On This Page

As soon as that pregnancy test indicates a baby is on board, you’re faced with so many decisions! But before you delve into picking baby names, nursery decor, constructing birth plans, and interviewing pediatricians, you’ll need to figure out who’s going to take care of you during your pregnancy. After all, regular prenatal care with someone you trust improves your chances of a healthy pregnancy—and a healthy baby.

While it’s true that most parents-to-be choose an OB/GYN for prenatal care, many don’t have that option. (Approximately half of all counties in the U.S. have exactly zero obstetricians working there, notes a 2020 report from the March of Dimes.) And still others simply choose to see a non-OB/GYN provider for their prenatal care. For help deciding which is the best prenatal care practitioner for you, check out our guide to finding the best maternity care.

How to Choose the Right Prenatal Care Provider

First and foremost, you want to select a healthcare provider who’s qualified to handle your specific pregnancy. That means, if you’re gearing up for, say, a VBAC (vaginal birth after a C-section), you want a provider with lots of experience in that area. If you’ve a history of complications from previous pregnancies, a homebirth with a midwife is not ideal. Beyond that, remember that you’re deciding on a person to guide you through your pregnancy, not just an expert. You want to gel with your prenatal care provider and feel comfortable asking any question that may arise. In fact, research in the journal BMC Pregnancy and Childbirth found that fostering a meaningful relationship between a pregnant individual and their provider was key to experiencing “quality care.” For more help selecting your maternal health provider, consider asking your contenders some questions beyond Do you take my insurance? And Where do you deliver? To get a better sense of their bedside manner and general philosophy on pregnancy and childbirth, such as…

  • What’s your role during labor and delivery?
  • How much time do you allot for each prenatal visit?
  • Are you available by phone, email, or Telehealth for questions between visits or after-hours?
  • How do you feel about birth plans?
  • What are your views about pain relief during labor?
  • Do you perform episiotomies as a matter of course?
  • Are you comfortable working with a doula?
  • What are your philosophies on “alternative” birthing practices, like water birth?
  • What’s your view on nutrition and weight gain during pregnancy?
  • What routine policies during labor do you recommend or require?
  • Do you ever recommend induction for an estimated large baby?
  • What do you tend to do if labor stalls or slows down?
  • If I feel I need to see you before my 6-week postpartum checkup, will you accommodate me?
  • What kind of postpartum follow-up do you do?

Types of Prenatal Care Providers

The healthcare provider you’ve been seeing for your pap tests, annual check-ups, and even pre-pregnancy planning might not be the right person to usher you through pregnancy. Before you land on your ideal prenatal care pick, you’ll need to narrow the pool to the types of providers who can do the job. You can get prenatal care from a variety of providers, but they need to be:

  • Obstetrician/gynecologist: Also called OB/GYN, this type of doctor has been specially trained to take care of you during pregnancy—and deliver your baby. It’s important to know that not all gynecologists are OB/GYNs.

  • Perinatologist: This type of doctor specializes in high-risk pregnancies and is also called a maternal-fetal medicine (MFM) specialist.

  • Certified nurse-midwife: These experts have specialized education and training to not only deliver babies, but they can care for you before, during, and after pregnancy, too.

  • Family physician: In communities where there are plenty of OB/GYNs, family doctors may not deliver babies. But many family doctors can provide prenatal care and offer vaginal deliveries. (Some can perform C-sections, as well.) In fact, a 2021 report found that 67% of babies born in rural hospitals were delivered by family physicians.

  • Nurse practitioner: While NPs are trained to be able to provide prenatal care, they don’t deliver babies.

Choosing an OB/GYN as Your Prenatal Care Provider

An obstetrician-gynecologist (OB/GYN) is a medical doctor who’s specially trained in women’s reproductive health, pregnancy, childbirth, but also primary health care. That means an OB/GYN is 100% qualified to give you a pap test, a breast exam, prescribe birth control…and take care of you from preconception to delivery to postpartum. (PS: Not all gynecologists are obstetricians!) OB/GYNs have been through four years of medical school and another four years of hands-on post-grad training as an OB-GYN-centered medical resident in a hospital setting. These maternal health care expert shepherd the vast majority of folks through pregnancy and delivery.

An OB/GYN may be a good choice for…

  • Vaginal deliveries
  • C-section deliveries
  • VBAC deliveries
  • Low- to (most) high-risk pregnancies

Choosing an Perinatologist/Maternal-Fetal Medicine Specialist as Your Prenatal Care Provider

A perinatologist (also known as a maternal-fetal medicine specialist) completes four years of med school and four years of an OB/GYN-focused residency, just like an OB/GYN. But a perinatologist also receives three more years of training, focused on medical complications related to pregnancy, including the assessment and treatment of fetal issues. Generally speaking, an OB/GYN, midwife, or another healthcare provider would be the one to refer you to a perinatologist. They’ll do this if you have certain pre-existing medical conditions, if you develop a medical issue during pregnancy, or if your baby-to-be has an abnormality. (If it’s your baby who needs the extra attention, your perinatologist will work with the pediatric care team to coordinate your little one’s care.) Having a perinatologist care for you does not necessarily mean they’ll replace your original prenatal provider. Oftentimes, they’ll care for you together, with your primary prenatal provider usually delivering your baby.

A perinatologist may be a good choice for…

  • High-risk pregnancies due to an autoimmune disorder, diabetes, heart disease, inflammatory bowel disease, lupus, seizures, severe high blood pressure, or kidney problems
  • Certain a sexually transmitted diseases, such as syphilis or HIV
  • Abnormal prenatal screening test
  • At risk of preterm labor
  • Expecting multiples
  • Over 40
  • Multiple prior miscarriages or stillbirths
  • Prior pregnancy complications, like preeclampsia, preterm labor, or gestational diabetes

Choosing a Midwife as Your Prenatal Care Provider

Midwives—mostly certified nurse midwives (CNM)—attend nearly 1 in 10 births in America. While “midwife” sounds like an old-timey provider, CNMs are highly qualified registered nurses who also have a graduate degree (or higher) in midwifery. Certified nurse midwives provide comprehensive pregnancy and postpartum care, they deliver babies, and they offer well-woman checkups, routine women’s health services, they can prescribe meds, order lab tests, and diagnose conditions. CNMs can work in hospitals, birth centers, and some oversee home births as well. Midwives don’t perform surgery or care for moms-to-be with medically complicated pregnancies. While folks with chronic medical conditions are often considered high-risk and discouraged from midwife care, a 2021 report from Denmark found that those with certain chronic medical conditions who saw a midwife during pregnancy were more satisfied with their maternity care than those who experienced standard care with an OB/GYN.

A midwife may be a good choice for…

  • Vaginal deliveries
  • Low-risk pregnancies and births
  • Home births
  • Water births
  • Hypnobirthing
  • Minimal intervention
  • Holistic care, focusing on wellness and emotions
  • Support throughout labor and delivery
  • Fear of childbirth (A 2022 report notes that midwives play a pivotal role in reducing fear of childbirth.)

Choosing a Family Physician as Your Prenatal Care Provider

Did you know that family medicine training in the U.S. has always included maternity care? It’s true! In fact, according to the March of Dimes report mentioned above, family physicians provide the majority of maternity care in rural parts of the country. Of course, that doesn’t mean that your family physician offers prenatal care or delivers babies... but it’s worth the ask if you want to stick with a doctor you trust. It’s also important to know if you live in a “maternity care desert,” where there’s limited access to prenatal care. (Approximately 10% of births nationwide occur in these deserts.) The range of prenatal care offered by family physicians varies, with some managing medical problems during pregnancy, others only handling prenatal care, and still others who offer comprehensive prenatal care for low-risk or high-risk pregnancy, including performing C-sections.

A family physician may be a good choice for…

  • Those with limited access to alternatives
  • Vaginal deliveries
  • Low-risk pregnancies
  • One-stop care, with primary, maternal, and pediatric care offered

Choosing a Nurse Practitioner as Your Prenatal Care Provider

Women’s health nurse practitioners (WHNP) is a registered nurse who has studied at the Master’s or Doctoral level with a special focus on women’s health. And they offer many of the same services as an OB/GYN or a certified nurse midwife, including diagnosing conditions, ordering medical tests, prescribing medications, and prenatal and postnatal care…but they do not deliver babies. Instead, WHNPs work collaboratively with physicians, including OB/GYNs, who would guide you to the finish line. That said, these providers often are a solid choice to oversee your prenatal care. After all, research shows that roughly 73% of pregnant folks are more concerned about choosing the right prenatal care provider than choosing their delivery hospital.

A nurse practitioner may be a good choice for…

  • Those with limited access to alternatives
  • Personalized care
  • One-stop for prenatal and primary care beyond pregnancy

More on your prenatal health:

 

***

REFERENCES

  • Routine prenatal care visits by provider specialty in the United States, 2009-2010. NCHS data brief, no 145. March 2014
  • March of Dimes: Nowhere to Go: Maternity Care Deserts Across the U.S. 2020 Report
  • March of Dimes: Prenatal care checkups
  • The impact of family physicians in rural maternity care. Birth Issues in Prenatal Care. September 2021
  • Michigan Health: OB-GYN, family physician, midwife, doula: Which pregnancy specialist is right for you?
  • Johns Hopkins Medicine: High-Risk Pregnancy: What You Need to Know
  • Cleveland Clinic: Perinatologist
  • Cleveland Clinic: Midwife
  • Effects of a Midwife-Coordinated Maternity Care Intervention (ChroPreg) vs. Standard Care in Pregnant Women with Chronic Medical Conditions: Results from a Randomized Controlled Trial. International Journal of Environmental Research and Public Health. August 2021
  • Midwives’ interventions for reducing fear of childbirth in pregnant women: a scoping review. JBI Evidence Synthesis. December 2022
  • Supporting Family Physician Maternity Care Providers. Family Medicine. 2018
  • The American Academy of Family Physicians (AAFP): Maternal/Child Care (Obstetrics/Perinatal Care)
  • East Jefferson General Hospital, LCMC Health: More than catching babies: the role of NPs in obstetrics and gynecology
  • Nurse Journal: Certified Nurse Midwife vs. Women's Health Nurse Practitioner: What's the Difference?
  • How do pregnant women use quality measures when choosing their obstetric provider? Birth Issues in Prenatal Care. January 2017
  • Women's and care providers' perspectives of quality prenatal care: a qualitative descriptive study. BMC Pregnancy and Childbirth. April 2012

View more posts tagged, pregnancy health

Have questions about a Happiest Baby product? Our consultants would be happy to help! Submit your questions here.

Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider.