Childbirth Options

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General Information and Where to Start

This guide is designed for pregnant or soon-to-be pregnant women who want to know more about their options for giving birth. There's so much information available about birth — books, videos, web pages — how do you know where to start? This Pathfinder will help clarify your choices so that you can make the best decisions for you, your baby and your family.

When it comes time to have your baby, there are three big choices that you need to make:

1. Who will attend me?
2. Where will I have the birth?
3. How do I want my delivery to go?

1. Choosing A Care Provider

In most locations, you have the option of giving birth with a physician (an OB/GYN or a family practitioner) or a midwife (either a nurse-midwife or a direct-entry midwife). In addition, you can also choose to have a doula or a monitrice with you during labor.

A. Midwives are trained in normal birth (over 90% of all pregnancies). They deliver babies in hospitals, birth centers or at home, and are highly skilled at non-interventive care such as listening and communication, and non-medical pain relief for labor and delivery.

Resources About Midwife-Attended Birth:

• This site describes the differences between nurse-midwives and direct entry midwives.
• The ACNM (American College of Nurse-Midwives) has a good page of information about nurse-midwives, including articles and a searchable database of nurse-midwives.
• Here's the Yahoo! category on midwifery.

  Finding A Midwife:

• Call your local hospital to find out if they employ midwives. Also, check the resources on birth centers.
• BirthPartners.com has a searchable database of midwives and a separate database for doulas with contact information , qualification information, and a description of their practice. It's not a very big database at this time.
• The Midwives' Alliance of North America (MANA) can help you find a midwife: email them at MANAinfo@aol.com.
• BabyCenter has a health provider search to help you find a nurse-midwife in your area.
• Also, ACNM has a directory line for finding nurse-midwives: 1-888-MIDWIFE.

  Books About Midwives:
  All books about pregnancy are listed in the 618 section of your local library.

• Choosing a Nurse-Midwife: Your Guide to Safe, Sensitive Care During Pregnancy and the Birth of Your Child by Catherine M. Poole and Elizabeth A. Parr. Gives information on finding a nurse-midwife.
• Special Delivery: The Complete Guide to Informed Birth by Rahima Baldwin (Celestial Arts, 1990). For parents looking for a direct-entry midwife.

B. Physicians are trained in abnormal birth, or birth with complications. OB/GYN's are specially trained to deal with pregnancy-related problems and surgical births. If your pregnancy is termed "high-risk", such as in the case of high blood pressure or other conditions, you will probably want to give birth with a physician.

Resources About Physician-Attended Birth:

• Call your health provider and ask for referrals to OB/GYNs in your area. Or, look under "Physicians" in your phone book and interview some of the OB/GYNs.
• BabyCenter has a health provider search to help you find an OB/GYN in your area.

  Books for physician birth:
  All books about pregnancy are listed in the 618 section of your local library.

• What to Expect When You're Expecting by Arlene Eisenberg (Workman Publishing Company, 1994). This book is recommended by the American Medical Association, so is geared well toward women who want a hospital birth.
• A Good Birth, A Safe Birth by Diana Korte and Roberta Scaer (Harvard Common Press, 1992). Helps you choose the right hospital by suggesting questions to ask your doctor.

C. A doula is a woman who is trained in supporting women in childbirth. She provides emotional support, information and reassurance. A monitrice is similar to a doula, except that she provides clinical skills as well. Monitrices are usually nurses. Both doulas and monitrices can be of great help during labor, especially if you choose to birth with a physician.

Resources About Doulas and Monitrices

• Frequently Asked Questions about doulas
• Personal accounts of birth using doulas: Jackson's birth | Kiera's birth | Jostin's birth
• Here's the Yahoo! category on doulas.

  Finding A Doula

• Here's a doula directory provided by Childbirth.org.
• Doulas of North America (DONA) has a doula directory service which can be accessed by email or by phone at 1-206-324-5440.
• The Association of Labor Assistants and Childbirth Educators (ALACE) also trains doulas.
  Email: alacehq@aol.com Phone: (617) 441-2500

  Books about doulas:
  All books about pregnancy are listed in the 618 section of your local library.

• Mothering the Mother : How a Doula Can Help You Have a Shorter, Easier, and Healthier Birth by Marshall H. Klaus et al (Perseus Press, 1993). The role of the doula, plus results of studies on doulas.
• The Birth Partner by Penny Simkin (Harvard Common Press, 1989). A concise guide to the role of a doula before, during and after labor.

2. Choosing A Birth Location

You have three choices for a birth site: at home, at a hospital or at a free-standing birth center.

Resources for Birth Sites

• Options for Childbirth is an excellent overview of the pros and cons of giving birth at a hospital, birth center or at home.

  Hospital Birth Resources:

• Your best bet is to look up "Hospitals" in your phone book and call around to find out which hospital offers your ideal environment. Or, your physician may be affiliated with a hospital.

  Birth Center Resources:

• Personal accounts of birth at a birth center: Maddy's birth | Madeline's birth | Carlan's birth
• Birth Centers Online, sponsored by the National Association of Childbearing Centers (NACC), has a directory of accredited birth centers.

  Home Birth Resources:

• Here is a literature review of studies on the safety of home birth.
• Many home birth stories can be found here.
• Midwifery Today has an online book on the Homebirth Choice.
• Pregnancy, Birth and Beyond has a list of homebirth resources, as well as a directory of midwifery resources by state.
• Here's the Yahoo! category on Homebirth.

3. Choices In Labor

The foundation of a good labor is a carefully considered birth plan. This is simply a short document detailing the specific care measures, interventions and procedures you do or do not want at your birth.

Birthplan.com guides you through the process of creating a birth plan, and helps explain why you would want one.

The following books include information on how to write an effective birth plan. All books about pregnancy are listed in the 618 section of your local library.

• Creating a Joyful Birth Experience by Lucia Capacchione (Simon and Schuster, 1994).
• Gentle Birth Choices by Barbara Harper (Inner Traditions International, 1994).
• Pregnant Feelings by Rahima Baldwin (Celestial Arts, 1986).
• Pregnancy, Childbirth, and the Newborn by Simkin, Keppler, and Whalley (Meadowbrook Press, 1991).
• Trust Your Body! Trust Your Baby! Childbirth Wisdom and Cesarean Prevention by Andrea Frank Henkart (Bergin and Garvey, 1995).

This site details some specific choices which you may wish to consider for your labor and delivery.

• Water Birth:
• Giving Birth Underwater, sponsored by the Global Maternal/Child Health Association (GMCHA), provides answers to questions, books, birth stories, rental tubs and everything else you need for a water birth.
• Also visit the Waterbirth Website.
• Here's the Yahoo! category listing about water birth.

More Resources on Childbirth Options

Reviews of 31 videos on birth, which you may be able to find at your local library.

Birthstories.com provides a wealth of birth stories shared by moms in all circumstances of labor and delivery.

Childbirth Bookstores — these bookstores specially deal in hard-to-find books for midwives and interested consumers:

• Cutting Edge Press
• Birth and Life Bookstore

Journals and Magazines on Birth

• Midwifery Today
• The Birth Gazette: Ina May Gaskin, Ed. 42, The Farm, Summertown, TN 38483. Email: belly@io.com

This pathfinder was created by Maggi R. Seymour

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You may also wish to see IPL Pregnancy, Birth and Breastfeeding Resources

 

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