Women today have more options for their pregnancy care than ever in history. They have their pick of several doctors, a midwives, or family physicians. They can choose someone who likes a hands-off natural approach, someone who works in a high tech medical facility, or who prefers to actively manage more medical births. They can choose to birth at home, in the hospital, or in a birth center. There is no single provider for every woman - each approach will fit for someone.
Your provider should be compatible with your personality, but they should also be compatible with the type of birth you would like. For instance, if you would like an unmedicated birth in a hospital, it wouldn’t be prudent to hire a doctor who has a 90% cesarean rate. Perhaps he has a high cesarean rate because he takes a lot of high risk cases, and you do not fit the profile of the type of patient he sees the most. He may be very nice, but his practice may not be the best fit for you so it’s probably best to look elsewhere.
Many women question whether or not they can switch doctors during their pregnancy. Let me reassure you: it’s never too late to change your provider. Doctors and midwives are no strangers to taking on a client or patient at the end of their pregnancy. Their training has enabled them to thoroughly understand your charts from your previous provider, just as in any other practice of medicine. You do not need to stay with the doctor you have just because they have seen you since the first trimester.
Finally, it’s important in your interviews to ask questions that require more than a “yes” or “no” response. This is to ensure that you get as much clarification about that particular topic as possible. If you don’t understand the answer, ask for further clarification. It’s ok to press until you feel you’ve gotten the answer you need.
With that, here are some questions to consider when interviewing a care provider:
Logistics And Approaches To Care
- What is your philosophy on pregnancy and birth?
- What was your training?
- How long have you been in practice?
- How many births have you attended?
- Where do you practice? Home, hospital, or birth center? Which one, and why is that your choice?
- What is your cesarean rate?
- Do you work solo or are you in a group practice? How many midwives / doctors are there, and will I get to meet them all prior to birth?
- Do you collaborate with midwives (if you’re hiring an OB)?
- Do you collaborate with OB’s (if you’re hiring a midwife)?
- Do you take my insurance?
- What are the costs involved with my care?
- Are you supportive of integrative medicine? Would you cooperatively collaborate about my care with my preferred alternative support care providers?
Prenatals and labor
- What will our prenatal visits look like? Do you provide any additional information or education during that time?
- What prenatal testing do you require? How would you feel if I opted out of any of those tests? Would it change your plan of care for me?
- What would you do if I became a “high risk” client / patient?
- How do you feel about doulas? Are you comfortable with my hiring one for the birth?
- Do you recommend that I take a childbirth class? Which one?
- Can I have additional family members at my birth?
- How would you feel if I chose to eat or drink during labor?
- How many vaginal exams do you routinely do?
- What is your policy for monitoring in labor?
- How would you feel if I asked an alternative care provider to come to the birth? (Chiropractor / acupuncturist, etc.).
- Are you supportive of my choice to labor in as many positions as possible? Can I deliver on my hands and knees, squatting, side lying, etc?
- What do you do if labor slows down? Do you support natural augmentation techniques?
- What are your preferred pain management techniques? How do you feel about medication for pain management?
- What complications have you seen in your practice?
Postpartum
- What is your preferred method for managing tears?
- Do you practice delayed cord clamping? (The WHO suggests delaying cutting of the cord for a minimum of 3 minutes).
- Can I breastfeed as soon as possible?
- How do you support skin to skin for your patients?
- Are the newborn procedures performed immediately or can they wait until I have had a chance to bond with my baby?
- Do you do the newborn care or that the responsibility of someone else? If it is someone else, how can I communicate my desires with them?