HMO Insurance

I'm sorry you're not receiving the personal attention and celebration of your growing baby that you deserve! The frustration you're feeling is, unfortunately, built into the medicalized and depersonalized system supported by insurance. In trying to navigate within a large HMO, first make sure you know what your options are within that system. Do you have a choice of doctors--there's nothing wrong with interviewing and changing doctors! Does the HMO cover midwives at some other hospital? It could be worth driving an hour or two, if so.

Assuming you've made the best choices you can within the system, then the most important thing is to inform yourself about pregnancy and birth. You need to know what your options are regarding the barrage of tests they want to do during pregnancy. As you read, write down questions to take with you to your prenatal appointments, as it's easy to forget your questions and concerns in the "assembly line" care.

In addition to reading, take childbirth classes now, rather than waiting until nearer the end of your pregnancy. I would recommend skipping the hospital classes, because they are likely to explain "what the hospital does" rather than tell you what all your options are (they're working for the system, after all, and sometimes they don't have choices--like having to have an anesthesiologist come in and extol the virtues of epidurals, for example). You'll get a more complete picture by finding classes offered by an independent childbirth educator (trained by ALACE, Birthworks, the Bradley Method, etc.). You can find these instructors by searching the websites of these organizations, or by talking to other women in your community. Attending the monthly support groups offered by LaLeche League International will not only give you valuable information about breastfeeding, but it will also put you in touch with the local grapevine of childbearing women, who are in touch with all the resources in your community. Really becoming informed of your options can help you to formulate a written birth plan, which can be an important piece in navigating the system.

And seek out a doula! Doulas are women who are experienced in birth and who have had special training to accompany you (and your partner) in labor and delivery. Spending the extra money to have a doula during labor and delivery is the best investment you can make--and your best protection against having an unnecessary cesarean. You can find doulas who have been trained by organizations such as ALACE and DONA--search on the web, and start asking around!

Since you can't expect the system to change, I recommend finding other sources of celebration and empowerment with women in your community. In addition to looking into La Leche League meetings, is prenatal yoga offered in your community? Or prenatal massage? It's too bad that no one during your prenatal visits wants to listen to you, but they're not likely to be the ones who are present at your birth, in any event. So formulating what you want in writing and having a doula are your best bets for having a good birth--unless, you want to leave the system altogether by having a homebirth and can find (and afford) experienced homebirth midwives in your community. Best wishes!