Your care team

You deserve to be listened to, spoken to with respect, and included in every decision about your body and your baby. Good communication isn't a bonus. Research links it with better experiences, less stress, and better follow-through on care.

Illustration of a pregnant woman looking down at her belly, with a glowing brain and a baby with a glowing brain inside
Illustrated families, a doctor with a tablet, and people texting across the world, all connected by gentle lines.
Support can come from your doctor, your family, and a phone in your hand, wherever you are in the world.

What respectful care looks like

A review of research on communication in maternity care points to a few things that make the biggest difference.

Active listening

Your provider gives you full attention, acknowledges your feelings, and asks what matters to you.

Clear, honest information

Options, risks, and benefits are explained in plain words, and you get time to ask questions.

Respect for your culture

Your beliefs, traditions, language, and privacy preferences are taken seriously, not stereotyped.

Shared decisions

Your provider brings medical knowledge, you bring your values, and you decide together.

When communication breaks down

A study in which women in Malawi described their experiences during childbirth found that when providers were warm and respectful, women wanted to come back. When they were shouted at, mocked, ignored when they asked questions, couldn't understand their provider's language, or were treated worse for being poor or unable to read, some said they would rather give birth outside the health system next time. Research from many countries, including the US, describes similar barriers.

Language

You have the right to understand your care. In the US, health care providers that receive federal funding must offer language help, such as a qualified interpreter, usually at no cost. Ask for one, including for sign language.

Questions

If you're rushed, it's okay to say "I have two more questions before we finish." Writing them down beforehand helps.

Disrespect

If you're treated rudely or unfairly, you can ask for a different provider, bring a support person, or contact the facility's patient advocate.

Urgent maternal warning signs

These can signal a life-threatening problem, during pregnancy and up to a year after birth. Get medical care right away, and say that you are pregnant or gave birth within the last year. Many pregnancy-related deaths are preventable when these signs are heard and acted on.
Call 911 or go to the nearest emergency room right away for chest pain, trouble breathing, a seizure, fainting, heavy bleeding, or thoughts of harming yourself or your baby. For emotional crisis you can also call or text 988, and tell them you are pregnant or were pregnant in the past year.

If something just doesn't feel right, trust that and talk to a provider. Partners, family, and friends: if she says something is wrong, listen and help her get care. List from the CDC's Hear Her campaign, developed by the Alliance for Innovation on Maternal Health.

Free and low-cost help

Money and access shape every pregnancy. These federal programs can help.

Community health centers

Nearly 1,400 federally funded health centers offer prenatal, primary, and mental health care regardless of your ability to pay. Find a health center

WIC

Free healthy foods, nutrition counseling, and breastfeeding support for eligible pregnant and postpartum people and children under 5. Learn about WIC

Early Head Start

Free programs for eligible pregnant people, babies, and toddlers that support early learning, health, and family well-being. Learn more

Safe sleep

Babies sleep safest alone, on their backs, on a firm flat surface with no soft bedding. CDC safe sleep tips

If you feel you can't keep your baby safe

Every US state has Safe Haven laws that let a parent leave a newborn safely and confidentially at designated places like hospitals and fire stations. Reaching out for help is an act of care.

More federal resources

Moms.gov gathers federal information on pregnancy, breastfeeding, nutrition, mental health, and family support in one place.

OB-GYN, midwife, doula: who does what?

You don't have to choose between them. A doctor or midwife provides your medical care and delivers your baby; a doula can add non-medical support alongside either one. In the US, most births are attended by a physician and about 1 in 10 by a midwife, while in many countries and cultures midwives are the main caregivers through pregnancy and birth.

RoleWhat they doOften a good fit if
OB-GYNA medical doctor with four years of medical school and a four-year residency, often board-certified, specializing in pregnancy and reproductive health. Manages complications, performs procedures, and does cesarean births. Maternal-fetal medicine specialists handle the highest-risk pregnancies. Some family physicians also provide pregnancy care and deliver babies, though not all do, and not all perform cesareans.You have a health condition or higher-risk pregnancy, or you want a doctor-led hospital birth.
MidwifeA trained health professional who cares for healthy pregnancies, monitors labor, and delivers babies, and consults or transfers care to a doctor if complications arise. In the US there are three main credentials: certified nurse-midwives (registered nurses with a graduate degree), certified midwives (non-nurses with a graduate degree in midwifery), and certified professional midwives (certified by the North American Registry of Midwives, who mostly attend home and birth center births). Nurse-midwives usually work in hospitals, provide routine gynecological care, and can prescribe. Training and licensing vary by state and country.Your pregnancy is low-risk and you'd like a lower-intervention approach, in a hospital, birth center, or at home.
DoulaA trained, non-medical support person who stays with you through labor: comfort measures, breathing, massage, information, and help speaking up for your wishes. Doulas don't deliver babies or give medical advice. Many offer mental health check-ins, and postpartum doulas help at home after birth.You'd like continuous, one-on-one emotional and physical support, whatever kind of birth you have, including with an epidural or cesarean.
Your hospital teamNurses, plus your doctor or midwife, care for you safely through labor, though nurses often care for more than one patient at a time.You plan to rely on your partner, family, and care team for support.

Questions to help you choose

Finding and hiring a doula

Birth or postpartum doula?

A birth doula supports you continuously through labor and delivery. A postpartum doula helps in the weeks and months after, with newborn care, feeding, rest, and adjusting to your new roles. Some families choose one, some both.

Where to look

DONA International's directory lists certified doulas worldwide. Your provider, hospital, local parent groups, and community doula programs can also recommend people, including free or sliding-scale options.

A good doula supports your choices

DONA's code of ethics says doulas support each family's decisions without judgment and don't make choices for you or push their own preferences, whether you want an epidural, an unmedicated birth, or a cesarean.

Questions to ask in an interview

  • What training or certification do you have, and how many births have you supported?
  • How many visits are included before and after the birth, and what does it cost? Do you offer sliding-scale fees, or take insurance or Medicaid?
  • When do you join me in labor, and who is your backup if you can't come?
  • How do you support my partner and work with my medical team?
  • How would you support me if my plans change, like needing an induction or a cesarean?
  • Have you supported families from my culture, faith, or language, or with my family's needs?
  • Can I talk with families you've worked with?

Trust how you feel with them. Feeling safe and understood matters as much as experience.

Why doulas matter for mental health

Continuous labor support is linked to less use of pain medication, fewer interventions, shorter labors, and more positive birth experiences, and feeling supported and heard during birth matters for how parents feel afterward.

Paying for a doula

Some state Medicaid programs and insurers now cover doula care, and many communities have sliding-scale, volunteer, or nonprofit doulas, including programs for Black, Hispanic, and Indigenous families, who face higher risks in pregnancy. Ask your provider, hospital, or local doula organization.

Who may benefit most from a doula

Doulas can be especially helpful for first-time parents, people who had a hard or traumatic birth before, and people hoping for an unmedicated birth. In a national survey of births in 2011-12, only about 6% included a doula, often because families don't know about them or can't afford one.

Finding your team

Start with your insurance plan's list and ask people you trust. Directories can help: the American College of Nurse-Midwives and the North American Registry of Midwives for midwives, and DONA International for doulas. Midwives often care for your whole self, physical, emotional, and social, which fits a biopsychosocial approach.

Check credentials

Look for a certified nurse-midwife or licensed midwife and a trained or certified doula. Many hospitals and birth centers don't allow uncredentialed providers in the birth room.

Take a childbirth class

Whoever is on your team, a childbirth education class helps you and your support people know what to expect. Many hospitals offer them free or at low cost, online or in person.

Every choice is valid

A hospital or home birth, a midwife or a doctor, medication or none, a planned or unplanned cesarean: there's no "better" way to give birth. What matters is that you're safe, respected, and supported.

Finding a perinatal mental health specialist

Postpartum Support International (PSI), the largest nonprofit focused on perinatal mental health, created the first certification in this specialty in 2018. Providers who hold it use the letters PMH-C after their name.

What PMH-C means

The provider has at least two years of experience working with pregnant and postpartum families, completed specialized perinatal mental health training plus advanced training, and passed a certification exam.

Who can hold it

Therapists and counselors, prescribers such as psychiatrists and nurse practitioners, and allied professionals like nurses, doulas, lactation consultants, and peer supporters.

Where to look

PSI's online provider directory and free HelpLine (1-800-944-4773) can connect you with trained providers and free online support groups.

What perinatal mental health care can include

Before pregnancy

Preconception counseling to plan for your mental health, including medicines, before you conceive.

Medication guidance

Specialists who understand medicines during pregnancy, breastfeeding, and postpartum, and who weigh the risks of treatment against the risks of untreated illness with you.

Therapy

Evidence-based talk therapy before, during, and after pregnancy, including support after loss and bereavement.

Groups and partners

Support groups for parents adjusting to life with a baby, and care for partners whose mood is affected too.

This kind of care may be for you if…

If any of these fit, that's reason enough to reach out. You don't need to be in crisis to deserve support. This is a reflection tool, not a diagnosis, and your answers aren't saved.

Example: Washington State

Perinatal Support Washington runs a free Warm Line (1-888-404-7763): leave a message and a trained volunteer calls back within a day. They also offer support groups, therapy, and referrals. Many local hospitals, such as EvergreenHealth, have perinatal behavioral health programs too.

Wherever you live

Ask your obstetric provider, midwife, or pediatrician for a referral, or contact PSI, which has volunteer coordinators in many countries. Outpatient programs aren't for emergencies; in a crisis in the US, call or text 988.

A simple way to make decisions: BRAIN

Many childbirth educators teach these five questions. Tap each one.

Plan your next visit

Jot down what you want to ask. Your notes stay only in this browser.

If you're asked to join a research study

Research during pregnancy is how we learn what's safe and what helps, and taking part is always your choice. In the US, federal rules add extra protections for studies involving pregnant people. Here's how consent works under those rules:

Your consent alone

When a study might benefit you, or you and the baby, or when it carries no more than minimal risk to the fetus and seeks important knowledge that can't be gained another way.

Both parents' consent

When the possible benefit is to the fetus alone, the other biological parent (the regulation says "father") must usually consent too. That isn't required if they can't reasonably be found or reached, can't consent, or if the pregnancy resulted from rape or incest.

Your rights

You can ask questions, take time to decide, say no, or leave a study at any time without it affecting your regular care.

You don't have to wait until it's bad

These free US lines are for parents, partners, and anyone supporting them, during pregnancy and after.

Outside the US, contact your local emergency number or health service. If someone has confusion, hallucinations, or thoughts of harming themselves or the baby, call 911 or go to an emergency room.

Physical warning signs like chest pain, trouble breathing, a severe headache, or heavy bleeding during pregnancy or in the year after birth also need care right away. See urgent warning signs

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