Confused About the Different Types of Pregnancy Care? I got you!

Newly pregnant and trying to decide on the best route to go for prenatal care?

Then you’re in the right place!

If you’re reading this from the US, then odds are, you’ve been around friends who have delivered a baby or you’ve watched births on TV. The typical way of doing things here are:

• You’ll schedule an 8 week sonogram to check for a viable pregnancy with an OB

• You schedule monthly appointments with said OB and you’ll see them for short amounts of time over the course of your pregnancy until delivery

But did you know that there are two different models of care?

Obstetric care has been around for a few hundred years but what did women do before that?

Midwifery care! Today I’m going to go over both so you can make an educated choice on how to move forward with your prenatal care and decide what you want out of your birth experience.

Obstetric (OB-GYN)/Medical Model of Care

98% of women see an OB for prenatal and well women care. The medical model was developed primarily for high risk pregnancies. These include women who are of geriatric age (36 years+), moms who are on blood thinners (lovenox), mothers who have had several previous cesareans, mother’s who are diabetic, mother’s who are at risk of preeclampsia, uterine rupture, placenta previa, or placenta abruption (there are more, but these are most common).

Commonalities for the Medical Model of Care:

- Designed for high risk moms

- Deliver babies in hospital

- Have a rotation of OB’s on call

- Pain medications, such as epidural, are available

- At least a 24 hour stay post delivery (but up to 3 days for cesarean deliveries or complications)

- Doctor typically comes into labor room for interventions or to deliver baby

- Most offices are high volume, so you may see your provider for 15-20 minutes max during prenatals

-You won’t see your doctor after delivery until 6 weeks postpartum

-Insurance will typically cover some or most of costs. However, there are usually pop up costs that occur after birth

While majority of pregnant women utilize this option, most don’t fall into the high risk category.

Midwifery Model of Care

More and more moms are choosing to utilize this option. It is completely safe for low risk mothers who have a generally healthy pregnancy. There are two different types of midwives: CNM’s and CPM’s. CNM’s are certified nurse midwives and have typically worked at a hospital and are RN’s. They deliver in hospitals, birth centers and do home births. They have an overseeing physician who usually sees their patients in their third trimester, CNM’s see clients for prenatals and can also provide well women care and provide prescriptions for moms, such as progesterone. CPM’s are certified professional midwives. They have went through 2-3 years of midwifery college and rigorous training. They deliver babies at birth center and home births. Both types of midwives might work in a collective of other midwives or have a solo practice.

Commonalities for Midwifery Model of Care:

- Designed for low risk moms

-Deliver babies in hospitals, birth centers or home births

- Depending on the practice, you might have one midwife who you know will show up to your birth or their will be a rotation if you’re birthing at a birth center or hospital

- Trained in natural child birth. Typically will deliver breech babies, VBAC moms, geriatric age, and more

- If you birth at a birth center, you go home within 4-6 hours

- Midwives provide all postpartum care. Will see you at one day, two days, 1 week, 3 weeks, then 6 weeks (some midwives might have different schedules of seeing moms, but this is pretty typical)

- Midwives can suture if mom tears during delivery

- Laughing gas and/or Nubain can be provided for out of hospital births as pain management

-Insurance does not cover home birth midwives, but will sometimes cover birth centers (out of network) However, midwives cost are significantly lower than what you might pay for interventions done in the hospital.

This is just an abstract view of both models of care. As parents going thorough pregnancy, there may be different factors on why you would choose one location over another, such as having a previous cesarean and you’re worried about an emergency. Emotions play a big factor in deciding the location of where you birth just as much as what you’re wanting out of your birth.

I know this was a lot of information, but the goal is for you to make an educated decision. Remember that intuition is your best friend during pregnancy and birth. If something feels off to you or you no longer feel safe, change directions!

If you have any comments or questions, feel free to write them below!