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You just found out you’re expecting—congratulations! You’ll learn a great deal over the next nine months, and make many decisions that will shape your pregnancy and childbirth experience.

When it comes to those decisions, though, pregnant women today navigate a very different medical environment than just a decade ago. With medical literature and the experiences of countless other mothers at everyone’s fingertips via books, social media, documentaries, and podcasts, pregnancy today comes with personal birthing expectations and preferences. The doctor-knows-best attitude of a century ago has given way toward a more collaborative model of care where birthing women have greater autonomy over their care and choices.

So with all this information, how do you choose a provider? How do you plan the delivery you want? Virginia Hospital Center’s (VHC) women and infant experts explain three considerations for building the birthing experience best suited for you. 

Consider the type of provider you want

One of the most important decisions you’ll make over the next nine months is choosing your care team.

Certified Nurse Midwives: While you’re probably familiar with the type of care an OB/GYN provides, you may wonder: What is a midwife? Why choose to work with one?

While some think of midwives as someone who plays a supporting role in childbirth, midwives are actually trained as primary caregivers throughout every aspect of pregnancy, from prenatal care to delivery. Certified Nurse Midwives (CNM) are registered nurses who have completed a graduate-level nurse-midwife education.

“As a midwife, I work with my patients to make decisions together based on the experience they want, and using the latest consumer-driven, evidence-based medicine available,” says Karen King, CNM, a member of Virginia Hospital Center’s OB/GYN midwifery practice. King—who has been a practicing midwife for 13 years following 33 years as a labor and delivery nurse—adds, “I focus a lot on patient education, and discuss pregnancy from a lifestyle and whole-person approach: ‘How do you feel? What are you eating? How are you moving?’ Some of my patients want an unmedicated labor, so we prepare laboring techniques. Others say ‘I want more help managing my pain,’ so we explore all those options together.”

OB/GYN Physicians: While OB/GYN physicians employ a collaborative-care model with patients, they’re also trained to manage high-risk pregnancies and can perform surgeries. At VHC, OB/GYN Dr. Mary Crowther works closely with Karen King, and says their collaboration is key to promoting low-intervention care for their patients (that is, minimizing the need for surgical intervention during delivery).

“Working alongside midwives like Karen has made us especially skilled in low-intervention care and has minimized our use of unnecessary C-Sections” Crowther says. Recently, VHC was the only hospital in Northern Virginia earning Newsweek’s “Best Maternity Care Hospital,” a recognition driven in part by VHC’s low C-Section rate and adherence to evidence-based safety practices.

“Pregnancy care has a tendency to become over-medicalized. It’s important to see pregnancy as a natural life process and a major moment of life worth celebrating,” Crowther says. “I work with my patients to support the natural, normal process of pregnancy—and use the latest knowledge and technology available to keep moms safe.”

Maternal-Fetal-Medicine Physicians: For many women, the joy and excitement of pregnancy is tempered by caution and concern. “Pregnant women with chronic health conditions and those who have developed unexpected problems need special attention and expert care,” says Dr. Kelly Orzechowski, who practices Maternal-Fetal-Medicine (MFM) at Virginia Hospital Center. “MFM doctors work with you to monitor your health throughout pregnancy and reduce your risk of complications,” she continues. “We can do specialized testing to track healthy development and analyze genetic history and provide a range of services to prevent premature labor, minimize the risk of diabetes complications, provide fetal treatments, or re-position the baby, for example.”

Learn your options

“There’s a seemingly endless amount of information regarding pregnancy, and unlimited opinions from friends and family to consider,” Crowther says. “You are going to have questions as you evaluate your options and hear from the stories of others. As your provider, we’re here for you to weigh the options and support your utmost safety and comfort.”

The exercise behind creating a birth plan is a great opportunity to discuss your expectations, hopes and wishes for your birth experience with your care team. You might consider developing a plan with your provider that’s bulleted, simple, and easy to read—one you can bring on delivery day to communicate preferences to your hospital care team.

Topics to consider include your desired support team, medication preferences, preferred comfort measures, preferred pushing positions, prior medical injuries, and more.

Choose where to deliver

It’s important to know whether the place you deliver can support your preferences. Make sure to ask your provider where they deliver and discuss the services important to you on delivery day.

“Many of our patients and providers are drawn to deliver at Virginia Hospital Center due to our on-site Level III Neonatal Intensive Care Unit (NICU) and neonatologists from Children’s National Health System,” says Dena Carey, a registered nurse and assistant vice president of Women and Infant Services at Virginia Hospital Center. “More than 100 NICU team members work on-site to provide the best care for our babies—in the same building as our delivering moms.”

“Our labor and delivery staffs are specially trained on laboring techniques and positions and have laboring tools on-hand,” says Carey. “All our mother-baby nurses are also trained Certified Lactation Counselors, and moms have bedside lactation support 24/7 to guide them through those first few hours and days.”

“Getting rest and feeling at ease is critical for a mom’s health and recovery,” says Carey. “That’s why all our delivery and recovery suites are private with en-suite baths. We also offer bedside pre- and post-partum massage from our on-site Certified Massage Therapists.”

And while VHC has temporarily restricted visitors throughout the hospital during COVID-19, the Women and Infant division has allowed maternity patients to bring one support person through their stay. “A partner’s support throughout childbirth and recovery is critical—we made sure they can continue to come and support our moms,” Carey says. “We also allow moms to bring a certified doula or midwife for delivery—these are key components of many moms’ care teams.”

As you plan for your pregnancy, consider Virginia Hospital Center’s team of OB/GYN physicians, Certified Nurse Midwives, Maternal-Fetal-Medicine specialists, Genetic Counselors, and childbirth educators. Schedule an appointment with their maternity care team and explore their Labor and Delivery services.

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