Do you have a serious chronic medical condition?
If you have a medical condition such as high blood pressure, epilepsy, heart disease, or diabetes, or had certain serious complications in a previous pregnancy, your pregnancy will probably be considered high risk. In this case, you’ll need to see an obstetrician or possibly a maternal-fetal medicine specialist (a physician who specializes in high-risk pregnancies).
Be aware that if you start out with a midwife and develop a problem down the road – such as premature labor or preeclampsia – or find out that you’re having twins, your care will be transferred to an obstetrician or perinatologist.
Do you already see a practitioner you trust and feel comfortable with?
If you already have a good relationship with a certified nurse-midwife, an ob-gyn, or family practitioner who provides prenatal care and delivers babies, you may want to stay right where you are.
What kind of setting do you want for your delivery?
If you have no health problems or pregnancy complications and you have your heart set on giving birth in a birth center or at home, you’ll want to find a midwife who practices in these settings.
Birthing centers are usually staffed by CNMs. Birth centers are known for being supportive environments for having a natural birth without routine interventions and for welcoming anyone you’d like to have there with you, including family, friends, and siblings.
If you want to give birth at home, you can choose either a certified nurse-midwife or a direct-entry midwife to attend you.
On the other hand, if you want the option of getting an epidural, or you’re very anxious about something going wrong during labor and delivery and don’t want to chance having to transfer to a hospital, you’ll want to be in a hospital from the get-go. For a hospital birth, you can choose an ob-gyn, a family physician, or a certified nurse-midwife as your primary caregiver.