As soon as you find out you are expecting, decisions need to start being made. There are the fun and exciting ones like deciding on your baby’s name, nursery style, and which cute clothes and accessories should be added to the registry. There are also the more serious things to think about, like how do you want the delivery to go and how do you actually take care of a baby.
If you are pregnant or thinking about becoming pregnant, it’s a good idea to start as early as possible with getting your care team in place. These are the providers who will assist you in pregnancy and delivery as well as postpartum after your baby is born.
During pregnancy, you’ll want to make sure to have prenatal care from a medical provider. Most commonly, expectant mothers make an appointment with an obstetrician or OB-GYN, and will see this doctor for check-ups until the baby is born and in postpartum. An OB-GYN is a doctor who specializes in obstetrics (pregnancy and delivery) and gynecology (women’s reproductive care).
If you have a low-risk pregnancy, you may see a certified nurse midwife instead of the OB-GYN. A midwife is a registered nurse who is also certified through the American Midwifery Certification Board to help with pregnancy and birth.
Both a midwife and an OB-GYN can see patients during pregnancy, help deliver a baby and provide postpartum care and education. Midwives cannot perform c-sections but they can assist with them.
“Both providers truly have the same goals of ensuring safe outcomes for both parents and for babies,” explains Dr. Catherine Caponero, OBGYN at the Cleveland Clinic. “They both have a personalized family focused approach. At the Cleveland Clinic, in particular, at Hillcrest, we have a really wonderful teams-based approach, where a midwife team handles most of the low-risk patients. And our physician team focuses on the higher risk patients or the patients who are more likely to need surgical intervention or medical intervention.”
In addition to medical care, expectant parents may also want to consider hiring a doula to be part of their care team.
A doula is a nonmedical professional who can provide educational, emotional and physical support throughout pregnancy, delivery and postpartum.
“We’re like your cool aunt or cool older sister who knows about birth and postpartum and babies and really comes in without any of the judgment or the opinions that sometimes our family members can have or our friends can have,” says Dr. Ashley Sova, founder of CLEBaby, which provides pregnancy, birth and postpartum services to families throughout Northeast Ohio. “Doulas are like coaches and friends who help you understand options and just kind of guide in decision making.”
A doula can help you understand what’s going on in your pregnancy and help you prepare for birth.
“This doula is going to be your partner in planning your birth, the interventions you want, you don’t want, the decisions you’re going to have to make in the heat of the moment, they’re going to educate you on all of that,” explains Lisa Falkenstein, founder of Nurtured Foundation, which provides doula services across Northeast Ohio. “So, you go in eyes wide open, instead of just reacting as things are happening to you.”
They can also provide support to your partner by keeping them educated and level headed during the process.
“It’s really hard to watch your spouse or your partner, going through the pains of childbirth,” Falkenstein says. “So, we also educate them as to what’s happening, and keep them focused and grounded as well.”
After birth, doulas can also assist families with newborn care training, breastfeeding help, overnight care and more.
“Even for people who do easily connect to parenthood, it’s just so helpful,” Sova says. “Our clients say it’s life changing. It’s transformative, to be able to have doulas, to be able to have expert resources, who really care about your family and can help you advocate for yourself to really manage some of the overwhelm and the newness and provide direction and a shoulder to cry on.”
In most cases a doula is not covered by health insurance but you can use your Health Savings Account (HSA) or Flexible Spending Account (FSA) to pay for the service. Some companies may also pay for doula services for employees.
Hospital Services
In addition to securing your care team, you’ll also need to decide where you’re having your baby and how you’d like the birth to go. Your doctor or midwife will likely have a certain hospital (or multiple hospitals) where they have admitting privileges.
You may want to tour the hospital beforehand and familiarize yourself with the services offered to create your birth plan.
“At Hillcrest, we offer several low intervention birthing suites where we’ve got labor tubs available as well,” Caponero adds.
The hospital may also provide classes and services to help you prepare.
“During pregnancy, we offer a lot of childbirth classes, breastfeeding classes, to help parents prepare for both birth and delivery and breastfeeding afterwards,” Caponero says. “We also have some really good preparing for baby classes too, so that parents know what to expect after they bring the baby home.”
You may also want to see what type of neonatal or NICU services are available in the event that your baby would need extra care.
After birth you may need lactation services, pelvic floor therapy, or other specialists for recovery.
“If patients did have a difficult recovery, we have a really wonderful Urogyn (urogynecologists) team that can help with postpartum vaginal repairs,” Caponero says. “We also have a really wonderful cardiology team for our patients that have histories like high blood pressure, or preeclampsia to make sure that they have optimal care postpartum as well.”
The 4th Trimester
The 12 weeks following birth is often referred to as the “fourth trimester.” This is the postpartum period when your body is healing from childbirth and you’re
adjusting to life with a newborn.
Whether you’re a first-time parent, or have had multiple babies, this stage can be challenging for parents who are adjusting to a new family dynamic.
“We spent so much time as a society focused on pregnancy and childbirth. But we never think about what happens when the baby actually gets here and what does that look like physically and emotionally and practically,” Falkenstein says.
Having a postpartum plan can help your family decide how you’re going to handle household responsibilities and caregiving duties.
In addition to finding your new rhythm, the birthing parent is also adjusting to a major physiological change and sometimes a change in mental health. Parents should pay attention to signs of postpartum depression and anxiety.
“My biggest piece of advice is to reach out and ask for help,” Caponero says. “Along with all these huge physical changes, there’s a bunch of sleep deprivation, which makes it really challenging for parents to get their bearings straight. So, making sure that they are reaching out for help from their community, from resources, because you don’t need to struggle alone.”
