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.
But I Already Have a Doctor or Midwife!
If you already have a midwife or OB/Gyn, you can still interview them! Take some time to get clear on what you want, and follow the interview tips using the questions in the PDF. You may want to skip the more basic questions, and just ask a few of the more specific questions that are important to you. Hopefully, you will get answers that agree with your birth wishes, and you will feel more confident in your birth attendant. If not, the earlier you find out, the easier it is to find a doctor or midwife that you will be happy with and switch to their practice.
How To Decide Who to Interview
There are many birth attendants in most communities. To find out where to start, ask people who have similar feelings about birth who they would recommend. Sometimes asking on an online pregnancy board can work, but you need to make sure you find out about the preferences of the person making the recommendation, and specifically what they liked about the doctor or midwife.
If you think you want a natural birth, you can find great birth attendants by asking someone who gave birth naturally, or ask local doulas or natural childbirth educators. If you want someone who will help you have a good scheduled birth when your family will be in town visiting, ask other women who were induced. If you want a great, family-centered cesarean since you need one for medical reasons, ask other women who had c-sections.
How to Conduct an Interview
- Call and ask as many questions over the phone as you can. This will probably help you thin your list down to just a few practitioners to visit on face-to-face interviews. When calling a doctor or midwife’s office, ask their staff standard questions such as whether or not they take your insurance, office hours, and so on. Then, instead of asking about the practitioner’s birth philosophy, ask something like, “what do you think patients like best about ___________ (doctor or midwife’s name)?” This may give you an insight into the philosophy of this birth attendant which may or may not appeal to you.
“Once my students were aware of the connection … those who made some changes … found that their symptoms improved.”
- Make use of “meet the professional” events. Many obstetric practices (and pediatricians!) hold regular “Meet the Midwives” or “Meet the Doctors” events. These can be low-risk and low-stress way to see if a particular practitioner’s style fits well with your needs, desires, and style. Hearing other parents’ questions can be very helpful, too.
- When asking what someone thinks about an issue or procedure, ask open-ended questions. Asking someone, “How do you feel about epidurals?” will get you a much more honest and complete answer than, “I want to have a natural birth, will you support me?”
- Before going into an interview, memorize the most important topics and questions you want to discuss. Many medical professionals feel somewhat defensive when someone comes in with a written set of questions and takes notes. (Think of how you feel when someone takes notes in a job interview.) Conversely, since doulas are more laid back and expect you to interview several before choosing, many are fine with you taking notes. Just ask first.
- Try not to write notes while in a personal interview. Remember your feelings and impressions as well as you can and write notes as soon as you’re out of the office. If you really want to have your written list with you, ask the professional first if they mind if you take notes. Of course, you can take notes on the phone all you want.
“Taking notes during an interview can make a doctor or midwife feel like they are on trial, which is not the best way to build rapport.”
- Go with your gut. If you meet with someone that seems to meet all of your other criteria, but you just don’t really like them for some reason, trust that response. You want to feel completely confident and safe with anyone on your birth or healthcare team. If you are not comfortable with someone, you may frequently second-guess their judgment. That does not help you get the best care in a timely manner, and may cause stress and more problems in labor.
Questions to Ask an OB or Midwife
You are probably wondering what specific questions would be good to ask when interviewing. I have put together a list of suggested questions to ask when interviewing an OB or midwife into this PDF. It is a single page, and you are welcome to print it, share it, or put it into Evernote to view it more easily as long as the copyright and contact info at the bottom remain intact.
What do you think?
What did you feel was a helpful question you asked or thing you did to choose your doctor or midwife? Please tell me in the comments below!