Roles of your Medical Birth Team
If you read our What is a birth team and do I need one? article, you noted that various medical providers make up some of the members of your “birth team.” Sometimes, especially for a first-time mother, it is not always clear what the differences are between medical providers, nor who is primarily responsible for which tasks or roles, including the role of labor support. You are told to “choose your birth team wisely,” but how do you know who to include, what they will be doing and how much time they will spend with you? To help clarify, we have created a brief “job description” for many of the most commonly-present medical team members.
Midwives have extensive training and experience in normal, healthy pregnancy and birth and provide medical care throughout your pregnancy and birth (and beyond). Your midwife may or may not see herself as a support person, although she will bring experience and understanding of the needs of a laboring woman. Her role in labor support is an important topic to ask about ahead of time. However, it is important to note that in a hospital setting, even the most supportive midwife may simply be unable to be with you for the bulk of your labor if she has other clients in labor, has been awake for many hours already, or if other factors affect her ability to be present with you. Midwives in birth centers or home births often play a greater support role, though your health and baby’s health will always be her primary focus.
Your OB/GYN (Obstetrician-Gynecologist) or Family Medicine physician is a specialist who provides medical and surgical care to women (or families). Typically, women hire either a physician or midwife to provide medical care during pregnancy, though some group practices employ both. Like with a midwife, your physician may be managing multiple people in labor and/or office hours during your labor. This means that your doctor may not be present for much of your labor other than a few moments where he/she may stop in, and at the very end to assist in the birth, often after pushing has already started. Your physician will be receiving periodic updates on your labor through the nurse who is caring for you, or sometimes through residents at the hospital.
Residents are physicians who have graduated from medical school and are going through on-the-job medical training. They often provide care for laboring mothers at larger hospitals. Residents are eager to learn and try new things, but may be lacking in experience, especially with normal birth. Residents are often the go-between doing the communicating with your primary doctor (OB) and your nurse. Depending on circumstances, residents sometimes manage all of the care you receive until birth is near.
Labor and delivery nurses are the “worker bees” in maternity units. They do the monitoring of your baby, put in IVs, do charting, and carrying out midwife’s or doctor’s orders. You see them frequently during labor. Some nurses enjoy providing support and encouragement during labor, while others do not see labor support as part of their role and/or primarily rely on medical pain management techniques (like IV narcotics or epidurals) instead. Nurses communicate with your care provider and advocate for you. Keep in mind that in very busy units or when nurses are managing multiple patients at a time, your nurse might not be present for periods of time and/or not involved in your labor support.
Other people who may be involved in your labor and birth experience include medical students, interns, student nurses or other staff who are somewhere in their journey toward a medical degree, license or certification. Members of this group are usually in a bystander role, learning through observation but not directly involved in your care.
If you are giving birth in a hospital, you will have some medical personnel caring for you, most likely people that you don’t know prior to coming to the hospital. This is simply part of the process of hospital birth. However, keep in mind that it is always your right to ask for someone else, such as a new nurse, if you are having conflicts or difficulties. You may also inform the medical professionals that you prefer not to have any “extras” such as residents, students or interns. The bottom line is that you get to decide who is with you for your labor and birth. They’re all on your team, but you are the captain and definitely the MVP.
Now that you understand the roles of medical providers a bit better, find tips on choosing the right care provider in the two part article “Steps for choosing the right care provider.” For more information on assembling a birth team and finding support during labor, see our article “What is a birth team and do I need one?” The effort you put into creating a supportive birth team will pay off!