14 Major Decisions to Make During Pregnancy

Pregnancy decisions go far beyond nursery themes or picking out the perfect stroller. Once you and your partner decide to become parents, there are several important choices to make before your baby arrives. Many families wait until the last minute, only to discover certain options are no longer available. Now is the perfect time to think through these bigger questions so you feel prepared, confident, and supported throughout your pregnancy.

Major Decisions To Make During Pregnancy

These choices can influence your birth experience, postpartum recovery, and the early months of parenthood, so it helps to think through them ahead of time.

1. Who should be my care provider?

Choosing the right provider shapes your entire pregnancy and birth experience, so take time to explore who aligns best with your preferences.

As soon as you find out you’re pregnant, it’s time to start thinking about the type of practitioner you want to work with throughout your pregnancy and for the birth of your baby. I want to let you know that this doesn’t have to be your current provider. Even though they may be super friendly and you have known them for years, that person may practice differently than how you want your labor and birth to go.

Take me, for example! When I first moved to Houston, I googled “great OBGYNs” that accepted my insurance and selected an OB/GYN group with good reviews and a nice reputation. My doctor was super lovely, and her staff was very nice. But once I became a doula and saw how she and her fellow partners practice during labor and delivery, I knew I had to find a new provider. The way they worked compared to other doctors I saw was not what I wanted.

This is why it’s essential to ask around and consider what type of experience you want and which person can provide it, whether it’s an OB/GYN or a certified midwife. In my opinion, it’s the biggest decision to make during pregnancy.

Related: 21 Questions To Ask Your OB/GYN at Your First Prenatal Visit

Once you have chosen the practitioner you would like to work with, that decision will dictate where you will have your baby — in a hospital, a birthing center, or at home, which leads me to your next decision:

2. Where should I give birth?

Your birth setting influences everything from policies to comfort to how supported you feel during labor, so it’s worth exploring your options early.

When making this decision, I want you to imagine where you would like your baby to be born: in a hospital, birth center, or home birth.

I highly recommend getting friends’ recommendations and listening to their labor and birth experiences. I also recommend talking to doulas. They are familiar with all the hospitals and doctors in your area. They can tell you the truth about the type of experience you can probably expect. Exploring different options is probably a good idea if they are negative stories.

Once you have a few ideas of where you would like to give birth, based on the recommendations you’ve heard, visit the places you’re considering. Then, check with your insurance provider to confirm your coverage. This should be done early in your pregnancy.

Related: 5 Steps to Understand Your Health Insurance Before Giving Birth

3. Should I find out my baby’s gender?

Nowadays, most expecting parents choose to find out their baby’s gender during their pregnancy. Knowing can help them feel better prepared. (You can determine the gender through a blood test as early as 8 weeks or at your 20-week ultrasound). Others prefer the old-fashioned approach of not finding out the gender and being surprised in the delivery room.

I will say that the families I have worked with that have waited to find out the gender have the most magical experiences. Discuss this with your partner and decide what feels right to you. Finding out the sex of your baby allows you to:

narrow down the name instead of choosing a name for each gender
decorate the baby’s room (nursery) with the colors that you would like, rather than going with a gender-neutral nursery theme
buy specific baby clothes ahead of time
have a gender-reveal party!

Keeping it a surprise can be a great motivator during labor and delivery, though. Women are eager to meet their little ones, having waited so long to find out if they are having a daughter or a son. And when they finally get that moment to meet their child and welcome them into the world, it is absolute pure joy.

4. What’s my maternity leave plan?

Planning ahead helps reduce stress for both you and your workplace, and gives you time to understand your leave options before baby arrives.

Informing your boss about your pregnancy and arranging your maternity leave plan is necessary. Most women usually tell their employer about the big news at 12 weeks (or before their pregnant belly begins to show). This news is always appreciated, as it allows for several months to plan for your absence. I understand that revealing your pregnancy to your employer can be nerve-wracking, but there is nothing to worry about. Once you have announced it to them, you can discuss your maternity leave options with your company and decide what works best for you and your family.

5. What are my plans after maternity leave?

Another big decision during pregnancy is how long you will take away from work after childbirth. It’s relatively easy for some women to make this choice, while for others, it can be a tough decision. Most mothers have a plan in mind before giving birth. However, your plans may change depending on your physical or mental health after giving birth, your baby’s health, and other factors you can’t predict. Family finances are a significant consideration, so calculate whether you can afford to stay home.

Additionally, consider the pros and cons of staying at home versus returning to work. If you do plan to return to work, start researching childcare options during your pregnancy. Places fill up quickly in many areas and often have waitlists several months in advance. Try to start your research early.

Related: Going Back to Work After Baby Checklist

6. What should I name my baby?

This is one of the most fun and difficult decisions during pregnancy! Some women have a long list of potential baby names in hand even before they are pregnant, while others don’t know where to begin with this monumental decision when it comes time to name their baby. If you can’t decide before you go into labor, make a shortlist of about three potential names (per sex or baby, in the case of multiples) when you head to the delivery room. It can help you and your partner feel excited rather than overwhelmed by your selection. It also allows you to meet your baby and see if the name fits them.

7. What childbirth education class will I take?

Some doulas, birth centers, and hospitals offer childbirth education classes to teach you and your partner what to expect from labor and birth. There are numerous types of childbirth classes, so it’s beneficial to research and ask for recommendations to determine which class best suits your needs. Some of the options are:

Lamaze
ICEA
Hypnobabies
Hypnobirthing
Bradley Method
Birth Boot Camp
The Birth Prep Challenge (Baby Chick’s new course!)

Some classes you can take during pregnancy are one day, a few days, or a few weeks long. You need to take your childbirth class during your third trimester, so it’s important to register for the class by your second trimester. These classes will cover everything from breathing and relaxation techniques to help you cope with labor pains to medical procedures and what to expect during labor and birth.

8. Who should be present at the birth?

Your support team plays a significant role in how calm, safe, and encouraged you feel during labor, so choose the people who truly support you.

Some hospitals have policies on how many visitors you can have in the labor and delivery room. Be sure to ask how many people can be in the room with you on your big day. Some hospitals will allow you to have as many people as you want. Others may only allow three visitors in the room (including you, the laboring mom). So, if you would like to have your spouse, mother, doula, birth photographer, or friend, everyone will have to rotate in and out of your room during your time in L&D.

Many women I work with usually have their spouse with them and their doula with them. Their families are waiting in the waiting room, coming in periodically to check on them. Stand your ground if you don’t want anyone other than your partner at the hospital during labor and delivery! It is your decision who will be in the room during your delivery, and you need to feel as calm and supported as possible. Surround yourself with positivity and people who support you and your wants.

9. Should I use pain-relieving medications?

The question of whether to have pain medication during your labor and birth or to have an unmedicated birth is something to think about and research before making a decision.

You may think you want one thing, but then change your mind. It’s always important to learn about the pros and cons, as well as the benefits and risks, of each procedure and medication, because there are more than one option for pain medication during childbirth.

Remember that the decision you make during pregnancy isn’t set in stone. Even if you have a written birth plan, you may change your mind at the last minute, which is okay. However, it’s essential to educate yourself and understand what you want your experience to be like.

10. Should I breastfeed or bottle feed my baby?

According to the American Academy of Pediatrics (AAP), breastfeeding is recommended as the healthiest way to feed your newborn.¹ However, it does come with a few barriers and challenges. Bottle feeding is a fine alternative and, in some cases, is the only way some women can feed their babies.

The choice of breastfeeding or bottle-feeding is entirely up to you. If you haven’t already experienced this, it’s one of the most sensitive and controversial subjects for new mothers, so be kind to yourself about whatever decision you make. You need to tune out other people’s judgments (even though it can be difficult) and be open to changing plans if necessary. We are all doing the best we can with the circumstances we have.

11. Should we bank our baby’s cord blood?

Some parents choose to save and store their baby’s umbilical cord blood because it is rich in stem cells that could be used later to treat many different types of illnesses and disorders. Private cord blood banking (where the blood is available only to the donor’s family) can be costly. In contrast, public cord blood banking is usually covered by insurance and makes the blood available to anyone in need. However, a lot of what is donated is discarded.

Some studies have shown that private cord blood banking may be cost-effective only for families with an increased risk of certain medical conditions that can be treated with stem cells, and even then, it is not a guaranteed treatment. Research cord blood banking and weigh the options with your partner. It never hurts to be extra prepared because those stem cells could be used for that child or your next child.

12. Should my baby boy be circumcised?

Along with breastfeeding and bottle-feeding, this is another highly controversial topic. Choosing whether to circumcise your baby boy is a big decision during pregnancy. Hospitals usually perform this procedure 24 hours after birth, but you could also go to a mohel and have it done at your home or a clinic. Circumcision, the surgical removal of the foreskin that covers the tip of the penis, has multiple pros and cons.

According to an expired policy statement from the AAP, the health benefits are not significant enough to recommend the procedure for all male newborns. However, the benefits of circumcision are enough to justify the procedure for families choosing it. They go on to say parents should ultimately decide whether circumcision is in the best interests of their male child.²

This is a personal decision for you and your partner to make. Do your research and decide what you think is best for your son.

13. Who Will Be My Child’s Pediatrician?

A few parents forget about this question and don’t choose a pediatrician before their baby is born. If you don’t choose your baby’s pediatrician before you give birth, the hospital will assign you one while you and your baby are there. You may not like the pediatrician who is assigned to your baby. This is why it’s a good idea to start researching by the end of your second trimester.

Ask your primary care physician and friends for recommendations, then interview your top picks to find the right fit. Some pediatricians offer prenatal consultations, allowing you to meet with them and discuss your preferences, ensuring you’re on the same page about everything, and review your baby’s vaccination schedule. That way, you can determine if they are the right doctor for you and your baby.

14. Who can visit and help after the baby arrives?

Planning for visitors and support can make early postpartum smoother and protect your recovery and bonding time.

It’s essential to have a plan in place when bringing your baby home from the hospital. Some questions you need to consider are: who would you like to see your baby right after birth? When would you want them to visit? Either at the hospital or at your home, and for how long?

Discuss some reasonable visitation plans with your partner so that you both feel comfortable during your first hours, days, and weeks as parents. As your baby’s due date approaches, share your wishes with your friends and family, even if it’s to lay some ground rules. But keep an open mind about visitors at home, and line up as much help as possible for your first days and weeks at home.

The third trimester is a good time to consider if you would like a postpartum doula to come and help you as well. Their assistance can really help during your transition to parenthood. You might be surprised by how much help you need and how much a friendly face can lift your spirits as you adjust to motherhood.

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Pregnancy comes with many important choices, but you don’t have to make them all at once. Talk with your partner, trust your instincts, and reach out to your care team when you need guidance. Preparing ahead will help you feel supported and confident as you get ready to welcome your baby.