Which prenatal care provider is for you?


pregnant belly cradled by hands with a moon tattoo

Choosing a prenatal care provider can seem complicated. It is becoming common knowledge that there are more options for pregnancy and birth care than the traditional obstetrician. Here are the basics of the types of providers that offer prenatal and birth care in Arizona as well as what types of pregnancies they work with.

Licensed Midwives (LM) attend low-risk births in out of hospital settings including homes and birth centers. They are trained and experienced in monitoring pregnancies, births and postpartums for potential complications. LMs usually provide longer prenatal and postpartum appointments, home visits, more personalized care and carry far fewer clients at once than medical practices. You can expect an LM to have the time to answer all of your questions, remember your name and the name of your partner and family members, your wishes for your birth, and provide breastfeeding and postpartum support. LMs perform all the same clinical care you receive at a routine OB appointment, can order labs and ultrasounds as needed, and although LMs work independently, they will consult with physicians and hospitals if complications arise. Midwives also provide routine newborn care and can treat birth emergencies that may arise while arranging for medical care. Midwives often have lower rates of unnecessary interventions as well as can provide a safe and satisfying birth experience. For low-risk pregnancies, a midwife attended birth at home can be as safe or safer than a physician attended birth in hospital.

Most Arizona midwives are also Certified Professional Midwives (CPMs)In short, CPMs have attained a national certification establishing their ability to attend out of hospital births though didactic and clinical studies and passing the North American Registry of Midwives (NARM) exam. NARM provides a good explanation of what a is CPM here.

Certified Nurse Midwives (CNMs) attend births mostly in hospital and may provide an alternative to home or birth center birth when people are more comfortable in the hospital setting or have minor complications that make out-of-hospital birth too risky. CNMs in hospital always work under the direction of a physician. Some CNMs attend home births. The American College of nurse midwifery offers a short explanation of CNMs here.

An Obstetrician (OB or ObGyn) is what most people in the US think of when they think of birth providers. OBs in the US provide prenatal care for all pregnancies and most attend births in hospital only, although a few work in birth centersIn many developed nations, OBs are used only in the event of complications while the normal pregnancies and births are left to the midwives. Having an OB attend low-risk births is not linked to better birth outcomes, but OBs are trained in complications of pregnancy and in how to perform surgical births if the need arises. Many midwives work in collaboration with physicians to coordinate the best possible care for their clients.

Although more common in the past, some Family Physicians (MDs, DOs, Naturopathic Doctors) continue to attend births in hospitals, birth centers and homes, Family physicians usually focus more on low risk pregnancies, referring higher risk folks to OBs. They often have the advantage of providing care for the entire family.

Perinatologists are specialist OBs that deal with high risk pregnancies only. They are experts in pregnancies that require advanced monitoring and treatments, genetic screening, and if there are pregnancy complications that develop. Most perinatologists do not attend births but work in conjunction with physicians or midwives during a high-risk pregnancy.

We offer free initial consultations where you can ask questions about midwifery care, ask about our practice and review your medical and health history to make sure a midwife is the best option for your pregnancy. Call us at 623-206-8531 or email if you’d like to set up an appointment.

For information on how midwifery in Arizona is regulated, look here.