After the shock of the positive pregnancy test wears off a little bit, one of the first things you will need to decide is WHO you are going to have as your care provider for this pregnancy and birth. If you’re like me, you start by asking your friends who they used for their pregnancies, and then you make an appointment. Other people make an appointment with their usual GYN and leave it at that. Here are a few things you want to think about when you’re choosing a provider:
Does their idea of birth align with yours?
All providers have ideas about birth based on their training and experience (both professional and personal btw). Generally, OBs are watching to make sure nothing goes wrong and midwives are watching to make sure everything goes right. While that may not sound like a huge difference, I urge you to think about what their expectations might be with each of those approaches. OBs are generally looking to DO something to help while midwives are looking to NOT have to do anything to help. This is a really broad generalization, but an important distinction when you’re thinking about the kind of care that you’re looking for, and the same answer isn’t right for everyone. Think about your specific situation and how you’d like to approach birth. Research has shown, that the provider you choose can make a difference in how your baby comes out in case you didn’t know that already. Here are a few things you might want to know your provider’s attitude about:
- Weight Gain: What limits do they have for you? When do they get concerned about baby’s weight in utero?
- Ultrasound: How many & when? Why?
- Induction: When? Why? How?
- Questions: When & where can you ask them? How long are usual appointments?
- Schedule: How often are you on call? Who do you share call with? Surgery days?
Location AND Provider Matter
Many times your insurance will dictate which hospital or group of providers they will cover. Look at some of the stats for the location where you’re planning to delivery. You won’t be able to look at provider specific data, but you can definitely ask potential providers their cesarean and episiotomy rates by the way. What about their induction rates? All of these things add up to the way that pregnancy and birth are handled at an institutional level. Is birth handled like an emergency no matter what? Is the staff trained in trauma-informed care? What does it look like to arrive in labor and to go through triage? Can you get a tour before the big day? You’ll have plenty of unexpected things to navigate during your pregnancy and birth, but the location and your treatment shouldn’t honestly be one of them. What are their policies about eating and drinking during labor? What kind of pain relief options do they have? Is anesthesia on site at all times? Do they support VBAC?
This can all seem really overwhelming, especially to first time parents that haven’t ever had to deal with any of these questions. Maybe you’re still trying to figure out how YOU feel about these things before you even can have an opinion about how your provider does. That’s ok, seriously. As doulas, we want you to feel ready to make these decisions. We want to give you all the information you might need to figure out how YOU want to approach pregnancy and birth without any bias. This is one of the reasons we highly recommend a quality childbirth education course for everyone by the way.
Not the vibe?
Finally, it needs to be said that if a provider isn’t the right fit for you, then it’s ok to move on and find someone else. You have NO OBLIGATION to stay with a provider just because you’ve established care or even because you’ve been seeing them since you were a teenager for GYN services. Chances are, they’re so busy they may not even realize you’ve stopped coming to them. Also of note: YOU HAVE A RIGHT TO SWITCH AT ANY TIME, including during labor. You are under ZERO obligation to be cared for by anyone who is not the right fit. You have the right to fire them on the spot and ask for someone else, yes, seriously…including your nurse btw. While that might sound scary, so is being cared for by someone you don’t trust during labor and delivery! You’re the boss applesauce, and if anyone in your space makes you feel anything other than that, you can make a change at any time!
Choosing a provider doesn’t have to be overwhelming. This is one of the things we cover in our FREE E-Book: Getting Started. We also talk about this stuff with all of our clients. Even if you have a limited pool to choose from, we can talk to you about our experiences with different providers. Yes, we do have a list of providers we won’t work with too, and we’re happy to tell you who they are if you ask! You deserve the best, no matter what your skin color, income, or insurance situation is. Demanding better options and hitting the bad providers in the pocketbook is the only way we’re going to make change here, clearly.