Choosing A Care Provider

Choosing the right care provider for your birth can often be a daunting and somewhat confusing process, especially if it’s your first pregnancy or birth.

“What is their role?”, “How do/can they help?”, “How are they different?”, “What about emergencies?”, “How much do they cost?”, “Who can I trust more?”, “Who will give me the birth I’m hoping for?”

There are so many questions you may have when choosing a care provider (midwife, GP or gynea) so let’s explore each one:

1. The Midwife

Choosing a midwife for your birth is the perfect option when considering the following:

• You have a low risk pregnancy.
• You want a vaginal or natural birth.
• You want an unmedicated birth (no epidural/opiates).
• You want minimal risky interventions.
• You want a body led birth.
• You want an active labour/birth.
• You want a doula.
• You want a less “clinical” and more “comfortable” experience.
• You’re considering lower costs.
• You want someone to walk a personal road with you to assist you prenatally and postnatally as well.
• You want someone with a specialised and extraordinary amount of experience with normal vaginal births.
• You want a home birth.
• You’re birthing at a private home birth centre.

Midwives generally have the highest amount of experience with natural/vaginal births. They do not diagnose patients and do not conduct specialised procedures such as ultrasound scans, surgeries, etc. They often work alongside a gynaecologist as a back up option for any emergencies that may arise.

2. The GP (Obstetric)

A GP (general practitioner) is a general doctor, rarely a specialist… The same doctor you visit if you’re ill? That’s the one. Some of them specialise slightly further into the obstetric field with extra training and some are currently specialising into the gynea/obstetric medical field.
Things to consider about a GP:

• They support low risk births and only a few “high risk” births, depending on the individual case.
• They conduct mostly vaginal births with a back up Gynea as a lot of them are not yet trained or qualified in major surgery.
• They are more medically specialised than a midwife and can diagnose cases and prescribe stronger drugs that carry higher risk.
• Some may/may not conduct ultrasound scans.
• Fewer GP’s work alongside doulas (due to preference and clinical facility policies).
• They conduct births in a more clinical environment.
• Can conduct more interventions than midwives due to their specialisation.
• May/may not allow more active labours/births (depending on preferences, facilities, policies and procedures).
• They can be slightly more expensive than a midwife but not quite as pricey as a specialist/ gynaecologist.
• They may assist less prenatally and less postnatally (normally only for a 6 week check-up or emergencies).
• May have less experience than a midwife with conducting births (in general) as their field often extends beyond just childbirth.
• Very rarely conduct home births, if at all.
• Very rarely conduct births at private home birthing centres, if at all.

3. The Obstetric Gynecologist

An obstetric gynaecologist is a specialised medical doctor, trained in major surgery and high risk emergencies. Their skills are specialised in the area of female reproduction, including labour and childbirth (obstetrics).
When considering a gyneacologist, keep the following in mind:

• They are specialists for high risk and emergency cases and this may be your only care provider option of you have a high risk pregnancy.
• They are predominantly surgeons and may conduct more cesareans than vaginal births due to their specialisation and field of expertise.
• They are specialised in more high risk procedures and interventions than midwives and GPs.
• They can conduct ultrasounds.
• Not all gyneacologists work alongside doulas (due to preferences, facilities, policies and procedures).
• Conduct births in highly clinical environments (due to emergencies and surgery).
• Can conduct more interventions (especially high risk interventions) due their specialisation.
• May/may not allow active labours/births (depending on preferences, facilities, policies and procedures).
• Because they are a specialist, they can cost a lot more than a midwife and/or GP.
• They may assist less prenatally and less postnatally than a midwife (normally only for a 6 week check-up or emergencies).
• May have less experience than a midwife with conducting births in general (especially vaginal/natural births) due to their specialisation and their field of expertise often extending beyond just childbirth.
• Very rarely conduct home births, if at all.
• Very rarely conduct births at private home birthing centres, if at all.

It is important to understand what type of pregnancy you have (high/low risk) and what type of journey and birth you desire to help yourself make an informed decision on which care provider best suits your situation, needs, budget and preferences.

What about Doulas?

Doulas are not medically trained and do not conduct any form of medical duties like a midwife, GP or gynea. But, unlike medical care providers, a doula’s support is more ‘personal’ (focusing also on emotional, mental, intimate, and sometimes even spiritual support).

Doulas are support members who may be further trained in additional natural/holistic therapies that offer alternative options from standard allopathic healthcare for relief and comfort (such as hypnobirthing, rebozo technique, acupressure, meditation, yoga, aromatherapy, herbalism, reiki, massage, etc.)

They basically support and “coach” a woman through labouring comfortably, effectively and safely while assisting the birth partner by encouraging their participation and relieving them of mundane duties (cleaning, music, environment, fetching food/drink, running a bath, etc.), and providing information. Doulas may also care for and facilitate young siblings attending the birth.
As a whole, a doula guides and facilitates the birth process and birth environment to assist the couple in having a calm, relaxed and empowered birth experience with minimal stress, distraction and discomfort.
Doulas work alongside a woman’s care provider as part of the birth team unit but works exclusively for the birthing mother according to her needs, preferences and expectations.

Doulas generally have personal experience in childbirth (vaginal or cesarean) and are further trained into the knowledge of the physiological aspects of pregnancy, labour, birth, and postpartum.
Some doulas may be further trained in bereavement and trauma situations to emotionally support and facilitate a mother and/or couple through high risk births, emergencies or even painful/traumatic birth outcomes.

Doulas cost a lot less than care providers and often walk a more personal/intimate road with a mother/couple prenatally (regardless of her risk factor), during labour and birth (regardless of the type of birth), and postnatally.

Read here for more information on doulas.

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