Types of Birthing Practices

You may come across many different options when it comes to where to deliver your baby. Here are some options other than your typical clinic setting:

• A solo practice would be one where the doctor/midwife works independently, but has another doctor/midwife that covers for him/her when he/she is away. 
• Partnership or group practice. Usually two or more doctors/midwives join up to take care of patients. You'll often see them on a rotating basis (though you usually get to stick with your favorite one throughout most of your pregnancy - you might start rotating at then end when you're there on a weekly basis). The advantage of this type of practice is that you'll have a familiar face with you when it comes time to deliver, since you'll have met all the doctors. The disadvantage is that you may not like all of the doctors and be disappointed with whoever ends up at your birth. Also, one doctor may have a different point of view than one of the others; this could become either a blessing or a curse.
• Combination practice would include a group of obstetricians and nurse-midwives. The advantages and disadvantages are the same as in the partnership/group practice. The added advantage is the extra attention you'll receive from your midwife. You'll have the option to let the midwife be there at the delivery, but your OB available at the drop of a hat.
• Birthing Centers are usually headed by nurse-midwives and physicians are on call as needed. Some of these are right in a hospital and others are separate facilities. These are for low-risk pregnancies. The advantages are great for women who prefer a midwife to be their primary caregiver. The disadvantage would be that if you develop into a high-risk case, you'll have to transfer to a physician and start a relationship all over again. Or, if a complication happens in delivery, you may end up with a physician that is a total stranger to you. The disadvantage of a separate facility (on that isn't in a hospital) would be that if you have a complicated delivery, you'd have to be transported to the nearest hospital for emergency care. CNMs and birthing centers are usually less expensive than physicians and hospitals. 
• Indpendent certified nurse-midwife practices are of service to low-risk pregnancies. Sometimes these deliveries take place at home, but a lot of the time they are in a hospital or birthing center. A CNM should have a physician available for consults and emergencies. Care by an independent CNM is covered by most health plans, though only some insurance companies cover midwife-attended home births or births anywhere but a hospital.