The person you choose for your obstetrical care can have a major influence on how satisfied you are with your pregnancy experience. You may have a doctor or midwife in mind before you become pregnant, and your friends undoubtedly will pass along recommendations. But your needs and expectations may not be the same as those of your friends. And your needs may change during your pregnancy.

Before choosing your caregiver, consider all of your options — family physicians, obstetricians, certified nurse-midwives and perinatologists. And remember, no matter what type of obstetrical caregiver you choose, the goal is the same — healthy mothers having healthy babies.

Family physicians are superb primary care providers. They have training and experience in various fields of medicine, including obstetrics, pediatrics, internal medicine, gynecology and surgery, which allows them to deal with many problems and skillfully choose specialists when referral is necessary. Because of this experience, family physicians are able to manage most pregnancies, including the minor surgical procedures that may accompany vaginal delivery. Family physicians may work in solo or large group practices.

You might choose a family physician if:

• You want your doctor to be involved with every member of your family, from newborns to grandparents.
• You want continuity from prenatal care throughout childhood and beyond.

Doctors of obstetrics and gynecology, commonly abbreviated as OB-GYN, specialize in the care of women during pregnancy and in diseases that affect a woman’s reproductive organs. OB-GYNs have advanced training and experience in obstetrics, infertility and surgery. They may work in small or large group practices, or in hospital or clinical settings.

You might choose an OB-GYN if:

• You have a high-risk pregnancy. Risk factors may include maternal age over 35, development of gestational diabetes or preeclampsia.
• You're carrying twins, triplets or more.
• You have a pre-existing medical condition, such as diabetes or hypertension.
• You wish to avoid a transfer of care if an operative vaginal delivery or a Caesarean delivery is required.

Perinatologists are specialists in maternal-fetal medicine. They've received special training and certification in the care of very high-risk pregnancies. These highly skilled physicians concentrate exclusively on pregnancy and the unborn child, dealing with the most severe complications that arise.

You might choose a perinatologist if:

• You have a severe medical condition complicating your pregnancy, such as heart disease, kidney disease or cancer.
• You're a known carrier of a genetic condition that may be passed on to your baby.
• Your baby has been diagnosed in utero with a medical condition, such as spina bifida.

Certified nurse-midwives (CNMs) are registered nurses who have completed advanced training and have graduated from an accredited nurse-midwifery program. CNMs work in collaboration with at least one doctor. They provide maternity and gynecologic care in private practices, birthing centers and hospitals nationwide. Despite popular belief, most CNMs don't oversee home births — out of their desire to provide the best and safest care.

CNMs provide preconception, maternity and postpartum care for women at low risk of complications during pregnancy. Some can prescribe medications, and most can recommend diet, exercise and lifestyle changes. Like physicians, CNMs discuss medical procedures, such as amniocentesis, thoroughly with parents-to-be and encourage them to make informed decisions. CNMs don't provide these types of services, however.

You might choose a certified nurse-midwife if:

• You're free of health problems and you're experiencing a low-risk pregnancy.
• You want someone who can spend a significant amount of time discussing your pregnancy with you.

Before choosing your obstetrical care provider, consider these questions:

• Is the caregiver located close to your work or home?
• Is the caregiver able to deliver your baby in the hospital where you want to give birth?
• Does the caregiver work in a solo or group practice? How is call time shared?
• Is the caregiver available to answer questions in between your scheduled appointments?
• How much do the caregiver's services cost?
• What level of expertise do you feel your pregnancy demands?
• How much do you value the opportunity for your caregiver to serve the entire family?

Whatever the practice style of your obstetrical caregiver, you deserve someone who listens to your concerns and provides helpful answers to your questions. Your caregiver should help you become as informed as you can be and allow you to participate in medical decisions affecting you and your baby.