The profession of midwife is a medical profession with defined skills set by the Public Health Code (1). A specialist in physiology, the midwife can independently monitor the pregnancy as long as it does not present complications. Thus, it is empowered to:

• perform the seven compulsory prenatal consultations;
• declare the pregnancy;
• prescribe the various pregnancy exams (blood tests, urine tests, screening for Down’s syndrome, pregnancy ultrasounds);
• perform obstetric ultrasounds;
• prescribe medication related to pregnancy;
• perform the prenatal interview for the 4th month;
• provide birth preparation classes.
• in maternity or private clinic;
• in private practice (2);
• in a PMI center.

As soon as a pathology occurs (gestational diabetes, threat of premature childbirth, high blood pressure, etc.), a doctor takes over. The midwife can however practice the care prescribed by this doctor.

On D-day, the midwife can ensure delivery as long as it remains physiological. In case of complications, she will call a doctor, the only one authorized to perform certain acts such as instrumental extraction (forceps, suction cup) or cesarean section. After the birth, the midwife provides first aid for the newborn and the mother, then the follow-up of childbirth, post-natal examination, prescription of contraception, perineal rehabilitation.

As part of the overall support, the midwife provides pregnancy follow-up and has access to a technical platform in the maternity ward in order to carry out the delivery of her parturient. Unfortunately, few midwives practice this type of follow-up, often for lack of agreement with the maternity hospitals.

Unlike the midwife, the obstetrician-gynecologist can take care of pathological pregnancies: multiple pregnancy, gestational diabetes, high blood pressure, threat of premature birth, etc. He performs difficult deliveries (multiple delivery, breech delivery), deliveries by instrumental extractions (suction cup, forceps) and cesarean sections. It is also called for any complications after childbirth, such as delivery hemorrhage.

The obstetrician gynecologist can exercise:

• in private practice where he ensures the follow-up of pregnancy, and performs deliveries in private clinic or public hospital;
• in the hospital, where he monitors high-risk pregnancies;
• in a private clinic, where he monitors pregnancy and childbirth.

The general practitioner can make the declaration of pregnancy and, if the pregnancy does not present complications, prenatal visits until the 8th month. In practice, however, few future mothers choose their general practitioner to monitor their pregnancy. The attending physician still has a role of choice with the pregnant woman to treat small everyday ailments, especially as self-medication should be avoided during pregnancy and some ailments, mild in normal times, may turn out to be. a warning sign during those nine months. A fever for example must always be the subject of a consultation. The general practitioner is then a close contact of choice.

Even if the pregnancy does not present a priori any complications, it is possible to be followed by your town gynecologist and to register at the private clinic where he practices so that he ensures the delivery. For some future mothers, it is indeed reassuring to be followed by a known person. Another possibility: to be followed by your city gynecologist and register at the clinic or maternity unit of your choice, for different reasons: proximity, financial aspect (depending on the complementary mutual, the delivery fees of the gynecologist in a private clinic are more or less supported), establishment’s birth policy, etc. The prenatal consultations of the last trimester will then be carried out within the establishment, which will have received the pregnancy file from the gynecologist.

Some future mothers immediately opt for follow-up by a liberal midwife, emphasizing their less medical approach, greater listening, especially for all the little ailments of everyday life, and more availability – but it is not a question of there that subjective opinions. The financial aspect can also be taken into account: the vast majority of midwives are contracted in sector 1, and therefore do not exceed fees.

The desired type of childbirth is also taken into account when choosing a practitioner. So mothers wishing for a physiological childbirth will turn more easily to a liberal midwife, or to follow-up in a maternity unit offering, for example, a physiological center.

But in the end, the most important thing is to choose a person with whom you feel confident, to whom you dare to ask any questions or express your fears about pregnancy and childbirth. The practical aspect should also be taken into account: the practitioner must be easily available for an appointment or by telephone in the event of a problem, and it must be possible to go to consultations easily, especially in the last trimester when it becomes more difficult to travel. .