What should I choose first? My midwife or OB or my hospital or birth center?
Monday, May 26, 2025
Back in April when I taught All Things Birth (our mini-class for folks trying to conceive or in their first trimester) a student asked for advice about where she should deliver.
Her friends suggested a “trendy” hospital in New York City, but when she called around to find a provider, everyone was booked for her due date. She started her search anew and found a provider she loved who delivered in a totally different –and totally fine– hospital.
Your birth location defintely matters. There are important hospital wide considerations such as wether or not they have bathtubs in L&D rooms or they offer nitrous oxide for coping. Some folks are interested in choosing –or actively not choosing– a hospital based solely on their C-section rates. And while that _can_ be a useful tool overall, we’ve found that in many cities, an individuals provider, or practice’s C-section rate is actually a more helpful barometer. For example, we know many a practice with a 13% primary C-section rate working within a hospital that has a 45% C-section rate in New York City alone.
All that said, we typically recommend choosing a midwife or doctor before choosing a hospital. (Wondering what the differences are between a midwife and OBGYN? Read this!)
We recommend choosing your provider before your birth location for these 5 reasons:
1. You’re considering having an out of hospital birth and are looking for homebirth midwives or the practitioners that serve your local birth center.
2. You have an existing relationship with, or you’ve gotten a recommendation from a doula, friend, or family member for a provider whose practice aligns with your general birth preferences. (Not sure what your birth preferences are? Come to All Things Birth!)
3. You are in a marginalized group and would feel most confident with a provider who understands your lived experience (eg a Black OB/GYN or Midwife, or an LGBTQ+ affirming provider).
4. You fall into a special category and therefore need specialized support! There are providers who specialize in VBAC, Breech, Multiples, or medically complex pregnancies.
5. You searched your insurance directory to see which providers in your area take your plan, and you found a provider you’re interested in working with.
(This PDF lists questions that might be helpful to ask a prospective provider.)
Consider choosing your hospital before your provider if:
1. You live in a more remote or rural area and need to consider proximity first.
1. You live anywhere but are a second-time (etc) parent and had a precipitous birth with your first, so want to choose the closest hospital.
2. You are interested in the comfort or pain measures offered (eg nitrous oxide, bathtubs, family-centered cesareans) in a specific location.
3. You are interested in special programs featured by that hospital (accessible doula programs, Simple Birth Program, Rainbow Clinic)
Want more advice on setting yourself up for success? Join an upcoming All Things Birth class!
Find live, virtual & on-demand classes and support groups near you: