As a new mom-to-be, it can be overwhelming to dive into the world of obstetrics and wrap your head around some of the simpler things, let alone choose the right provider. But this is actually one of the most important decisions you make to ensure a good birth experience, and taking action before your first visit can help you find the perfect birth team for you. I worked as an administrator in women’s healthcare for over a decade, and there are some key things to keep in mind when choosing your doctor, midwife, doula, and birth class.
Get to Know Your Birth Team
Finding a physician or midwife who will be a good fit for you and your needs is an imperative first step for having a positive experience from prenatal care all the way through postpartum support.
Schedule a consultation visit or attend a “meet the provider” group event. This is the best way to “shop around” for a provider and learn about what you can expect from the experience. It also gives you a chance to get to know the staff at the office; they are just as integral a part of the birth team.
Ask Tough Questions of Your Birth Team
When you meet with doctors or midwives, bring a list of questions with you and don’t be afraid to ask about whatever is important to you. This is your birth; it’s a private, personal experience and you want to make sure your provider understands exactly what you are looking for.
Things that are important to know would be:
- What is their primary cesarean rate? The overall will include VBAC deliveries or repeat C-sections, so it’s good to know the stats for what applies to you.
- What is their episiotomy rate, and do they perform them regularly or only if medically necessary?
- What is their call schedule like at the practice? Do they rotate call, and does that mean someone who you haven’t met could be at your birth?
- Insurance! Is the provider in or out of network, and will you owe any copayments or coinsurances? In the years that I worked in medical billing, I was shocked by how many people didn’t have any idea about their maternity coverage within their health plan. Pregnancy can be an expensive insurance claim, so learn about your coverage so you’re prepared.
- If the birthing facility is a hospital, are they mother and baby friendly? Do they have any policies about induction, cesarean, or early discharge restrictions you should know about?
- If your facility is a birthing center, what is their transfer rate, and what would a transfer look like?
See how far you are from the back up hospital in case of emergency and see if the facility is state licensed and accredited. Take a tour of the facility where you’ll be delivering. Do they have a NICU and what level of care do they provide? What type of postpartum support is offered? How the facility looks is nice, but it is the skilled, safe hands of the provider and staff that are most important. You’ll remember the nice nurse who held your hand more than the thread count of the sheets.
Be Honest About What You Need in a Birth Team
Consider what you want from your labor and delivery experience, and create a birth plan that suits your needs. A hospital or birth center can help you create one, but remember that with the unpredictability of childbirth, flexibility is key.
Decide if you want a medicated or unmedicated delivery, and who will be in the room with you. Being honest with yourself about your personality and your needs is a great step to choosing a doula, birth class, doctor, or midwife.
Are you a procrastinator? Maybe a class like hypnobirthing wouldn’t be a good fit in this case. Are you an information junkie? A class like the Bradley Method that gives you an overabundance of clinical knowledge might be a good fit.
Do you require tough love or a nurturing presence? This helps you pick providers and find a doula with a more motherly bedside manner, or with a no-nonsense attitude that is going to be stern but caring during your labor. My boss at the clinic used to say that people give birth the way they live their lives, so it is a good time to have a little self-reflection.
Do Your Homework on Your Birth Plan and Birth Team
One of the best ways to have a positive pregnancy and delivery experience is to be an active participant in your healthcare. Giving informed consent to procedures and making informed choices can make a world of difference and help you feel like you’re part of the decision-making process. Friends and family often have the best suggestions, so first ask people you know and trust (tread lightly with online reviews, which may not be as reliable). Check organizations like the American College for Nurse Midwives (ACNM), the American College of Obstetrics & Gynecology (ACOG), the American Association of Birth Centers (AABC), and Commission for the Accreditation of Birth Centers (CABC). These will give you names of practices and providers who are licensed and are part of organizations that put safety and quality first.
Go with Your Gut About Your Birth Team
So often, patients joined our practice after having a previous birth with a different provider they weren’t satisfied with. The biggest complaints were that their previous providers didn’t spend enough time with them, they weren’t informed about their care, or they didn’t feel heard. The best secret I can share with you is to start going to your doctor or midwife before you’re pregnant. These providers will see you for routine gynecological services, and this is the best way to learn if they are someone you can trust for your pregnancy or any other complicated reproductive issues.
If you don’t feel comfortable or see red flags, make a change. But be aware that practices, particularly solo practitioners, have a cut-off of a certain week’s gestation, after which they won’t accept transfers.
The sooner you choose a provider and find a doula, the better. You’ll have more appointments with the same practice, you can get to know each other, and you’ll feel confident that they’ll take your needs into consideration during labor.