Once you are at your birth location, who has the most influence over how your birth turns out?
Yes, you have a lot of influence. But your OB/Gyn or midwife has an equivalent – possibly greater- amount of influence over your birth experience. This is true even if you have a birth plan, a well-trained coach, and a doula. That’s why it is very important to find an OB/gyn or midwife (also called a birth attendant) who supports the kind of birth you want to have.
When I doula births where mom wants to have a normal, natural labor, and has a doctor that is fine with letting her “try,” mom often ends up with interventions that she did not want, and that may not have been truly medically necessary. During one labor I was at, mom’s labor partner spent a good deal of the time in the hall, “talking” with the doctor. The doctor thought mom’s labor was going too slowly, but mom did not want to speed anything up. Poor dad had many quiet conversations in the hall with the doctor, declining the interventions, instead of being a constant support to his wife. Mom was healthy, had the birth experience she wanted, and got her wonderful present at the end (a healthy baby), but it was a fight. Other women are not as fortunate. I have been at births where the birth attendant was about to do a procedure such as amniotomy (breaking the bag of waters) without even telling mom what they were going to do, let alone asking consent. I had to announce the doctor or midwife’s intentions and ask mom if that was ok with her. No woman should have to spend labor wondering if something will be done to her without her knowledge, or arguing with the hospital staff to have the kind of birth she prefers. As long as you and baby are safe and healthy, a birth attendant that has similar beliefs in regard to pregnancy and birth as you have will support you in the kind of labor you want to have. That is what you are looking for.
Before you can interview birth attendants (doctors and midwives), you need to know a bit about your own desires for labor and birth. Take some time thinking about what kind of birth experience you want and where you want to have your baby. Also consider your feelings on medical procedures such as episiotomy and cesarean, and whether or not you might like to have a natural (unmedicated) birth. You can always change your mind later, but if you drastically change your desires, you may also need to change birth attendants.
Below are some interview tips, and a link to a PDF with suggested interview questions that you can print and bring with you.