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
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.
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