Choosing a Maternal Healthcare Provider

Choosing who will care for you during pregnancy, birth, and postpartum is one of the most important decisions you'll make. Your provider will answer your questions, help you navigate unexpected situations, and support you through some of the biggest changes in your life.

But not every provider practices the same way. Their training, experience, approach to childbirth, and the settings where they work can all shape the care you receive.

Whether you're hoping for an unmedicated birth, planning a cesarean, or navigating a high-risk pregnancy, understanding your options can help you find a provider whose approach fits your needs and preferences.

Understanding Different Approaches to Care

You may hear providers describe their approach as following the medical model or the midwifery model of care.

The medical model focuses on identifying, preventing, and treating complications through clinical assessment, monitoring, and medications or procedures when appropriate.

The midwifery model views pregnancy and birth as normal physiological processes. It emphasizes individualized care and informed decision-making, and it avoids unnecessary interventions while still recognizing when treatment is needed.

Put simply, the medical model focuses on managing potential risks and complications, while the midwifery model focuses on supporting the body's natural processes and intervening when necessary. These approaches aren't opposites. An obstetrician may strongly support physiological birth and shared decision-making, and a midwife may recommend medical interventions when they're needed. Rather than choosing a provider by title alone, ask how they handle the situations that matter most to you.

Types of Maternity Care Providers

Several kinds of healthcare professionals provide maternity care, each with different training, qualifications, and areas of expertise. Depending on your health, your pregnancy, and where you plan to give birth, you may see one provider or a team.

Beyond choosing the type of provider that's right for you, it's also important to understand who will actually be there when you give birth. Keep in mind that many practices work as a group and rotate who is on call. The person you see at prenatal visits may not be the one who helps deliver your baby. If that matters to you, ask how the practice handles births and whether you can meet the other providers ahead of time.

Obstetrician-Gynecologist (OB-GYN)

An OB-GYN is a physician who specializes in pregnancy, childbirth, and reproductive health. They provide prenatal care, manage pregnancy complications, attend births, and perform cesarean deliveries when needed.

OB-GYNs care for both low-risk and high-risk pregnancies, although patients with particularly complex conditions may also see a maternal-fetal medicine specialist.

OB-GYNs typically practice in hospitals, and their approaches to labor and birth can vary. Some routinely use medical interventions, while others support low-intervention approaches when clinically appropriate.

Maternal-Fetal Medicine Specialist (MFM)

Maternal-fetal medicine specialists, sometimes called perinatologists, are OB-GYNs who have completed additional training in managing complex and high-risk pregnancies.

You may be referred to an MFM specialist if you have an existing medical condition, develop pregnancy complications, are carrying multiples, or your baby has a condition that requires specialized monitoring.

Depending on your circumstances, an MFM specialist may work alongside your regular maternity provider or take a more active role in managing your pregnancy and birth.

Family Medicine Physician

Some family medicine physicians provide maternity care, including prenatal appointments, labor and birth, and postpartum care. Their training and services vary, and not all family physicians attend births.

One benefit of choosing a family physician who provides obstetric care is the possibility of receiving care from the same provider before, during, and after pregnancy. Some also provide ongoing pediatric care for your baby.

Certified Nurse-Midwife (CNM)

Certified nurse-midwives are registered nurses who have completed graduate-level education in midwifery and passed a national certification examination.

CNMs provide prenatal care, attend births, offer postpartum care, and provide reproductive healthcare throughout the lifespan. They commonly practice in hospitals and birth centers, although some also attend home births.

Midwifery care generally emphasizes individualized education, shared decision-making, and supporting the normal processes of pregnancy and birth while recognizing when medical intervention is needed.

CNMs can prescribe medications and provide certain medical treatments. Their scope of practice and collaboration requirements vary by state.

Certified Midwife (CM)

Certified midwives have graduate-level midwifery education and meet the same national certification examination requirements as CNMs, but they enter midwifery through a non-nursing educational pathway.

They provide maternity and reproductive healthcare within the scope permitted by their state. However, CM licensure is available in fewer states than CNM licensure.

Certified Professional Midwife (CPM)

Certified professional midwives are trained specifically in providing maternity care, particularly in community birth settings such as homes and freestanding birth centers.

Their educational pathways may include accredited midwifery programs or supervised clinical training. CPMs must meet national certification requirements, although state licensing and practice regulations vary.

If you're considering an out-of-hospital birth, ask about your midwife's qualifications, experience, emergency training, and arrangements for hospital transfers.

Traditional and Other Direct-Entry Midwives

Traditional and other direct-entry midwives may receive training through apprenticeships, formal education, or a combination of both. Some hold state licenses, while others practice without a state-recognized credential.

Because training, licensing, and legal requirements vary considerably, it's important to understand a prospective midwife's qualifications, clinical experience, emergency preparedness, and the laws governing their practice.

What's the Difference Between a Midwife and a Doula?

Midwives and doulas can both play valuable roles in your maternity care, but their responsibilities are different.

A midwife is a healthcare professional who provides clinical care during pregnancy, childbirth, and postpartum. Depending on their credentials and scope of practice, midwives perform examinations, monitor maternal and fetal health, order tests, prescribe certain medications, and attend births.

A doula provides nonmedical emotional, physical, and informational support. Doulas may help you prepare for childbirth, practice comfort measures, communicate your preferences, and navigate the early postpartum period.

A doula doesn't replace your medical provider, and you don't have to choose between having a midwife or an OB and a doula. Many families include both a medical provider and a doula on their birth team.

Finding Inclusive and Culturally Responsive Care

Everyone deserves maternity care that respects their identity, background, and individual needs. Unfortunately, not everyone receives it. Black, Indigenous, and other families of color; LGBTQ+ parents; people with disabilities; immigrants; and families who speak languages other than English may face discrimination or communication barriers. They may also struggle to have their concerns taken seriously.

Finding a provider who respects your traditions, family structure, and individual needs can make a meaningful difference. You should also feel comfortable discussing past experiences with discrimination and how they may affect your relationship with healthcare. For some families, having a provider who shares their identity can help build that sense of trust and understanding.

But shared identity isn't the only thing that matters. A provider should be willing to listen, recognize their own biases, accommodate your needs, and include you in decisions about your care. Asking questions during prenatal visits can help you decide whether a provider and their practice can offer the respect and support you deserve.

Vaginal Birth After Cesarean (VBAC)

If you've had a cesarean before, a vaginal birth may still be an option. Whether it's reasonable for you depends on your medical history, the type of uterine incision you had, your current pregnancy, and the resources where you plan to give birth.

A trial of labor after cesarean (TOLAC) is an attempt to have a vaginal birth after a previous cesarean. When successful, it's called a VBAC.

Not every provider or hospital offers TOLAC, and those that do may have specific eligibility requirements. A provider experienced with VBACs should walk you through the benefits and risks, including the small but serious risk of uterine rupture, and explain what would happen if a repeat cesarean became necessary.

Cesarean Rates

Cesareans (usually referred to as c-sections) can be lifesaving, and sometimes they're the right choice. But some hospitals perform far more c-sections than others, even among healthy, low-risk patients. That difference usually reflects hospital policies and practice patterns, not the patients themselves. A hospital's c-section rate can be one of the best clues to how likely you are to have a cesarean there.

The most useful number to look for is the NTSV cesarean rate (nulliparous, term, singleton, vertex). It measures c-sections among first-time mothers carrying one baby, head-down, at full term. Because this group is generally low-risk, the NTSV rate makes it easier to compare hospitals fairly. A hospital that cares for many high-risk patients may have a high overall rate for good reasons, but a high NTSV rate suggests cesareans are being used more readily than necessary. The national Healthy People 2030 goal is 23.6%, so a rate well above that is worth asking about.

Many state health departments publish hospital c-section rates, and The Leapfrog Group reports NTSV rates for participating hospitals. You can also use BirthBot, our childbirth education chatbot, to check statistics for hospitals near you. Individual provider rates are harder to find, but you can ask a provider or practice directly. A provider who is comfortable sharing and explaining their numbers is a good sign.

What If Your Provider Isn't the Right Fit?

You may not know whether a provider is right for you until you've had several visits. Pay attention to how they respond when you ask questions, share a concern, or request an accommodation. Do they listen without interrupting? Do they explain your options? Do they take the time to understand what matters to you?

If you often feel rushed, dismissed, or uncomfortable, you have options. You can ask for a second opinion, meet with another provider in the practice, or transfer your care. It's easiest to switch earlier in pregnancy, but it's never too late to look for care that feels right.

Speaking up can be hard, especially if you've faced discrimination or had your concerns brushed aside before. But you should never have to fight for basic dignity and respect. That is the minimum you deserve.

Finding the Right Care for You

Choosing a provider is about more than credentials. It's about building a relationship with someone who takes your concerns seriously, respects your decisions, and stands with you through both the expected and the unexpected.

To help you get started, download our list of questions to ask when choosing a provider. Bring it to your first visits, and use it to compare practices and start the conversations that matter most to you.

Pregnancy and birth are experiences you'll carry with you for the rest of your life. You deserve to go through them feeling informed, supported, and heard. Ask questions, trust what you notice, and don't settle for care that makes you feel small. The right provider won't just deliver your baby. They'll help you begin this new chapter feeling confident and cared for.