1. You Want a Personal Attention and Relationship with the Person Who will “Deliver” Your Baby
When a woman becomes pregnant, she enters into one of the biggest transitional times of her life. She understands that pregnancy requires some medical supervision but she also wants her provider to become a friend and confidant in this highly personal, private and intimate moment of childbirth. If you feel like your relationship with your provider is purely professional lacking any recognition of the emotional side of pregnancy and birth, maybe you should look for a provider who cares about you, your experience and your family. That is NOT too much to expect from your healthcare provider in this normal physiologic process of pregnancy and birth.
2. You Want More Choices and Support in Your Pregnancy and Birth
How does your provider help you stay healthy in your pregnancy and guide you toward a low intervention vaginal birth?
Has your provider ever discussed food and nutrition during pregnancy, chiropractic care or even acupuncture and how they might benefit you during pregnancy?
Does the OB practice offer wellness programs and motherhood groups and events?
Does your provider believe once a woman has a cesarean, her only choice is another cesarean? Do you HAVE TO go for multiple ultrasounds and genetic testing?
How does your provider view an ideal birth? Do your wishes factor into your provider’s ideal? Keep in mind that most obstetricians have only delivered babies with a woman lying on her back in a hospital bed numb from the waist down. Has he/she ever delivered a baby when the mom was kneeling? On the floor? On the toilet? In a tub of water? Without an epidural?
Have you asked if you can eat or drink during labor? Many OB practices do not allow eating, drinking and even moving around while in labor.
Is your provider already discussing inducing your labor? You might want to look for another provider if you are getting the feeling that your provider is uncomfortable with any variations in his/her routine delivery, if the provider seems disturbed when you question their routine and especially if your provider is making plans for induction or cesarean weeks and months prior to your due date.
3. You Want the Best Chance to Have a Vaginal Birth
Keep in mind that midwives’ patients have fewer cesareans than doctors’ patients. This is true around the world, whether a woman is considered to be low risk or high risk. Knowing that 1 woman out of 3 women seeing at obstetrician in the United States have cesarean section deliveries should concern you! Especially when the World Health Organization says a reasonable cesarean rate should be between 10- 15%. As the cesarean rate increases, so does maternal mortality. Make no mistake, I fully recognize that cesarean birth saves lives.
It is a good idea to start asking questions about the cesarean rate in your hospital and in the OB practice you are currently seeing. Lamaze International’s 6 Healthy Birth practices http://www.lamazeinternational.org/HealthyBirthPractices and Rebekka Decker’s website Evidence based birth http://evidencebasedbirth.com/updated-table-on-the-state-of-maternity-care-in-the-u-s/ provide women a better understanding of the care that they should not be hoping for but should be receiving; care that is rooted both in science and in nature! While having a cesarean is sometimes necessary, there definitely are Midwife Providers who are better at avoiding unnecessary surgeries than others.
4. Once you Have Had a Cesarean, All the Rest of Your Births Will be More Risky.
Both Vaginal Birth After Cesarean and Repeat Cesarean section carry significantly more risk than vaginal birth in a woman with no prior uterine surgery. Once a woman has had a surgical birth, her birth choices become much more limited than if she had had a vaginal birth. A prior surgical birth may preclude a homebirth, a waterbirth or a labor without fetal monitors, IV and sometimes even an epidural! (some hospitals demand an epidural in place in the event of an emergency). A previous cesarean section in many places and ob practices can take away a woman’s choice to have a vaginal birth. Not all-many providers support VBAC. Our practice has seen VBAC success rates over 80%. Women delivering their babies by C-section are generally told to limit their number of children to 2 or 3 because of the greater and greater risks involved in multiple cesareans.
It is not too late to seek a care provider who more effectively meets your needs. You are not obligated to stay with a provider, especially if you suspect you are not both on the same page. Best of luck and Happy BIRTH day!
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Glenn Cameron
April 21, 2016 at 10:25 amDear Midwives of NJ – hank you for providing this information to birthing women .
My career in direct entry midwifery began in the 70’s with the home birth of my daughter . A few years later I apprenticed with a nurse midwife in my community who was doing home birth care. Along with a small group of women we organized study groups and began attending births. In 1997 I joined the administrative staff of a direct entry midwifery program for aspiring midwifery students.
The school not only developed an excellent curriculum but we also achieved MEAC accreditation . I spent the last 17 years in this position and enjoyed supporting future generations of midwives .
Sincerely,
Glenn Cameron