Choosing a care provider is one of the first decisions you make after getting your positive test. One simple way to help narrow down your search is to prepare yourself with some questions ahead of time that go well beyond, “are they in my network?” and “how close are they to a decent burrito joint?”
Why does it matter who delivers my baby?
While each person should theoretically have a similar skill set, there are big differences between care providers – even within the same practice. The care provider you choose can influence the kind of birth you have, the interventions you encounter, the positions you birth in, the location you deliver, and even the kind of care you receive after your bundle has arrived. One great place to start is determining if your care provider practices evidence-based fetal and maternal medicine.
What does it mean to be evidence-based?
Evidence-based care means the practice is based off current medicine.
Medicine is always changing, and things that were once commonplace, like episiotomies, for example, are no longer the norm. Unfortunately, that doesn’t mean that every practitioner has embraced the change. Knowing where your care provider stands on certain things, like VBACs, episiotomies, and delayed cord clamping, can help ensure that you are being treated by someone who’s familiar with what is currently considered best practice.
Why is being family-centered important?
In addition to being evidence-based, pairing yourself with a family-centered delivery location is a way to ensure you’re presented with all the options.
Family-centered delivery locations are less likely to automatically push for things like Pitocin, routine cervical checks, and IV fluids, and will typically be more accommodating of different birthing positions. They are generally more supportive of different birth plans, and have access to things like bars, baths, and balls, to help you achieve your birthing goals.
Of course, there’s zero shame in doing it howeverthefuck you decide to do it, or howeverthefuck it ends up going down (HELLO surprise emergency C-section with ALL THE DRUGS!). This is merely a gentle reminder that for the average, low-risk pregnancy, there are a ton of options to explore when crafting your ideal birth plan, and that some places will be more accommodating than others.
What should I ask my care provider to help figure out if they are right for me?
Here’s a quick list of different questions to ask your care provider to help determine if they are evidence-based and family-centered:
• What happens when I go into labor? Walk me through what typically happens in your practice.
• Is there a possibility you won’t be the one to deliver my baby?
• What is your C-section rate? They may or may not know this (or be willing to share this, which is a red-flag), so asking around to local doulas, midwives, or even friends who have delivered within that same practice can help you get a feel for the number. The national C-section rate is about 32%, just to give you a general feel.
• Do you support un-medicated and medicated deliveries?
• Will I have access to pain management techniques (like birthing balls, tubs, bars, massage tools) other than drugs?
• What happens if I change my mind about trying for an un-medicated birth?
• Am I able to eat after being admitted, or will I have to fast until after delivery?
• What is your policy on episiotomies/IVs/IV fluids/Pitocin (or any other intervention you’re curious about)? If they answer, “when medically necessary” keep prodding. What constitutes medically necessary? Even if it feels uncomfortable, remember that you’re allowed to ask questions until you’re satisfied with the answer.
• How often do your perform cervical checks?
• Am I able to try for a VBAC? (If you’ve previously had a C-section)
• What happens if I end up needing a C-section, or other emergency interventions (important for birthing centers)?
• Can I birth in a position other than lying on my back?
• Will I have room to move around during labor?
• Do you support delayed cord clamping?
• How are decisions made during labor? What if shit goes down and I’m not able to answer? While there’s nothing wrong with going in and trusting your care provider to make the best decisions for you, it’s also totally reasonable to want to participate in the decisions being made. Getting a feel for how comfortable your care provider is with communicating and sharing decision making is tricky, but something worth talking about before your big day.
Sometimes the plan doesn’t match the outcome
Of course, asking these questions in no way guarantees you will control the kind of birth you end up having. It’s important to acknowledge that even the best, most Elle Woods-eque birth plan might go off the rails at any moment. But getting yourself educated about your options can help ensure you feel empowered, involved, and ready when the time comes.
Plan or no plan, you deserve to be respected
Maybe you already have a birth plan, or maybe you’re like me and your birth plan consists solely of GET THIS BABY THE HELL OUT OF ME. Either way, everyone deserves to feel confident, respected, and included when it comes to the birth of their baby.