Maternity Care in the U.S.A.


I’ve had several babies, and I’m pretty passionate about women taking charge of their healthcare in an educated manor.  My mom, who teaches English to foreign students, told me that many of her foreign students do not understand how maternity care works here in the United States.  Here’s a rundown:

In America, the mother has the freedom to choose (within reason) what she desires for her prenatal care and birthing plan. You can almost always find an OBGYN or midwife who will let you make many decisions regarding your healthcare.

Some women interview several doctors and/or midwives before making a decision on whom to see.

Interview Questions may include:

How long have you been practicing obstetrics?

How many births have you attended?

Do you have a limit on how many patients you’ll accept?

How can I reach you in an emergency? Are you very accessible?

Are you in a solo or group practice? If you’re solo, who covers for you when you’re gone?

At what hospital will I give birth?

Are you board-certified?

What is your general philosophy or pregnancy care, including birth?

How do you see your role as a physician at my baby’s birth?

How much time do you allow for each prenatal visit?

What is the average wait time in your office?

Which prenatal tests do you recommend? What if I have a concern about a specific test?

What percentage of your patients have episiotomies and/or C-sections?

What percentage of your patients have forceps assisted births?

How do you feel about inducing labor?

If you do not like your OBGYN/midwife or disagree with how your healthcare is being managed, you can and SHOULD change to a different OBGYN/midwife.

Difference between an OBGYN and Midwife

Generally, midwives are more holistic and lean toward a natural approach to childbirth. A CNM (certified nurse midwife) has completed a 2-year master’s degree program in midwifery in addition to 4 years of nursing school.

An OBGYN completes a 4-year obstetric residency program in addition to 4 years of medical school. Prenatal visits with an OBGYN and midwife are very similar, although often midwives spend more time with their patients during appointments. A midwife cannot perform surgery while an OBGYN can; high-risk pregnancies usually require an OBGYN.


Many websites and books are available that help guide you through your pregnancy. even offers free birthing classes!

OB appointment schedule

            8 to 28 weeks—one visit per month (every 4 weeks)

28 to 36 weeks—two visits per month (every 2-3 weeks)

36 weeks to delivery—one visit per week

What happens at appointments?

Mother’s weight, blood pressure, and urine is checked. Baby’s heartbeat and uterus size is also measured.

Often the doctor will do an ultrasound at the initial visit (8-12 weeks) to detect fetal heartbeat and ensure proper placement of baby.

Another ultrasound is typically done between 18-22 weeks to do an “anatomy scan” (check baby’s heart, spine, brain, umbilical cord, gender, etc).

Birthing Plan

As delivery time draws closer, many women choose to write out a birth plan. Usually the OBGYN/midwife and hospital will try to accommodate the wishes of the mother; however, the hospital rules and emergency situations always take precedence.

Delivering at a Hospital

You can schedule a tour of the Labor/Delivery section of most hospitals. Make sure you like the hospital that your OBGYN/midwife has privileges in. Not all hospitals are the same. Some hospitals are better equipped to help premature babies. Some hospitals have more strict policies (like limiting the number of people in the delivery room). In some hospitals you stay in the same room during labor, delivery, and post-delivery; other hospitals have you change rooms. It is good to learn the hospital policies beforehand.


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