Choosing a Care Provider
Having a baby is one of the most amazing things a woman can do. It can also be the scariest. It’s easy to worry about how you can afford a baby, if labor is going to hurt or who will take your insurance.
One of the most important steps though, is choosing a care provider. You want someone who will go along with your preferences, support you during labor and who is experienced and knowledgeable in their profession.
So how do you make sure that you’re choosing the right person? First impressions say a lot, but there are some questions that need to be asked before you choose.
Finding Out We’re Pregnant!
When I found out that I was pregnant with our son, I was in a bit of shock to say the least. I was still in college and working towards a full time career, with no plan to have children for a long time. My husband was equally surprised. ” Are you serious? You’re not teasing me, right?” were the first words out of his mouth when I told him.
We were both thrilled to be pregnant, but I knew I had a lot of research to do in order to make informed decisions about my pregnancy and birth.
Not Such a Smart Idea
I started off seeing a female obgyn at our local hospital. I knew I wanted a natural labor, preferably a water birth, but a home birth wasn’t an option since I was high risk.
My very first appointment sent off flashing red alarm bells, but I ignored them, thinking I had no other options. I have a heart problem that causes me to pass out when I’m over exerted. And labor can be quite exerting.
When I asked the doctor about testing, or precautions that could be taken to ensure a safe delivery, she said, “We’ll worry about that during labor.” Not something you want to hear from your doctor! She didn’t even use a stethoscope to check my heart beat. She also became defensive at the mere mention of a birth plan.
I knew that I didn’t want to be fighting with my doctor and hospital staff during labor, so 6 months into my pregnancy I began the search for a new care provider. I later found out that my local hospital required all delivering mothers to be on their back in bed with their feet in stirrups. Definitely not something I wanted to endure!
The Search Begins… Again
I wasn’t sure where to begin. I spent days calling all the hospitals within 60 miles to see if they had midwives on staff. I finally found the perfect place. A birth center with an attached suite for your family to wait for you. They made fresh nutritious electrolyte smoothies for the new mothers and baked fresh bread every morning for your breakfast.
But, they didn’t take our insurance.
When I finally found a hospital that had midwives and also took our insurance, I wanted to be sure it would be a good experience. I spent well over a week researching standard hospital procedures. I read about circumcision, episiotomies, c-sections, epidurals, pitocin, vaccinations at birth and everything else I could find. From my research I created a birth plan. And from that birth plan I created interview questions for the midwife.
What to Look For
It’s important that your care provider works with your decisions during pregnancy and birth, but also has the wisdom to know when different measures need to be taken in an emergency situation. We wanted to delay cord clamping until it had stopped pulsing. However, because I had excessive bleeding, the staff had to hand my son to my husband and rush me off to stop the bleeding.
Below is a list of questions to ask your midwife or doctor. Some of these would even apply to a doula. Most care providers will do an interview session with you, although doctors usually won’t spend as much time. Be sure to tour the hospital or birth center and ask lots of question there as well to see if they can accommodate the birth you want. It doesn’t do any good to plan for your dream water birth if the hospital won’t allow you to leave the bed.
Questions to Ask
Prenatal Care and Before you Begin
- How do you see your role as a care provider?
- What is your birth philosophy?
- How long have you been a midwife and what are your certifications?
- Describe a typical prenatal visit with you.
- Do you work with VBACS? What is your experience with this?
- What will I need to provide for a home birth?
- What supplies do you bring to a birth?
- How many births have you assisted?
- Do you have a backup hospital and doctor?
- What hours are you available in case of an emergency?
- Do you require certain pregnancy tests?
- What happens when I go past 40 weeks, 42 weeks?
- Do you require or offer any childbirth classes?
- Will you deliver multiples?
- Will you deliver a breech baby? If not and the baby is shown to be breech well into the labor, who would you refer me to?
- Do you have experience turning a baby and how do you do it? What is your success rate on this?
- Do you work with doulas or birth photographers?
- Who assists you at a birth? Can I meet them?
- Do you have experience with any types of natural medicine? ie herbalism, homeopathy, acupressure, essential oils
- What conditions do you consider “high risk” and what would happen if I develop one?
- Do you allow/provide for a water birth?
- What is your hospital transfer rate?
- In the event of a transfer, would you accompany me to the hospital, stay with me there?
- What is your C-section rate? (obviously a midwife wouldn’t perform this procedure, but how often does she hand a mother over to the surgeon?)
- At what point will you arrive at the labor?
- What is your plan if another client goes into labor at the same time as me?
- Have you ever missed a homebirth and why?
- Are you able to repair a torn perineum?
- How do you handle cord clamping?
- Do you use a fetal scope or Doppler to monitor the baby?
- What happens if you’re sick or for an emergency reason are unable to attend me?
- What precautions do you take for perineal tearing?
- What do you do if the cord is wrapped around the baby’s neck?
- How often do you perform episiotomies and when would you find one necessary?
- If an episiotomy may be indicated, what steps do you try first?
- What’s the best way to communicate with you, and how can I reach you when labor begins? ie phone, email.
- Are my husband, children, etc. allowed to be present at my birth?
- Have their been any bad outcomes with a mother and/or baby before?
- How often do you perform vaginal checks and do you rely on alternate ways of assessing dilation?
- Do you have experience with postpartum haemorrhage and what precautions and interventions do you administer?
- Do you help with breastfeeding at the birth or as part of postpartum care?
- Do you have neonatal resuscitation training?
- How long do you stay after the birth?
- What post-natal care do you provide?
- What procedures are provided/required for the infant after birth? ie vitamin k, Hep B, PKU test.
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These are some fantastic points; after all, finding the proper care during pregnancy can be quite hard. However, I do like that you recommend working with a care provider that will respect your decisions. After all, a lot of the aspects of the birth ultimately come down to your decision, so you’ll want a care specialist that respects that.
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