Choosing Your Place of Birth Matters
The biggest decision you make in your pregnancy that has an impact on your birth is to choose a care provider you trust that aligns with your birth preferences. That’s a little more complicated than just choosing a provider, though. Unfortunately, in most places of birth today, when you go into labor, you don't necessarily get your prenatal care provider, but rather who is "on-call" for that shift. You see who is “on-call” for that shift. If you find yourself admitted through several shifts, you may see several different providers throughout your labor. Shifts in most hospitals are usually 12 hours for nurses and 12-24 hours for doctors and midwives.
If you plan to give birth in a hospital with large groups of medical providers, you might consider looking up your intended birthplace to check its safety grade. You might also look up other hospitals in your area to see how your birthplace compares to others.
Leapfrog Hospital Ratings is a free, annual survey that assesses hospital performance on national measures of safety, quality, and efficiency. Their ratings also cover maternity care, including cesarean rates. Reporting is voluntary and 2 out of the 3 major maternity hospitals in Albuquerque have opted in to make their data public. If your intended birthplace isn’t listed, you might share your interest in their transparency by writing to the hospital.
This health rating may give you a better idea about what to expect at your chosen place of birth across their providers. For families seeking low-intervention births, pay attention to cesarean, episiotomy, and elective early delivery rates.
If knowing who will be at your birth is important to you, there are a few options you can consider:
For healthy low-risk pregnancies, an out-of-hospital birth may be an option for you. We’re lucky to have many homebirth midwives in our area. With this option, you will receive prenatal care with the same provider who will be present at your birth. For families who are seeking more of a middle ground, the local birth center, Dar a Luz Birth & Health Center, is a wonderful option with a staff of Certified Nurse Midwives and the opportunity to meet them all during your prenatal care.
Seek care with a smaller team within a hospital system. For example, family medicine teams often have more limited care providers and you may be able to meet several of the providers during your prenatal time. Midwife groups are another option that can be more limited in the number of staff. If you’re able, look for a practice where all (or most) of the providers have similar philosophies on care and are matched with your own needs and preferences.
Some providers will agree to care for you in your place of birth no matter if they are on call or not. When in doubt, ask a provider about their availability and willingness to care for you even if they are not on call.
In the end, where you choose to birth is a very important decision that goes beyond just liking your prenatal care provider. Insurance, of course, can be a limiting factor in your options, but we encourage you to ask questions during your prenatal care so that you are well informed and can make decisions that are best for your family.