What type of birth do you want and where? Some women want very much to avoid any non-emergency medication interventions; some find comfort by knowing they are in a hospital where they can get pain medication if they want it. A fear of hospitals or previous bad experience may make a homebirth the best option. Birth centers can be the best of both worlds, for some. If you are giving birth at home, you will have a homebirth midwife. In Pittsburgh, there is a birth center staffed by certified nurse midwives who are backed by doctors at a local hospital. In the hospitals, there are both doctor practices and midwife practices. Certain practitioners are known to favor less interventions, others are more proactive. Having an idea of what you’re looking for is a great place to start.
Can you meet/do you like all the practitioners in the group? Are you aware of and comfortable with their differences? There may be 5, 10 or even more doctors or midwives in a practice. Are you able to meet all of them? How do they differ? While we assume that in a practice, everyone is generally on the same page. One of our clients had a doctor approve her birth plan and assure her that eating in labor was no problem unless she was on an epidural. During her labor, another doctor in the practice refused to allow her clear fluids, even mildly insulting her in the process. When the shift changed and a third doctor from the practice came in, he asked if she’d like to eat! These differences can make a birth a little confusing and frustrating.
Do you feel respected and listened to? Do you feel like a problem or number? One of the most common complaints we hear about a practice is that the client doesn’t feel that the practitioner is listening to her, or that her questions are a bother. Many feel that sitting for longer in the waiting room than the actual appointment isn’t respecting their time. All practices run late and now then, but if you regularly wait a half hour or more past your appointment time, you might wonder if they value you and your time.
Do they explain their recommendations in full and be sure you understand everything? Does the provider learn your partner’s name, and ask him/her about questions or concerns? If you practitioner waves off your concerns, or speaks to you in a patronizing way, or ignores your partner’s questions, it might be time to consider a different group These minor annoyances can be much larger issues during birth.
When you ask your doctor or midwife questions, also listen to how they answer. Are they annoyed you asked? Do they answer completely and make sure you are satisfied? Do they give a vague or generic response? For example: a mother who desires a natural birth will ask about it and be told something like “We’ll let you try.” Or “You can see how far you get before you need medication.” These may sound natural birth friendly, but there is a great deal of difference in a practice that “allows” unmedicated birth and one that supports it.
What do others say about them? This can be a tricky one because every doctor and midwife has clients who had great experiences and those who had awful ones. Plus, your friends may have different personalities, needs and desires than yours. Your friend who had a risky birth may have adored her doctor, but if you’re having a low-risk, normal pregnancy, that might not be the one for you. Your sister loved her midwife, but if you feel more comfortable with a family practice doctor, you might be better off elsewhere. Really listen to people’s stories, not just their opinion, to help you figure out a good fit.
Women can be afraid of hurting their doctors’ feelings if they leave, or even making them angry. There is the idea that it’s difficult or dangerous to switch providers during pregnancy. None of these things are true. We have seen patients switch due to conflicts in the last week of pregnancy (though we certainly don’t advise waiting that long!), and have terrific births. While we prize doctors’ and midwives’ expertise in birth, we also hope you will remember that you are hiring and paying them, and they should help you achieve your absolute best birth.