This is a post in my series on owning your birth.  It is my strong belief that your birth experience profoundly impacts your early days with your new child.  The way you feel while birthing your baby can inform how you feel about yourself as a person, mother, and partner.  If you feel respected, strong, and supported during pregnancy, labor and delivery, you will improve your chances of beginning your mothering journey with confidence and hope.  If you feel disrespected, controlled, or unheard during pregnancy, labor and delivery, you may enter your mothering journey with fear and sadness. 

Birth is normal and breathtakingly beautiful.  But it is also mysterious and unknown, sometimes overwhelming and scary.  With any labor and delivery, you can have an experience that is woman- and mother-centered.  Feeling respected and heard, and experiencing your own strength and power during birth, comes down to owning the experience, even in its uncertainty. And often still, things won’t go as you expected. If you are surprised, overwhelmed, or sad about your birth experience, you will be better able to confront it and work through it if you feel prepared, strong, and confident enough to reach out for support.  

You cannot plan your birth.  Birth will takes its own course and we do best when we can let birth happen.  But birth can happen best when we are physically, mentally, emotionally, and spiritually at our best.  In this series, I’ll share ideas about what you can do to own your birth experience. 

Own Your Birth: Part 2 of 24

Interview and choose your provider

I need to start by repeating what I said in the first post of this series because it’s important enough to repeat over, and over, and over again.

Your vision for your birth can be crystal clear, but if you don’t hire a provider who shares that vision with you, your chances of realizing that vision will almost definitely decrease. I can’t stress enough the importance of choosing a care provider who you connect with and who will wholeheartedly support your wishes and needs. This is one of the most important things you will do. If you’re reading this and you’ve already hired a care provider, I want you to know that it’s never too late to switch providers if you feel your current one is not a good match for you.

Interview multiple providers

I strongly recommend setting up interviews with at least two or three potential providers before hiring somebody. In my experience, many women automatically hire their existing OB/GYN as their care provider for pregnancy, labor, and delivery. Even if you have a great personal connection with your gynecologist, this doesn’t necessarily mean that he/she is the ideal person to support you throughout pregnancy and to be there when your baby is born.  You could interview your current OB/GYN about his/her philosophies and approaches to pregnancy and birth, as well as a couple more providers in your area.  If your gynecologist whom you love feels like a great fit after interviewing him/her, that’s great!  If he/she doesn’t, it’s OK to find somebody new for this important life transition.  I have had women tell me that they feel bad leaving their gynecologist and don’t want to hurt his/her feelings.  I understand this feeling and I’ve been there.  I switched practices when I was 28 weeks pregnant with my first child and felt those same feelings.  But having a baby, and the experience that comes along with that, is too important to stick with somebody who doesn’t plan to support your wishes and desires surrounding your birth experience.

Who do I interview?

Once you have decided what type of provider you’d like to hire, you need to decide specifically which ones to interview. And if you are torn between a birth center and a hospital midwife, or a homebirth midwife and a hospital OB, you can interview various types of providers. The best way to find out about options in your area is to ask around. Ask friends, family, colleagues, and acquaintances for recommendations. But remember that you should still do your own research on the providers who they suggest because your birth vision may be different than that of your peers. Local doulas, childbirth educators, chiropractors, and prenatal yoga instructors might have suggestions too. While these people may not choose to endorse any particular provider, they might provide a list of what’s available in the community.  Once you have a list of options, decide who you’d like to interview and find their contact information.

How do I set up an interview?

To be honest, the majority of women and their partners don’t interview providers before choosing an obstetrician or midwife. I think that many of them just don’t realize it’s an option. Because of this, some receptionists at OB and midwifery offices will be confused if you call and ask to schedule an interview. A homebirth midwife or midwives at a birth center might be more used to this and understand what you’re asking for right away.

When calling a provider to schedule an interview, you could say something like this:

“Hello, my name is _______ and I’m currently __ weeks pregnant. I would love to set up an interview with _______ to ask him/her some questions about his/her philosophy on prenatal care and labor and delivery. I’m trying to find a care provider who will be on board with my wishes.”

You may need to emphasize that you don’t want this to be a medical appointment and won’t be needing an exam. You can explain that you’re interviewing multiple providers if the receptionist is confused. If the provider doesn’t even offer an interview, this might be a sign that you will not be honored as the decision-maker for this pregnancy and labor. You might want to ask if the provider charges for this type of visit. I would hope that most providers offer a free interview, just as most doulas do, but if not, you’ll have to decide what you’re willing to pay in order to have some time with the provider.

How do I prepare for the interview?

This is where you need to do some work.  Take time to think about what is most important to you when it comes to prenatal care and your birth experience.  You might do some journaling, which I’ll talk more about in later in this series.  Research the different decisions that you will be faced with and think about what you would like to do.  Some common topics that you might look into and think about your stance on are: ultrasounds, genetic testing, induction, fetal monitoring, ability to move freely during labor, IVs, eating/drinking during labor, episiotomy, forceps/vacuum extraction, cesarean section,  management of the birth of the placenta, breastfeeding, and newborn care immediately after birth.   I especially like the book The Thinking Woman’s Guide to a Better Birth, by Henci Goer for researching evidence-based information about different options during pregnancy, labor, and delivery.  The website Evidence Based Birth has great evidence-based information about many of these topics as well.  You’ll also want to ask about general office policies, contacting providers outside of office hours, and how they determine who will be at your birth if it’s a large practice.  If you have a partner, discuss your choices and thoughts with him/her.  Keep in mind that your ideas and thoughts might change over the course of your pregnancy.  If you can find a provider who is on board with your general vision, you’ll be more likely to agree on the smaller details as they arise.  And once you’ve hired someone, keep asking questions as they come to you.   Remember, while I’m sure you’d rather not, you can switch providers if something all of a sudden starts to feel wrong.

Once you have an idea about what is important to you, write down some questions that you’d like to ask.  Your questions may be a little different based on what type of provider you’re interviewing.  This article is has some great ideas for interviewing obstetricians and hospital-based midwives. This article has a list of questions you might want to ask a homebirth midwife.

Make your question list in a way that will be helpful to you when you’re in the office with the provider and leave space for taking notes about their answers.  If you can do this on the computer, you can even print out a few copies and use one for each interview.

I’ve arrived for the interview. Now what?

When you check in at the front desk for your appointment, remind the receptionist that you’re just there for an interview.  You may need to repeat that information if they give you medical history forms to fill out.  You should be taken to the doctor’s office or an examination room.  There’s no reason for you to put a gown on or anything like that since this is just an interview.

When the provider arrives, you can introduce yourself and begin asking questions!  It’s good to think about how you want to word your questions so that you can get helpful, thorough, and honest answers.  Here are a few examples:

If you have determined that you do not want an episiotomy, you might ask, “What is your episiotomy rate?  In what situation would you suggest performing an episiotomy?”

If you know that you want the freedom to move according to your body’s instincts during labor, and you know that intermittent instead of continuous fetal monitoring and avoiding pitocin, IVs, and anything else that tethers you to machinery will make this more possible, you might say, “I’ve learned that moving freely during labor can be very beneficial to the process of giving birth. How do you support women who want freedom of movement during labor?”  If the provider doesn’t mention anything about intermittent monitoring or working to avoid induction, you could ask, “Would you support me to be monitored intermittently? Would you support me to stay hydrated on my own during labor as opposed to using an IV?  How far into pregnancy are you comfortable waiting before suggesting an induction?”

Pay attention to how you feel during your time at each office and with each provider.  Are you treated kindly and given the amount of time you feel you need?  Does the provider truly seem to view you as the primary decision-maker in this process?  Do you generally feel respected, listened to, and taken seriously?

After interviewing your selected providers, you can journal about your thoughts and talk with your partner. Think about the specific answers you received, how you felt with each provider, and finally try to tune into your instinct.  Is your gut leading you towards one of these providers more than the others?  Is your gut warning you to steer clear of anybody?  Listen to this.  Your instinct, if you can tune into it, will be your ally throughout your pregnancy, labor and delivery, and years of mothering.

I know that interviewing providers, asking tough questions, and having these conversations might not be easy.  I believe the mainstream cultural conditioning in our society tells us that medical professionals are authorities and that we should do as they say without questioning and doing our own research.  I didn’t interview providers and ask questions for much of my first pregnancy.  But as I began to see signs that I might not be with the right provider, I started asking questions.  For the rest of this pregnancy, and for my second (when I was living in a new region), I reminded myself that I was the consumer and I was hiring this person to provide a service for me.  This little mantra helped me remember that I needed to be calling the shots and that this birth was about what felt best for me and my family.

Hire a provider

If you find somebody who you are confident will support your wishes, you can go ahead and make an appointment for your first prenatal visit.  If you didn’t resonate with anybody, try to find a few more providers and set up more interviews.  While this may feel like a lot of work, it will be so worth it. Remember, I believe that your birth experience will significantly effect how you feel about yourself as a woman and a mother and how you approach mothering your child.

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