Advice for Women About Choosing a Maternity Caregiver and Place of Birth

Choosing a maternity caregiver and place of birth are two of the most important decisions of pregnancy. These decisions go hand in hand, as a limited number of providers practice in any given place of birth. Depending on your choices, you can receive very different care because practice styles and policies differ widely across birth settings and caregivers. These different styles and policies can have a large impact, for better or for worse, on your and your baby's health.

Your main decisions about place of birth are: hospital, out-of-hospital birth center or home and, if you choose hospital, which one? If you are a typical healthy pregnant woman, you may receive especially appropriate maternity care by planning a birth center birth or a home birth. In U.S. hospitals, many healthy women routinely receive technology-intensive care that is more suited to women with established health problems (see Related Links, below, for results of the national Listening to Mothers II survey). Needless intervention offers no benefit, yet poses risk of harm. Among hospitals, some are less likely than others to liberally or routinely use labor induction, episiotomy, cesarean section and other interventions that are best reserved for situations of genuine need.

Your main decisions about maternity caregiver are: obstetrician, family physician or midwife and, after this choice, which individual or group of providers? If you are a typical healthy pregnant woman, you may receive especially appropriate maternity care from a midwife. Many physicians also give priority to women's informed choice and try to use interventions that pose risk only when clearly justified. Within each type of provider, some are less likely than others to use practices that are best reserved for women with established problems.

As early as possible in pregnancy:
  • learn about the pros and cons of different options for place of birth and maternity caregiver
  • learn what is available in your community and what your insurance covers
  • get input from doulas, childbirth educators and others in your community who can help you make a good match for your needs and values
  • make careful, informed choices that are right for you
  • change your plans if you come to have doubts about your choices and have better options.

For help with these steps, see in-depth resources on this website:

Choose wisely! Your nearest hospital, your gynecologist or the person who attended the birth of a friend or your own previous birth may not be the best choices for you.

Know your rights! The Rights of Childbearing Women is Childbirth Connection's adaptation of established human rights to pregnancy and childbirth.

© 2016 Childbirth Connection. All rights reserved.

Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.
Most recent page update: 6/2/2008