Before you start picking out names and knitting booties for your growing baby, you’ve got an important job to do: Choose a provider for prenatal care.

“Proper prenatal care sets you up for a good childbirth experience,” says Abby Dennis, MD. Dr. Dennis is an obstetrician based in Baltimore. “That’s why it’s really important to find a provider you can trust who can offer safe, evidence-based care for you and your baby.”

The benefits of prenatal care are many, including:

• Lower risk of pregnancy complications.
• Higher birth weights.
• Lower rates of preterm births.
• Fewer cesarean sections.

And the care you get during your pregnancy can have health benefits for your child for years to come. Children in one study whose mothers had prenatal care had more well-child visits with their doctor. They were also more likely to get all the vaccines they needed. 

You should call to schedule your first doctor’s appointment as soon as you know you’re pregnant. Most first prenatal visits take place about 8 weeks after your last monthly period.

Here are some simple steps to get you started on your path to finding a prenatal care provider.

Step 1: Check with your health insurance company.

Find out which providers and which hospitals are covered by your plan. Your Wellframe digital health management app makes this easy. You can use it to search for an in-network doctor or certified nurse midwife. You can also connect with your care advocate through the app for provider recommendations.

Step 2: Find the right hospital for you.

Be sure that the provider you have chosen can deliver your baby at your preferred hospital. “Picking a hospital is really important,” says Dr. Dennis. First and foremost, you’ll need a location you can easily get to when you’re in labor.

If possible, get a tour of the labor and delivery floor. This will give you an idea of what the rooms look like. It will also help you know where to go once you’re in labor. Ask about any services the hospital offers, too. For example, do they have childbirth classes? Is there breastfeeding help?

Finally, check that the hospital has an advance care nursery or NICU (neonatal intensive care unit) just in case there’s a problem. If the hospital doesn’t have a NICU, ask what happens if your child needs advanced care and how long it takes to get there.

Step 3: Think about your health history.

Depending on your health history, you might need extra care during your pregnancy, Dr. Dennis says. For example, you might need extra care if you:

• Are older than 35.
• Have diabetes.
• Have high blood pressure.
• Had previous pregnancy or delivery complications.

The type of prenatal care provider you choose may also depend on your age and health. The three main types of prenatal care providers are:

Obstetricians (OBs). OBs are medical doctors who specialize in pregnancy and childbirth. OBs handle pregnancies of all types. They are trained to do cesarean deliveries (C-sections) and to handle most high-risk pregnancies. People with the highest-risk pregnancies might be referred to a maternal-fetal medicine specialist. That might be someone carrying multiple babies or who has a history of preterm birth.

Certified nurse-midwives (CNMs). These are advanced-practice nurses. They specialize in routine prenatal care, labor and delivery, and postpartum care. They work with expecting parents who have no serious health problems. Most CNMs practice in hospitals and birth centers. They often work in a practice alongside obstetricians.

If any complications pop up, they’ll refer you to a doctor. You might choose a certified nurse-midwife if you have a low-risk pregnancy. You might also go with a CNM if you want fewer interventions during your pregnancy and delivery. (Examples of interventions include inducing labor, episiotomy, and C-section.)

Family practitioners. These are medical doctors who care for patients of all ages rather than specializing in one area. They may have delivered a lot of babies. But if something out of the ordinary happens, they will likely connect you with an OB. You might choose this route if you have a history with the doctor and plan to keep on seeing them after you give birth.

Step 4: Find the right fit.

Now comes one of the most important parts to finding proper prenatal care: doing your homework to find the best provider fit. You want someone who (within reason) can give you the type of pregnancy and birth experience you want.

Start simple and read the websites of providers you’re considering. Many include answers to often-asked questions. But don’t hesitate to call the office if you have other questions. You can also schedule a consultation with the provider. Ask people you know and trust for recommendations for providers too. “A lot of patients at my practice come to us by word of mouth,” Dr. Dennis says.

Here are some questions to ask to help you find the provider who best fits your needs:

• At which hospitals do they have privileges? Where can you deliver?
• How do they handle pain management during labor? For example, what types of pain medication do they provide?
• What is their rate of delivery by cesarean section? (The World Health Organization considers the ideal rate for the number of cesarean sections to be between 10% and 15% of all births. Keep in mind that doctors who specialize in high-risk pregnancies may naturally have a higher rate of cesarean sections. You may also want to ask how long you will be able to labor before a C-section is ordered.)
• Do they practice solo or as part of a group? And who will deliver your baby if they’re off duty?
• Who can you call if you have questions after hours?

Finding a prenatal care provider who is experienced and makes you feel comfortable can take a little time and effort. But it will pay off by easing some of the stress you might feel and setting you up for a healthy pregnancy and birth.

[Sources:]

[1] Swartz JJ, Hainmueller J, Lawrence D, et al. “Expanding Prenatal Care to Unauthorized Immigrant Women and the Effects on Infant Health.” Obstetrics & Gynecology, vol. 150, no. 5, November 2017, pp: 938-945.

[2] Jansen L, Gibson M, Bowles BC, et al. “First Do No Harm: Interventions During Childbirth.” The Journal of Perinatal Education, vol. 22, no. 2, 2013, pp: 83-92.

[3] “WHO Statement on Caesarean Section Rates.” World Health Organization, 2015, https://apps.who.int/iris/bitstream/handle/10665/161442/WHO_RHR_15.02_eng.pdf?sequence=1. Accessed October 7, 2021.