The Best Birth for You: A How-To Guide

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'Women need to ask themselves, 'Where, and with whom, am I best able to deal with this process of labor?' ' says Block. ' 'In this huge physiological process-where my body needs to do this crazy thing of pushing out a baby-where am I going to feel safest and most comfortable?' '

Dream Team

Once you have an idea about your ideal birth, you can start assembling a team of experts who share your beliefs. According to the national Listening to Mothers II survey, women often choose a caregiver based on insurance coverage, personal recommendations, or past experience with the caregiver (for example, the person is her gynecologist). 'What struck us was that women gave very low priority to whether their chosen person fit with them, what their record was, or their beliefs,' says Sakala. 'I don't think women really understand the tremendous amount of variation between the provider classes.'

Interview at least two different practitioners, says Gould Rubin, and trust your instincts. If you're a healthy woman without extenuating circumstances, then a midwife birth could be a perfect fit, but be sure to research midwife licensure laws, as they vary from state to state. (For a guide, visit http://cfmidwifery.org/states.)

Certified nurse-midwives (CNMs) are advanced-practice nurses with specialized training in childbirth and gynecological care. They can prescribe medication in 48 states and can do routine procedures, like IVs, if necessary. The downside is that many CNMs do not attend birthing center or home births, and work only in hospitals. If you choose a hospital because it has a midwife on staff, ask about the odds of her showing up at your birth, says Gould Rubin; the midwife may be on
a rotation with the doctors.

Other midwives, generally called direct-entry midwives, include certified professional midwives, or CPMs, who are required to have out-of-hospital experience. Another group includes licensed (in 24 states) midwives, who may also be CPMs or CNMs, and lay midwives, who may have received training through apprenticeship or self-study.

No matter what road you take, says Gould Rubin, your goal should be to find caregivers who respect your needs and wants: 'Whether you want to give birth squatting and chanting to the sounds of the Brazilian rainforest, or you want to listen to Motley Crue and have a scheduled C-section, it's all good. The ultimate goal is not just a healthy mom and baby, but also a woman who comes through the experience feeling good about herself.'

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