At Blooma, we are big proponents of surrounding yourself with a supportive care team–and your direct provider is a crucial part of that team. Contrary to popular belief, one does not need to automatically continue on with a provider that you may have been seeing for general OBGYN care previous to pregnancy.
The greater Minneapolis and St. Paul metro is fortunate to have a deep list of care providers across many birth places. Even within one birthplace, such as a hospital, there often are multiple groups practicing and offering care.
Below is an overview of steps to take when choosing a provider and a list of provider types. The first step is knowing your options and giving yourself grace room to make a choice based on your unique needs.
Steps to Choosing the Right Provider for Your Family
1. Call your insurance. This can be a frustrating thing to navigate, but one of the best ways to narrow down your list of what providers to choose from is to call your insurance and ask what birth places they cover. They can help list what provider groups are within each birthplace as well.
2. Visualize your ideal birth environment. Think through what type of birth setting you may be interested in. In the Twin Cities, you have access to care in a hospital, freestanding birth center, or with a homebirth provider.
Ask yourself if you are interested in a Family Medicine doctor, an OBGYN, a Certified Nurse Midwife or a Certified Professional midwife (they all practice differently, in unique settings).
3. Tap your support network. Start asking friends, family, your doula, and/or our team at Blooma about recommendations people have that fit your insurance or chosen birthplace. It can be extremely helpful to hear from others specific providers they have felt were supportive.
4. Meet your potential providers. Call and make an appointment with a provider or ask to have a meet and greet. Yes – we promise it is an option to meet a provider and hear more about their practice. If a practice does not have time for this, that may be something to note.
5. Ask lots of questions. How many people are on their team? How much time do they spend with you at each appointment (there often is a huge difference here across providers – some are 15 minute appointments and others are a full hour which gives much more room to ask questions).
Do they follow their patients (i.e. will they likely be there at your birth) or do they rotate call? What is their approach to waterbirth, laboring without intervention, induction timelines, etc? What is their practice’s transfer or cesarean rate?
6. Trust your gut. Did the provider make you feel heard? Comfortable? Cared for? We birth our little ones best when we feel truly seen and respected.
We promise there are incredible providers out there–if you are not feeling supported, know it is never too late to switch and be with a practice that deeply cares for your wellbeing.
Provider Types
It’s important to understand that in our medical system you often have a choice of what provider you see for your pregnancy, birth, and postpartum (are you noticing a pattern? We simply cannot emphasize this enough!).
Below is a helpful explanation of provider types, their training, and their general approach.
UNDERSTANDING PHYSICIAN CARE PROVIDER OPTIONS
Physicians practice the Medical Model of Care which emphasizes the use of testing, as well as medical and/or surgical interventions to manage pregnancy and birth or to detect any complications before they arise.
Physicians tend to view birth as a medical event and support more medical interventions. Research shows that when used routinely, medical interventions may lead to unintended negative outcomes (e.g. potential harm from high rates of caesarean sections). Of course, when medically indicated, interventions are essential for birthers and babies, especially for pregnancies and births that are considered “high risk.”
Physician-led appointments tend to be 10-20 minutes. Physicians are not typically present for most of labor, but attend the birth.
OBSTETRICS & GYNECOLOGY PHYSICIAN (OB/GYN)
Training: The American Board of Obstetricians and Gynecology was established in the 1930s. OB/GYNs complete a postgraduate medical education program and a medical/surgical residency program in obstetrics and gynecology. OB/GYN Physicians are trained to diagnose and manage complications of pregnancy using the medical and surgical model of care.
Style of Care: Because obstetrics is a surgical specialty, OB/GYN Physician-led care tends to involve a higher rate of medical intervention, episiotomy, instrumental delivery, and need for surgical intervention compared to care led by a family practice physician or a midwife.
Percentage of Births Attended: Because OB/GYN Physicians practice in groups of varying size, they attend between 15-90% of their own clients’ births.
Location of Birth: Hospital and In-Hospital Birth Center
FAMILY PRACTICE PHYSICIAN
Training: Family Practice Physicians complete a postgraduate medical education program and a medical residency program in family medicine. Unlike other physicians who specialize in providing care for one particular organ/disease, family practice physicians are trained to provide basic comprehensive care to the whole person through all stages of life.
Style of Care: Not all family practice physicians attend birth. Family practice physicians that do attend medical births often provide care for the entire family. While family practice physicians practice the model of care, their rate of medical intervention, episiotomy, instrumental delivery, and need for surgical intervention falls between that of an OB/GYN Physician and a midwife.
Percentage of Births Attended: ~90% of their own clients’ births.
Location of Birth: Hospital and In-Hospital Birth Center
UNDERSTANDING MIDWIFERY OPTIONS
Midwives practice the midwifery model of care which emphasizes the physical, psychological, and social wellbeing of birthers. Midwives view birth as a normal physiological life event and avoid any unnecessary medical interventions.
Research shows that midwife-assisted pregnancies and births have outcomes that are as good, and in fact are often better, than those assisted by hospital physicians. Midwives have lower rates of medical intervention, episiotomy, instrumental delivery, and need for surgical intervention compared to care led by a family practice physician or an OB/GYN.
Appointments led by a midwife tend to be 30-40 minutes. Midwives tend to be physically present for the labor experience and actual birth.
Certified Nurse Midwife (CNM)
Training: CNMs are registered nurses who have graduated from a nurse-midwifery education program accredited by the Accreditation Commission for Midwifery Education (ACME) and have passed a national certification examination to receive the professional designation of certified nurse-midwife.
Style of Care: When attending births in the hospital setting, CNMs can order pain medications when requested as well as medications to induce and/or augment labor when medically indicated. When birthing with a CNM in a hospital setting, there is always an OB on staff in the event medically indicated complications arise requiring the skills of an OB.
Percentage of Births Attended: Because CNMs practice in groups of varying size, they attend between 30-90% of their own clients’ births.
Location of Birth: Hospital, In-Hospital Birth Center, Freestanding Birth Center, Home
Certified Professional Midwife (CPM)
Training: CPMs attend a Midwifery Education and Accreditation Council (MEAC) accredited program paired with an apprenticeship or complete an independently guided PEP Process paired with an apprenticeship.
All CPMs, regardless of educational path, are required to meet the rigorous standards set by the North American Registry of Midwives (NARM). The NARM certification process verifies a midwife’s knowledge and clinical skills through written examinations and clinical skills assessments.
Style of Care: CPMs work in conjunction with physicians should complications arise during pregnancy. CPMs will establish a thorough plan with their clients to ensure a seamless transfer to a hospital in the event pain medication is needed or a medical emergency arises.
Percentage of Births Attended: Because CPMs work in partnerships or very small group practices, they attend 95-100% of their own clients’ births.
Location of Birth: Freestanding Birth Center and Home
Traditional Midwife (TM)
Training: Traditional Midwives have been attending births out of hospital since the dawn of time. Their path to education involves independent study paired with an intensive apprenticeship. TMs have the option to become a CPM by completing the PEP Process and passing the NARM exam. TMs also have the option to be licensed by the Board of Medicine within their state.
Style of Care: TMs work in conjunction with physicians should complications arise during pregnancy. TMs will establish a thorough plan with their clients to ensure a seamless transfer to a hospital in the event pain medication is needed or a medical emergency arises.
Percentage of Births Attended: Because TMs work in partnerships or very small group practices, they attend 95-100% of their own clients’ births.
Location: Home
The Bottom Line
Selecting the right birth provider is a pivotal decision in your pregnancy and birth journey – one that can shape your birth experience profoundly. At Blooma, we understand the importance of this choice and encourage you to explore all your options – from OB/GYNs to midwives, from hospitals to home births.
Remember, you have the power to choose a care team that resonates with your values and needs. Whether you’re drawn to the comprehensive, holistic approach of midwifery or the medical model of physicians, know that each step you take is towards ensuring your comfort, safety, and joy during one of life’s most transformative moments.
Trust your instincts, ask questions, and embrace the support around you. Your journey to parenthood is unique, and with the right provider, it can be an empowering experience.
And if you need help, the Blooma birthworkers are here to support you with top-notch doula services, rich and engaging in-person birth classes, and prenatal movement classes to help you be fit and ready for your birth.
-Terra, Director of Doula Services at Blooma
No Comments