Choosing a Caregiver
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Certified Nurse-Midwife (CNM)
Registered nurses with an additional 1 to 2 years of clinical training in childbirth, CNMs are one of the faster-growing components of the healthcare system. They specialize in the prenatal care and deliveries of low-risk patients. They're trained to view pregnancy as a natural, healthy process. They tend to act as partners with the patient, taking emotional concerns and lifestyle issues into great account. The average midwife tends to provide greater one-on-one care and moral support during labor than the average doctor.
If you're a high-risk pregnancy, however, your medical needs will be beyond the scope of most certified nurse-midwives. And though CNMs practicing in hospitals have physicians in easy reach should something go wrong during delivery, those who practice at some birthing centers or at home do not have the necessary backup immediately at hand.
Family Practitioner (FP) or General Practitioner (GP)
If you see a generalist for your routine care, you may want to continue using that primary caregiver during pregnancy. Almost all are qualified for the job, since it's their role to oversee your general health and to refer you to specialists on as-needed basis. Both FPs and GPs are trained on obstetrics and gynecology.
Some primary-care physicians automatically refer their pregnant patient to an ob-gyn because they lack the higher insurance coverage required of that branch of medicine. Or, if your pregnancy deviates in any way from the norm, your doctor may feel that an ob-gyn is better positioned to handle your case.
Obstetrician - Gynecologist (ob-gyn)
They deliver the majority of American babies. Most women already have a gynecologist and choose to stick with that person during the momentous months ahead. If he or she doesn't handle obstetric cases, ask your gynecologist for an OB referral. Better yet, ask friends who have recently had babies. Consider the size of the practice. In a one-doc office, you can build a good rapport but may have long waits for exams. Some MDs in larger practices rotate checkups, giving you little continuity, while others stick to a specific patient load. Some obs work with nurse-practitioners and certified nurse-midwives, who may handle the routine screening.
Definitely select an ob-gyn if your pregnancy is high-risk or you're over age 35, in case unexpected medical emergencies arise.
Choosing a Caregiver