Birth Experience

Peaceful Birth – Choosing a Care Provider

10 Comments 10 March 2010

You might want to consider firing your doctor.

That’s right. I said it. Fire your doctor.

If the physician you’re seeing has opinions about childbirth that differ from your own, leave. Interview as many care providers as it takes to find your perfect match.

When looking for a specific type of care, one should understand the traditional roles of doctors, ob/gyns, nurse midwives and lay midwives alike.

What do each of these providers  have to offer you?

There will be several questions to ask yourself, and your physician. I’ll be getting to that a little later.

History, Job Duties,  and Standards of Care

An ob/gyn specializes in women’s health and must obtain a 4 year college degree followed by a 4 year Medical Doctorate degree and three to eight years of residency and internship.

As physicians, ob/gyns examine, diagnose and treat a plethora of diseases, illnesses and other health issues that are unique to women.

They specialize in pregnancy, to assist women through childbirth and with their general reproductive health.

Average time spent with mom during prenatal visits: 6 minutes.

Nurse Midwives practice under the supervision of an ob/gyn.

Schooling includes becoming a registered nurse (Bachelor Degree in Nursing). One must then enroll in a nurse-midwifery program accredited by the American College of Nurse-Midwives and pass the written examination before practicing.

Nurse Midwives work in a variety of settings including hospitals, birth centers and home deliveries.

Average time spent with mom during prenatal visits: 15 minutes.

Certified Professional Midwives practice midwifery autonomously and are certified through the North American Registry of Midwives. CPMs are strictly home birth midwives and do not have hospital privileges.

They are trained to provide expert care and to support women through pregnancy, childbirth and the postpartum period.

The midwifery model of care is such that labor and pregnancy are normal life events and believe in minimal technological interventions.

A CPM is however, trained to know when a women would be better suited to be cared for by an ob.

Average time during prenatal visits: 30 minutes-1 hour (or longer)

What Model of Care Best Suits You?

As much as it matters the medicine your care provider practices, something just as important to consider when hiring your physician is aligning your core values and vision of birth.

If you want a hands-off sort of approach, and you’d like to let your labor unfold as nature intends with less medical intervention and more “human” interaction, a Certified Professional Midwife might be right for you.

If the thought of birthing in a hospital turns you off but birthing at home makes you feel uneasy, a birth center could be a great middle option. Nurse Midwives work in birth centers.

If you’ve got a great relationship with your doctor and trust you’ll be taken care of best under their care in a hospital setting, great!

Q & A Time

Have a conversation based around these questions. Feel them out and go with your gut.

  • When do you cut an episiotomy?
  • What is your cesarean section rate?
  • How many of your patients induce or are augmented during labor?
  • What type of prenatal testing do you recommend?
  • Do you allow a doula and/or friends to be present at birth?
  • At what points during labor will you be with me?
  • Do you encourage movement and different positions in labor and delivery?
  • How much fetal monitoring do you recommend during labor?
  • What is the standard procedure right after baby is born?

Discuss your optimal birth scenario and write a birth plan.

Your idea of the “perfect birth,” means a lot. It could be the difference between your dilation being checked every 30 minutes or only twice through your entire labor.

With any provider, no matter how well you know them or how close your friendship may be, it’s a good idea to write a birth plan – for you and the rest of your birth team.

It is my sincere hope that through reading this series, you’ve come to understand the importance of self-advocacy during childbirth. Stay tuned for the next part in the series, Peaceful Birth – Writing a Birth Plan

Your Comments

10 Comments so far

  1. Sarah says:

    Did I tell you about my friend’s wife? Probably not. She didn’t know midwives existed until she was 38 weeks. At that point they decided that although they wanted a natural birth, and their OB/GYN wasn’t very supportive, they were too close to change anything. Actually, she ended up going until 42 weeks (by canceling a couple inductions). Unfortunately she ended up getting Pitocin, then an Epidural, and then a C-Section. :( The baby wasn’t positioned correctly and the Epidural made it impossible for her to move around to get the baby positioned right. The worst part is that since their state has really bad VBAC laws, she probably won’t be able to do trial of labor next time.

    This is why you fire your doctor.

  2. Amazon says:

    Writing from Canada, I’d like to add that we have another level of care provider, and that is a family doctor that delivers babies. They are not OB/GYNs, and in my experience are more likely to treat labour and delivery as a natural process than a medical problem. I very much agree with the need to find a care giver whose philosophies match your own, and friends of mine have suffered when this isn’t the case. The other challenge, here in Canada, is that doctors are often not taking new patients. It can be difficult to switch, if it’s too late to shop around. I count myself very lucky to have a family doctor that loves to deliver babies, and is supportive of my commitment to natural labour and delivery. I’m growing baby #2 right now, and baby #1, delivered 19 months ago, was delivered in a hospital, but with no drugs, no pressure to take drugs, in the position I chose (on the floor, on my hands and knees) and no tears. Very much looking forward to the next delivery!

    P.S. Midwives JUST got approved in my province, and I considered that route, but decided I was happy enough with the first delivery to stick with the same team (including my family doctor and doula).


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