Choices for Pregnancy and Birth

There are lots of choices to make when preparing for a birth. Many expectant parents focus on things like what to name the baby, and what color to paint the nursery, but may not know just how important their choices for maternity care are in determining whether they have a safe birth which leaves them feeling respected and supported. Read about:

And why those choices matter.

Why does it matter??

The first priority is safety. If you are having a high risk pregnancy, or expect to have complications in your labor or expect your baby to have health challenges, then you are best served by an obstetrician and a high tech hospital. However, if you’re expecting a low risk pregnancy, labor and birth, then you have many options available to you, including OB’s, family practice docs, midwives, hospitals, birth centers, and home birth.

For the majority of families, birth is a positive experience overall. (Average satisfaction rating on a scale of 1 – 10 is 8.2). When asked to reflect on it later, most will have stories of challenging times or awkward moments, but feel that the result (the baby) was worth it. However, there’s a difference between families saying a birth was fine, and families saying it was FABULOUS. And the majority of the people who say it was fabulous will attribute that to the choices they made about caregiver, birthplace, preparation, and support.

On average, in general:

  • parents who chose childbirth classes felt more prepared than those who did not
  • parents who used a midwife were more satisfied than those who used an OB
  • parents who had planned and had an out-of-hospital birth were more satisfied than those who had a hospital birth (although those who planned an out-of-hospital birth and needed to transfer for medical reasons were the least satisfied)
  • parents who used a doula were more satisfied than those who did not
  • low risk parents who planned and had an out-of-hospital birth with midwives experienced fewer routine interventions (such as IV, electronic monitoring, induction and augmentation) than those who had a hospital birth with a physician supervising their care, but had similar outcomes safety-wise
  • parents who participated in postpartum support groups or parenting classes expressed more confidence in their parenting skills

If we look only at parents who had a fabulous birth (i.e. those who rated their overall satisfaction with their birth as a 10 out of 10) – Source info

  • Of those who used a licensed midwife, 47% rated their birth 10 out of 10 vs. 39% of family practice clients and 33% of both nurse-midwifery clients and OB clients
  • Of those giving birth in an out of hospital birth center, 79% rated their birth as 10 out of 10 vs. 74% of home birthers and 28% of hospital birthers
  • Of those using a birth doula, 38% rated their birth a 10 out of 10 vs. 32% of those who had considered using a doula but chose not to

Those are, of course, average experiences. Every situation is unique, with individual providers and individual birthplaces that are a perfect match or not a perfect match for any individual family. Each expectant family can:

  • first evaluate their own goals and values – what do you want your birth to be like
  • then research their options
  • then meet with possible caregivers or tour possible birthplaces to really get the “vibe” of the place

Any caregiver or birthplace that helps you to feel respected, empowered, safe, and nurtured can lead to a satisfying birth experience.

For lots more information on this topic, including a quiz to help you decide what’s right for you, and testimonials from parents about their experience with various options, check out the Great Starts Guide.


If you’re planning ahead for after the birth, check out my post on Choosing Childcare.


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