she will have the responsibility for your health and your baby's health, so you want to be sure the individual is qualified and competent. And because your caregiver will intimately participate in a very special event in your life, you want someone with whom you can feel comfortable.
Choosing a caregiver is not always as easy as it sounds. Caregivers may differ vastly in their philosophies about pregnancy and birth and in their level of skill. Finding the right caregiver may take some work. In this section, we'll help you find the right doctor.
Physicians -- those with a Doctor of Medicine (M.D.) degree or a Doctor of Osteopathy (D.O.) degree -- provide most of the maternity care in North America. All physicians have completed college and medical school; most have further residency training. Those who care for pregnant women generally specialize in obstetrics and gynecology, perinatology, or family medicine.
You can get recommendations for doctors from many different sources. Friends and relatives may suggest their doctors. Another doctor, such as your family practitioner, internist, or pediatrician, may provide a name. (In some cases, your family practitioner may provide your obstetric care.) Maternity nurses or obstetric residents (doctors in training) at your local hospital may also help you locate a doctor.
You can ask the Department of Obstetrics and Gynecology at the nearest university hospital for the names of graduates or faculty members who practice in your area. If these avenues fail, try contacting a childbirth education group, such as the International Childbirth Education Association, a local childbirth educator, or your La Leche League chapter.
When you have the name of a doctor who sounds promising, your next step is to find out more detailed information about him or her. One way to evaluate a doctor's competence is to find out about his or her training.
A board-certified obstetrician has completed an obstetrics residency and passed a board-certification examination administered in the United States by the American Board of Obstetrics and Gynecology and in Canada by the Royal College of Physicians and Surgeons.
The most highly specialized obstetrician is the perinatologist. Beyond medical school and obstetrics residency, the perinatologist takes further training in the care of women with high-risk pregnancies: those who have underlying illnesses, such as diabetes, heart disease, and high blood pressure, and those who have complications during their pregnancies or who experienced complications with previous pregnancies. Perinatologists tend to practice in large cities. Most of their patients are referred to them with complications requiring not only their special expertise but also the facilities of a large hospital equipped with the latest technology.
Family physicians care for women at all stages of life, including during pregnancy, as well as other family members from infancy through old age. They tend to refer difficult maternity cases to obstetricians or perinatologists. The family physician provides most of the maternity care in Canada and much of the care in rural settings in the United States. Women who choose family physicians for their maternity care appreciate the fact that the physician can take care of them throughout pregnancy and birth and then continue to care for the baby and family members.
Osteopathic physicians also provide maternity and family care. Osteopaths differ little from medical doctors in training and practice and have about the same legal scope of practice.
Certainly, board certification is one way to judge a physician's qualifications, but training and experience are also important. Hospitals monitor a doctor's performance. The doctor you select to deliver your baby should be a member in good standing of the medical staff of a reputable hospital.
Some women choose a midwife instead of a doctor. Go to the next age to learn more about midwives and how to choose one that's right for you.