Pregnancy Care Choices

A healthcare provider is someone who provides you with health services such as a registered midwife, family doctor, an obstetrician or nurse practitioner. You have a choice of healthcare providers to care for you and your baby.

Who are Healthcare Providers?¹

• The following healthcare providers can care for you and your baby. It is important to choose someone who shares your beliefs about pregnancy, labour, birth and breastfeeding.
• Registered midwives can provide care for you and your baby through pregnancy, labour, birth and the first six weeks after birth. You may choose to give birth in a hospital, birth centre or at home.
• Family doctors can provide care for you, your baby, and family. Some also provide care during labour and birth. If not, your prenatal care may be started by a family doctor and then transferred to an obstetrician around your 32nd week of pregnancy.
• Obstetricians can provide care to you during pregnancy and for labour and birth but would not look after your baby.
• Nurse Practitioners can provide care for you, your baby and family. They do not normally provide care for labour and birth but may do so in isolated communities.

• Routine prenatal care delivered by any of these healthcare providers is covered by the Ontario Health Insurance Plan (OHIP). The availability of prenatal healthcare providers depends on where you live and the health status of you and your baby.

Tips for Choosing a Healthcare Provider:¹

• Different healthcare providers follow different models of care:
• The medical model tends to see pregnancy as a medical condition with inherent risks which require intervention. You may be a more passive participant in your care.
• The midwifery‐led model tends to see pregnancy as a normal life stage, which requires intervention only if complications arise. You are an active participant in your care.
• Research shows that the provider effect (i.e. the model of care the provider practices) is one of the biggest indicators of the care that you will receive.
• If, during your pregnancy, you find that your healthcare provider is not the best match for you, it may be because their model of care does not match your needs. You may or may not have the option to change healthcare providers (depending on the availability of healthcare providers in your area) but you have the right to try. It will also depend on your health and the health of your unborn baby.
• When choosing a healthcare provider, it is important to choose someone who shares your beliefs about pregnancy, labour, birth and breastfeeding. You can find out about a healthcare provider’s beliefs and model of care by asking specific questions, such as:
• How much time do you have for me during prenatal visits? What happens during these visits?
• What are my options about where I give birth?
• What happens when a typical client of yours goes into labour? Could you walk me through the process? (You want to get an idea of typical practices.)
• Who else will be involved in my care?
• Other things you will want to consider:
• Is the person easy to talk to and understand?
• Do they listen to you and answer your questions?
• Can you get to their offices easily?
• Can you reach them by phone?
• Where will the baby be born (home, birth centre, hospital)?
• Will they provide care for your baby?
• Do you prefer a male or female healthcare provider?
• What do other mothers say about their healthcare provider?

Importance of Regular Prenatal Care:¹

• A checkup before conceiving will help you prepare for pregnancy. Early and regular prenatal care will help you have a healthy pregnancy and baby.
• It is important to begin your prenatal care as early as possible in pregnancy to help decrease the possibility of preterm labour (labour beginning before 37 weeks).
• Prenatal care includes regular visits with a healthcare provider and may also include various tests and procedures to monitor the health and well‐being of you and your baby.
• Healthcare providers are interested in both the physical and emotional well‐being of you and your partner during pregnancy.
• You can speak with your healthcare provider about concerns and the changes that are occurring during your pregnancy.
• You also have the opportunity to ask questions to become informed about any tests or interventions you may need during your pregnancy, labour and birth, and share your preferences so that you can make an informed decision about your care.
• Healthcare providers are able to answer questions, discuss concerns, and link you to helpful community services. These include: hospital or birthing centre, prenatal education, and social services.

How Often Should I see my Healthcare Provider?¹

• Your first prenatal healthcare provider appointment is scheduled once the pregnancy is confirmed (usually through a home pregnancy test).
• After the first visit you will typically see your healthcare provider:
• Once a month until 28 weeks of pregnancy
• Every two weeks until 36 weeks of pregnancy
• Every week until the baby arrives
• Regular prenatal check‐ups ensure that you and your baby receive the best possible care and monitoring during your pregnancy.
• Your partner/support person is encouraged to attend prenatal appointments to become familiar with the caregiver and to discuss their role during pregnancy, labour and birth.

Adapted / Reproduced with permission from Best Start by Health Nexus.