By Erin Stertz-Follett, CD(DONA), LCCE, HBCE
Your appointments shouldn’t feel rushed. Yes, the pressures on providers to turn a profit and keep the insurance companies happy are real in the medical world. But there are providers out there who will take their time, in some cases 45-60 minutes for each prenatal appointment - And this is what you deserve! Longer appointments allow both parties to become familiar and comfortable with each other. They build trust. They open the door for education. They make you feel safe asking questions, no matter how big or small. In general, the midwifery model of care allows for longer prenatal visits. However, there are obstetricians or family practice doctors who buck the 'system' and spend that extra time with you! Look for a provider who sets down the chart, or turns away from the computer monitor, to look you in the eye and address all of your concerns.
2) They respect your opinions. You are equals.
The provider-patient relationship should never feel one-sided. This is your birth and your baby, after all. You shouldn’t feel like your provider dismisses your thoughts or instincts about your pregnancy or desires for your birth. It is okay to have disagreements throughout your relationship with your provider, but you shouldn't feel like you are constantly having to fight for what you want; and you should never feel belittled. Their opinions should always be backed by sound evidence, as per Sign #3...
3) They answer your questions… With best evidence.
Ever hear the term “evidence-based medicine” or “evidence-based birth?” Yeah, it’s real. We are living in a time where “this is just the way we have always done it” doesn’t hold water anymore. If your provider says, “Yes, I always practice evidence-based care,” yet the cesarean birth rate for their clinic is 45%, you may be right to question their answer! Listen to the language they use. A perfect example is a mother preparing to have a VBAC (vaginal birth after cesarean). If her provider is using language like, “we will let you try” or “we will allow you to go through trial of labor,” this signals that they are perhaps more "VBAC-tolerant" than VBAC-supportive. In reality, the evidence shows that VBACs are recommended and safe for the majority of women (ACOG and NIH agree). Words like “let” and “allow” have no place in birth.
If your provider is recommending a procedure for pregnancy or birth that you are unsure of, ask them for the literature... And use your B.R.A.I.N! A truly supportive provider wants you to be involved in making decisions about your care and upholds the tenets of informed consent/refusal. You can also visit evidencebasedbirth.com to aid in your research about common birth practices.
4) They include your partner/family.
Birth is a transformative event in the life of a family! Your partner/spouse/older children should be included. Appointments with your provider should feel welcoming to those who you care for and who care for you. Your partner/spouse should be involved in the discussion surrounding your pregnancy and birth and should be encouraged to ask their own questions. Birthing requires a team and you’re all in this together!
5) You leave each appointment feeling better than when you came in.
You should depart each visit with your provider feeling supported, informed, listened-to, and with a little bounce in your step! If you do not, this could be your gut telling you that you need to look elsewhere. You should never leave your visit feeling like you have more questions than answers or like you were wasting your provider’s time.
Helpful Hints for Finding a Supportive Provider:
- Interview a number of providers before making your choice. There are many good lists of interview questions out there. Click HERE for a great example from Lamaze International. Many providers are happy to schedule a consult before you sign-up for their care. Take advantage of this time to get to know their philosophy on pregnancy and birth, and decide if their personality and philosophies are the right fit for you! Be sure to ask what their rates are for cesarean birth and for other common birth interventions.
- Ask for recommendations from those you know. Friends, family members, doulas and childbirth educators in your community, and others can guide you towards selecting a provider who might match up well with your views on birth, whatever they may be. Explain what you are looking for and ask your contacts why they would recommend this provider, how they have seen them practice, etc. First-hand knowledge from others can be invaluable! Just remember that you have your own unique values surrounding birth, and someone who is right for your sister or friend may not be right for you.
- Remember: It is never too late in pregnancy to switch providers!
I have known families who have decided to follow their “parent antenna” and switch providers as late as 38-39 weeks of pregnancy. While it is never ideal to have to "start over" late in the game, it is usually a true game-changer. You are a consumer, and you have the right to receive only the best services. Don’t worry about hurt feelings; and don’t allow any guilt-tripping (real or perceived) from your current provider sway your decision. Sometimes the person who you have seen all of your adult life for your annual exam/pap smears is not someone who shares your birth philosophy… And that is okay!
Flutterby Birth Services, located in Edina, MN, provides childbirth education, breastfeeding education and support, doula care, placenta encapsulation, parenting groups and classes, prenatal fitness, and more!