Considering an out-ofhospital birth

While most women in the United States give

birth in a hospital, some women choose to give

birth at a standalone birthing center or in their

own homes 먹튀검증.

Talk with your care provider in choosing a

birthing location. Being pregnant for the first

time, being pregnant with multiples, having a

previous cesarean delivery and other risk factors

are considered in weighing the safety and

recommendations for each woman. For all

women, a certified midwife or physician

attending the birth and ready access to a nearby

hospital are critical for a safe outcome.

Birthing center Birthing centers can be

independent facilities, or they may be affiliated

with a hospital. Most birthing centers are run by

certified nurse-midwives or teams of obstetrical

care providers, and they strive to provide a more

natural birthing experience for low-risk, routine

pregnancies, without overuse of medical

intervention. Because of the reduced need for

personnel and equipment, birthing centers may

be more cost efficient. You might consider a

birthing center if your pregnancy is low-risk,

you’re looking for a homelike experience and

there’s an affiliated medical center nearby. Be

sure to check on the licensing and credentials of

the providers, as well as your insurance

coverage. If you’re worried that complications

could arise, a birthing center may not be the best

choice. If you do experience complications, you’ll

likely need to be transferred to a hospital, and

that takes time.

Home In the United States, each year about 1

percent of women have their babies at home.

The trend for home births has been growing in

recent years and remains somewhat

controversial, as the risks even for women with

healthy pregnancies are greater than in a

hospital. Midwives are almost always the care

providers for home deliveries. Women who

choose to deliver at home often wish to avoid

medical interventions and the hospital

environment. The disadvantage is that if

problems arise, they may not be recognized early

on. In certain situations, delay of care could

compromise the health or life of mom and baby.

Research suggests there may be certain benefits

to women in these settings compared with

hospital births, including fewer interventions,

such as labor induction or episiotomy, and fewer

perineal tears. However, the possible benefits of

a home birth must be weighed against a higher

risk for both mom and baby.

Keep in mind: Current research findings

reflect that women who plan to give birth out of

hospitals generally have fewer risk factors than

those planning hospital births, leading to

differences in outcomes. In addition, out-of-

hospital birth statistics may not include cases in

which a woman is transferred from home or a

birthing center to a hospital due to

complications.

Further research is needed to better determine

the benefits and risks of out-of-hospital births in

the United States. Meanwhile, care providers can

help review risks for those considering birth

outside a hospital setting.

Family physicians Family physicians provide

care for the whole family through all stages of

life, including pregnancy and birth. Some family

physicians, however, choose not to handle

pregnancies.

Practice Family physicians may work solo, or

they may be part of a larger group practice that

includes other family physicians, nurses and

other medical professionals. Family physicians

are usually associated with a hospital where they

can perform deliveries.

Advantages If you’ve had the same family

doctor for a while, he or she will probably know

you well and be familiar with your family and

medical history. Thus, a family doctor may view

your pregnancy as part of the larger picture of

your life. Another advantage of a family doctor is

that he or she can continue to treat you and your

baby after birth.

Issues to consider Family physicians can

cover most obstetrical care, but if you’ve had

problems with a pregnancy before, your family

physician may refer you to a specialist in

obstetrics or use a specialist as a backup

provider. The same may be true if you have

diabetes, high blood pressure or another medical

problem that may complicate your pregnancy.

You might choose a family physician for your

prenatal care if:

-You and your doctor don’t foresee any

problems with your pregnancy.

-You want your doctor to be involved with all

members of your family.

-You enjoy the continuity in care from

prenatal appointments throughout

childhood and beyond.

Maternal-fetal medicine specialists Also

called perinatologists, these specialists are

trained in the care of high-risk pregnancies.

They deal with the most severe pregnancy

complications.

Practice Maternal-fetal medicine specialists

often work as part of a group practice, and

they’re generally associated with a hospital,

university or clinic.

Advantages This highly specialized doctor is

familiar with the complications of pregnancy and

adept at recognizing problems. When women

with major medical concerns become pregnant,

their physicians often consult with maternal-fetal

medicine specialists to optimize care for

both the mother and her baby.

Issues to consider Maternal-fetal medicine

specialists concentrate solely on the problems

that occur with pregnancy.

A maternal-fetal medicine specialist rarely

serves as the primary health care provider for a

pregnant woman. This specialist is brought in at

the request of another care provider. You may be

referred to a maternal-fetal specialist if:

-You have a severe medical condition

complicating your pregnancy, such as an

infectious disease, heart disease, kidney

disease or cancer.

-You’ve previously had severe pregnancy

complications.

-You plan on having prenatal diagnostic or

therapeutic procedures, such as chorionic

villus sampling, amnio-centesis, or fetal

surgery or treatment.

-You’re a known carrier of a severe genetic

condition that may be passed on to your

baby.

-Your baby has been diagnosed before birth

with a medical condition, such as spina

bifida.

How to decide Navigating the health care

system to find the right care provider can be a

daunting process. Here are some suggestions

that may be helpful.

Ask for help Try these approaches:

-Check with your insurance company to find

out which hospitals and services are

covered. The “find a doctor” feature on your

health plan’s website may be helpful.

-Consult with your regular doctor and other

medical professionals.

-Ask family and friends whom they would

recommend.

-Check the website of the clinic or hospital

you prefer to find out who provides

maternity care.

-Contact the labor and delivery unit at the

hospital you prefer and ask for a

recommendation.

Issues to consider Ask yourself these

questions:

-Is the care provider certified by a medical

board or the board of nurse-midwifery?

-Is the provider’s office a convenient distance

from home or work?

-Is the care provider going to be able to

deliver my baby in the place I want to give

birth ? at a particular hospital or birthing

center, or my home?

-Does the care provider work in a solo or

group practice? If it’s a group practice, how

often will I see him or her? How often will I

see others from the practice?

-Who will replace my care provider if he or

she isn’t available in an emergency or when

labor begins?

-Is the care provider available to answer

questions in between my scheduled

appointments?

-Do I want my care provider to be able to

treat my entire family?

-Did the individual listen to my concerns and

answer my questions?

-Did the individual seem open and caring?

-Is the care provider covered by my

insurance company?

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