For years I have had conversations with upset students about the care they are receiving from their providers. Usually this happens around 25 to 30 weeks into a pregnancy, when the student is seeing her care provider a little more often and starting to think more seriously about her upcoming birth. Certain topics begin to emerge – such as the benefits of having a doula involved, or how far past the due date is allowed before labor is induced. The care provider’s birth philosophy and style of managed care can quickly become apparent with topics such as these.
The problem arises when the mother-to-be doesn’t like the way these conversations are going and realizes she is with a care provider who shares a different philosophy of birth. The woman is often left feeling uncomfortable or not as trusting of the doctor she has chosen. I believe it is vitally important to be in a birth environment where you feel completely taken care of and trust all those around you! If you are unsure about the support and care you are receiving, it is much harder to relax and let your body open into labor.
Switching care providers is also a bit of a tricky task. At least here in NYC, many OB/GYNs will not take on an expecting mother after 23 weeks, and some have an even earlier cut-off date. If you have not made your decision early, it can be a bit of a challenge to switch practices.
Here are some questions to think about when choosing the right care provider for you and your family:
Are you currently receiving the kind of care you want? Do you feel your provider is listening to you?
I am not suggesting that your care provider becomes your new best friend, but is this person rushing you through your appointment or taking the time for your questions and acknowledging your individuality? I feel fortunate that my OB/GYN always gives me time to express my fears and then nonjudgmentally answers my questions. To me, that kind of personal respect is very important, and it helps me feel more relaxed and thus able to trust my care provider.
Are you a low risk woman in a high risk practice?
High risk doctors are more accustomed to managing pregnancy, labor and delivery more aggressively and cautiously than what is necessary for a low risk woman. If you are not high risk and are looking for less medical interventions, take a close look at the practice and their statistics. For example, does your doctor or practice have a high induction and C-section rate? Are they strict about full time fetal monitoring or do they do intermittent monitoring? Will they allow you some leeway in passing your due date? These are some questions you can use to start investigating the kind of practice you are with currently.
Are you comfortable with a large practice that may not guarantee your provider at the delivery?
If you have a good rapport with your care provider and only want that one person to be with you during delivery, you should consider being with a sole practitioner. In larger practices, the doctors rotate days on call at the hospital. This means it cannot be guaranteed that you will have “your” doctor present at your birth. Often towards the end of your pregnancy you will start to see the other doctors in the practice so you can meet them at least once in case they are the one on call for your delivery. At these appointments, take a moment to discuss your preference for your birth. Although it would seem logical that all doctors in the same practice share the same birth philosophy and style of practice, this is not always the case.
How aggressively will your provider manage your labor?
Some care providers are very strict with how they like to manage the care they give. For example, does your care provider like to have a tight schedule in terms of passing your due date or how long you can labor for? Some providers do not like the woman to go more than a day or two past her due date and would want to induce should this happen; others will allow for her to continue on up to two weeks past her due date. Some providers are open to the woman laboring for a long time as long as mom and baby are healthy, while others want to see measurable progress within a shorter window of time.
Again, there are not necessarily “right or wrong” answers to these questions. As a pregnant woman, you should be aware of what to expect from your caregiver and the services they will provide to you during your birth.
I hope these questions can help you get a better sense of what to expect from your care provider. You cannot change the way your doctor practices medicine, but you can change doctors!
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*Disclaimer- not meant to take the place of medical advice.
Debra Flashenberg, CD(DONA), LCCE, E-RYT 500 is the director of the Prenatal Yoga Center. She has spent most of her life performing and was introduced to yoga through a choreographer in 1997. After several years as a yoga student, she decided to continue her education and became certified as a Bikram Yoga instructor. After being witness to several “typical” hospital births, Debra felt it was important to move beyond the yoga room and be present in the birthing room. In 2006, Debra received her certification as a Lamaze® Certified Childbirth Educator. In September of 2007, Debra completed a Midwife Assistant Program with Ina May Gaskin, Pamela Hunt and many of the other Farm Midwives at The Farm Midwifery Center in Tennessee. Drawing on her experience as a prenatal yoga teacher, labor support doula and childbirth educator, Debra looks to establish safe and effective classes for pregnancy and beyond. She is the proud (and tired) mother of new baby boy, Shay.
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