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The DOs and DON'Ts of choosing a great maternity care provider

by lizzi (follow)
Helping plant the seeds of positive birth. www.sproutbirthing.com.au
Birth (105)      DOs and DON'Ts (13)      Birth Revolution (10)     
DO assess ALL your options:
This is SUPER important! Just because “everyone” goes to a specific OB doesn’t mean that they will be the right fit for you. Check out all the different OBs, the different public hospitals and all their various programs and talk to some independent midwives about supporting you both at hospital and at home. If you are unsure about whether you have truly looked at every available option in your community have a chat with a local doula – they are often able to point out any options you may have missed.

DON’T forget the “non mainstream” possibilities:
Including choosing to have just yourself as your care provider. Homebirth and freebirth is a legal option for ALL women in Australia. While these are not terribly popular choices (largely due to a lack of homebirth midwives and "birth terrorism" in the form of crap media) you can’t say that you’ve considered all your options until you’ve looked into homebirth and chatted with a homebirth midwife.



Lotus waterbirth
Waterbirth at home, including lotus birth - non mainstream but very beautiful option for some families! Image courtesy of Wikimedia Commons.


DO have a preliminary plan:
You don’t need to have a full birth plan written out, but it is a really good idea to have a short plan done up. It should include: What sort of birth do you want? (vaginal, surgical, drug free, physiological, waterbirth). Are there any interventions you plan to avoid? (GTT, “routine” ultrasounds, induction, VEs). Are there any special circumstances you’d like to have considered? (medical conditions, IVF, previous trauma, planning a VBAC). Write down the things that are important to you and, as you interview care providers or talk to people about their experiences with care providers, jot down the responses beside each point. This will give you a good idea as to whether this particular care provider is going to help you achieve your birthing goals.

DON’T change your plan to suit your care provider:
The care provider who is right for your birth will not be asking you to change your plan without some solid evidence that it is medically necessary. You may need to ask yourself: Is it more important to have a “nice” care provider or a positive birth? Your care provider will be left behind, probably never to be seen again…you will carry the memories of the birth with you for the rest of your life. If your care provider “prefers” women to birth on the bed, but you want a waterbirth…find a new provider who supports waterbirth. You won't regret it!

DO ask open questions:
For example, don’t ask a potential care provider: Do you support physiological birth? If they say yes it doesn’t really tell you anything. It doesn’t tell you how they define a physiological birth - maybe they consider a physiological birth to be ANY baby that comes out the vagina, or any labour that starts spontaneously regardless of how it ends. It also doesn’t give you any idea of how they will support you and whether it is the support that you are looking for. We recently had a case of a Perth obstetrician advertising “How to have a natural birth” which included get an epidural and be induced…I don’t know many women who consider those to be natural!

Alternative questions to ask could be: HOW would you describe a physiological birth? How many births do you witness where you don't touch the mother at all? How do you support a woman as she reaches 40/41/42 weeks? How do you encourage informed decision making and how will you treat me if I disagree with a recommendation that you make?

Work out what’s important to you and ask OPEN questions to get the answers you need!



Lotus waterbirth
Some care providers "insist" on routine, regular ultrasounds - But not every woman is comfortable with that. It pays to ask! Image courtesy of Wikimedia Commons.


DON’T be fobbed off:
“Oh I only do xyz intervention when necessary” is a “fobbing off” response. If a doctor says they only do something “when necessary” keep pressing: “What do you consider to be necessary?” “How will you communicate to me the necessity of the situation?” “What if I decide that it’s actually NOT necessary?” Your birth, your responsibility. Make sure you have ALL the information to ensure that the potential care provider is on the same page as you.

DO be assertive and clear:
This is YOUR birth! You are coming to your power as a woman. You have no reason to be meek or shy. In fact, if you don’t feel comfortable asking questions and asserting your own views on your own pregnancy and birth then that suggests a power imbalance in the relationship. And a truly supportive care provider will always acknowledge where the birthing power lies – with the woman!

DON’T be afraid to use emotive language:
So many women tell me that they want “facts” to back them up. But there is nothing wrong with saying: I don’t want to do this because it feels wrong. You don’t NEED facts and studies to back up your views on how you want your birth to go. It’s okay to say that your previous experience left you traumatised, or sad, or disappointed and that you want to feel differently about this birth. Women seem to be afraid of having and showing feelings in case we are found to be “unreasonable women”…guess what? It’s YOUR birth and what YOU want is ALWAYS reasonable!



Lotus waterbirth
The pregnant woman is the one in charge! Image courtesy of Wikimedia Commons.


Choosing a care provider is usually the biggest decision that you will make throughout your pregnancy. It is a decision that will have far reaching implications and can be the deciding factor in whether your pregnancy and birth is calm and relaxed or stressful and anxiety laden. Take your time to choose a care provider who truly resonates with you and is excited about your goals – it will be worth the effort!

What points would you add for women working out how to attack the task of choosing a care provider?

Further reading about care providers:

Support VS Ok you can try

Choosing a maternity care provider who works for you

The illusion of choice in Australian maternity care

Dealing with adrenalin gremlins - birthing in an unsupportive environment

A birthing revolution for Australian midwives

Publicly funded homebirth and birth centres - How they connect to the maternity care revolution

Care providers - What women need to know before hiring you!

#DOs and DON'Ts
#Birth Revolution
#Birth
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