Other than the work you do to prepare yourself for birth, there are 2 factors that will have the greatest influence over your experience. Those 2 factors are:
- Who you choose for your prenatal care.
- The location you choose to birth.
Who you chose to provide your prenatal care and attend your birth will be one of the most important decisions you make in your lifetime. There is an incredibly wide variety of birth interventions that take place in different birthing rooms. The reality is that many factors affect a doctors decisions in the birth room, not just the well-being of a mother and child. For example, there are many doctors who will not ever use forceps, and some who use them regularly, some who always do episiotomies and some who believe that a natural tear is less danger to a mother, and a diagnosis of failure to progress or decicion to induce can be entirely personal preference (I want you to have your baby before I leave for vacation) etc.
Your birth experience will effect you physically and emotionally for the rest of your life. It’s more than knowing what contractions feel like and getting through them. Have fun finding the care that is right for you. Don’t be afraid to write your own story, want the things you want in your birth and do the things that will make your experience blissful.
How much of a difference does your care provider make? Consider this:
Rebecca Dekker PhD of Evidence Based Birth reminds us that nearly half of all c-sections performed on first time moms are given for failure to progress. Yet, this diagnosis is highly subjective. In a study of over 16 thousand home births, failure to progress was the number one reason births were transferred to hospital – occurring in only 4% of cases. However, in the state of Michigan, 20% of hospital birth are diagnosed as failure to progress.
While c-sections do have their time and place, they literally carry the risk of death, separate you from your baby as he or she is entering the world and create an environment where you need extra rest and recovery at the same time additional demands of a newborn placed on you.
To make sure you have the BEST care, not the okayest care or the whatever my insurance covered first care, ask your provider these questions.
Listen to how you feel as they respond and know that there are care providers out there that are both highly qualified and have the highest respect for the innate wisdom of the birthing mother in front of them.
Questions for your prenatal care provider:
- Ask them to share their birth philosophy. What do they love most about their job? Does this align with your own feelings about birth?
- What is their c-section rate? Is there a reason it’s here?
- When do you induce? Do you use pitocin regularly?
- How often do you use forceps or vacuum to get baby out?
- Do you promote vaccines during pregnancy, what about newborn shots?
- Can you work hand in hand with a doula and/or midwife? If asking a midwife, what OBs do you work with for hospital transfers?
- Will you work through my birth plan with me and make sure that bar emergencies, my wishes are honored?
- How often do moms you take care of choose delayed cord clamping, hep locks, minimal cervical checks etc?
- In what circumstances do you perform episiotomies?
- How often does someone other than you attend the birth of a mom in your care?
- Who else do you allow in the birthing room (do they ever have students shadowing them etc.)?
- Do you allow moms to move around or choose birthing positions other than her back if she is unmedicated?
- What preventative care do you provide, do you recommend any resources for diet and nutrition? Or mental well-being?
- How much time will you spend with me in a typical appointment?
As you ask these questions, pay attention to the general feel of the appointment. Do you feel your provider listening and providing thoughtful responses or do you feel rushed? Are they excited about what you want for your birth or merely tolerant of it? Do you feel comfortable sharing your story, emotions and needs with this person?
After asking these questions, you should have a good idea if you are a match or not.
Many women interview 3 to 10 choices before finding the person they want for this job.
Remember, they work for you. Not the other way around. Though it is certainly nice to have the same doctor for all of your pregnancy, there is never a point where a second opinion becomes dangerous. If something doesn’t feel right with your doctor, look around and see if what they are saying has merit or is merely their personal preference.
