That I know of, I think it wise when a pregnant woman uses all of the basic tools that are available to her in order to safely carry her pregnancies to term in a healthy way. Go ahead and choose a reasoned course with a mind to using the best tools available (and affordable if $$$ is a true issue)--like, if she isn't covered by health insurance.
If she thinks at the outset to go to a hospital or clinic for care during pregnancy, labor and delivery, she still should pay attention to her diet--especially with an eye towards increasing her vitamin/mineral intake, and decide--yes or no--if she should add prenatal vitamins to her dietary regimen. She should still make sure she does daily exercise that's easy and safe to do. She should still watch out for (hope not to develop) swelling in her ankles, legs and hands. She should still get plenty of rest. She should live as free from stress as she and you can manage *for her*...stuff like this.
Here's the thing:
If she thinks at the outset to work with a midwife alone for care during pregnancy, labor and delivery, she still should pay attention to her diet--especially with an eye towards increasing her vitamin/mineral intake and decide--yes or no--if she should add prenatal vitamins to her dietary regimen. She should still get daily exercise that's easy and safe to 'get'. She should still watch out for (hope not to develop) swelling in her ankles, legs and hands. She should still get plenty of rest. She should live as free from stress as she and you can manage *for her*...stuff like this.
Six anecdotal things that I want to mention about my own experiences:
First: It wasn't at all common where I lived to have midwife services available when I carried my kids to term (the '80s). For urban care at that time, most insurance companies *refused* to cover midwife services, meaning that *all costs* would be out of pocket. I couldn't afford to do that, so... Luckily, I had health insurance all three pregnancies. The first pregnancy was ectopic, I spontaneously aborted at almost 2 months, ended up requiring a D & C (dilate and curretage procedure--uterus flush and scrape)--as I developed an infection that, if not aggressively treated *could* have cost me my life--I was *that* in trouble.
Second: When I realized that I was pregnant for a second time, and faced the fact that I'd have to birth and raise my child without his father, first thing I did was change my insurance coverage from 'single to family'. First thing I did. That change caused my insurance company to pay for prenatal care. Second thing I arranged was a 'move' into a less expensive place to live in my apt complex. I went from a 1 bdrm to a studio. Then I put my head down, worked and saved all I could over the next 6 months. A month before the baby was due, I moved *back* into a 1 bdrm (same complex, again). About a week later, I went into early delivery!
I followed the same line of thinking with my second pregnancy (reduced my living expenses in order to save more).
Third: My second and third pregnancies resulted in low birthweight babies (5 lb 10 oz and 5 lb 13 oz, with both born 3 weeks early), but also, both boys were strong and healthy at birth, regardless. I got plenty of exercise as I worked during both pregnancies, and built-in with working, I had to walk at least 20 blocks per day (10 blocks total linked to catching buses to work, and to return home). One thing I failed to do during that pregnancy cost me in the long run--I'll mention that cost later.
Fourth: The only pain meds I ever received in connection with my pregnancies was DEMEROL, which I was given when I began to lose my first pregnancy. As for *blocks*, at the time, blocks were available and in use, but not offered to Black women during natural labor--at least, not done here in Phx. Black women here had to deliver 'all' of our children 'au naturel'. It wasn't until the '90s that blocks were offered to all women in labor here, but as an option only.
Fifth: I am the 8th born of 10 kids (10 live births). Except for the 9th and 10th births which happened in a hospital, all of my mom's deliveries were done by a midwife. Rural setting, though (mid-50s)--no dedicated Negro clinics/hospitals around, so I wound up being born on a farm.
Sixth: My dad's mom died during childbirth (midwife situation, again). She had had 5 prior healthy births, but for some unknown reason she couldn't deliver her 6th child. Both didn't make it.
All that (up there) is the reason why I think it wise should a pregnant woman use all of the basic tools that are available to her in order to safely carry her pregnancies to term in a healthy way.
Affordability: FIND *the money*. Find the free services. Move to less expensive digs if you gotta do that. Approach affordability thoughtfully, carry out your plans, but *make sure* you don't automatically disdain 'what is available or doable' UNLESS you and she feels confident that what's available/doable is unnecessary.
My mistake: During my second pregnancy, I didn't always take my prenatal vitamins. Didn't have the means to eat well all of the time. Money was TIGHT! I had daycare expenses that weren't subsidized. Thankfully, my baby was OK if low birthweight; but, that rascal drew so much from me that my *teeth weakened*!
NUTRITION during pregnancy is no joke! Cost me a grip to get fillings less than a year later. In the affordability battle, CHOOSE YOUR BATTLES *wisely*, OK?
Peaceful carry and delivery to you both.
One Love, and PEACE