Once you have made the major decision of choosing your birth place, it is time to start assembling that birth team. These are people that you are going to get to know pretty well over the next nine months, and will also be at one of your life-changing moments. So take some time and choose well.
Your choice of birth place will restrict your choice of care providers to a certain extent. So after you have chosen your birthplace, make a list of care providers. If you are using a hospital, then get a list of practitioners able to deliver there – doctors and midwives. You can often get a list from your insurance company of practitioners at a certain hospital. If you are using a birth center, Once you have an idea of how you envision your birth, you will have an easier time choosing a caregiver then you will be using their staff, so you will be choosing your care providers at the same time as you choose a birth place. If you have chosen a homebirth, there are various directories available to help you find some in your area.
First, you should do a bit of soul-searching. Think about how you imagine your birth. It is not a bad idea to start reading some books about birth now. Henci Goer’s The Thinking Woman’s Guide to a Better Birth isa great place to start to get you thinking about the things that are important to you.
Once you have an idea of how you envision your birth, you will have an easier time choosing a caregiver. If you envision squatting over a birth bar to deliver your baby, but that is outside your provider’s comfort zone, then that may not be the provider for you. Just like everyone else, doctors and midwives have comfort zones. They aren’t going to change for you, and the last thing you want at your birth is a nervous provider anyway. Finding a provider that you are compatible with from the start will definitely save you heartache later.
There are many different options of caregivers available to you. Whether a particular caregiver is right for you is a personal decision. It is not about the caregiver being "good" or "bad." What is important is whether they are the right fit for you. Do they share the same philosophy? Will they respect your wishes? Do they have the same approach to care as you have? Ultimately, every woman must make the choice that is right for her, in her specific circumstances.
So, how can you find out what the care providers you are interviewing truly believe about birth? Ask them! Nikki MacFarlane of Childbirth International has developed a really handy acronym, just for this purpose: B’LIEFS.
Bed – How do you feel if I want to be off the bed for labor and birth?
How Long – How do you feel about time limits during labor?
Induction – Under what circumstances would you It is not about the caregiver being "good" or "bad." What is important is whether they are the right fit for you recommend an induction?
Episiotomy – How often do you find it necessary to do an episiotomy?
Food – How do you feel about women eating during labor?
Supporters – How do you feel about me having labor support (a doula)?
The nice thing about these questions is that they are completely non-confrontational, while supporting a woman’s right to choose. You will find out what the care provider really believes!
Of course, you will also want to ask the more qualifications oriented questions.
Other things you may want to ask when planning a hospital birth:
· What is his personal cesarean rate? Does he encourage women to have a vaginal birth after a previous cesarean? What is his VBAC success rate?
· How often does she use a vacuum extractor/forceps? Under what conditions?
· What percentage of his patient’s deliveries does he attend? Who does deliveries when he is not available? Will you be able to meet those people as well?
· Is there standard testing that she thinks all pregnant women should have? What if you refuse certain tests?
When interviewing homebirth midwives the questions you ask may be a bit different. Some suggested questions would be:
· Ask about her education and training as a midwife. How long has she been a midwife and how many births has she attended?
· Does she work alone or does she have a partner/assistant? Will you be able to meet them? Who provides back-up if she can’t make it to the birth?
· Does she have any restrictions on the types of clients she takes?
· Does she have a back-up OB? Does she require that you see an OB at some point during the pregnancy?
· What happens if you need any testing done?
· How does she handle emergencies? What percentage of her clients get transferred to the hospital? For what reasons? Would she stay with you at the hospital? What percentage of her clients have had cesarean sections?
· Is she experienced in water births?
· Has she ever had to resuscitate a baby? Is she CPR certified?
· What kind of equipment/medications does she bring to a birth?
· What kind of post-partum/breastfeeding support does she provide?
Finally, don’t forget to ask about her fees, availability of insurance re-imbursement, and payment plan options.
No matter whom you choose, it is most important that you are comfortable and happy with your choice. Doing the research now makes it more likely that you will be happy with your choice throughout the pregnancy. However, people’s needs and desires often change throughout pregnancy. If your care provider is no longer meeting those needs, it is important to realize that it is never too late to change your provider.
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