It's no secret, the US ranks low in terms of maternal and fetal outcomes compared to other industrialized countries. The maternity care system, though expensive and well-educated, needs improvement. Mothers may feel they are at the mercy of the system, but are more powerful than they realize as the consumers drive the market. Here are three simple ways to influence change in the system overall.

1. Interview Your Care Provider

The first step in choosing a care provider is to make a list of questions, meet with them and get a sense of the provider's standards and philosophy about child birth to see if they match your own. If you need help figuring out your own philosophy or knowing what questions to ask, a childbirth class (outside of the hospital) is a great place to start. If you are looking for book recommendations that educate women on options and risks, check out The Thinking Woman's Guide to a Better Birth by Henci Goer and Gentle Birth, Gentle Mothering by Dr. Sarah Buckley. I often hear pregnant women talking about how they wish their care provider would offer a certain type of care, but knowing they will not, the women feel stuck or like it would be too much effort to change providers. I also know of women who changed providers within days of giving birth. You will not regret the efforts made to partner with a provider you trust, who respects your role and who honors the process of delivery. Pregnant mothers must send the message to maternity care providers that we are seeking mother-friendly care.

Related Article: 5 Questions to Ask Your OB or Midwife

2. Appeal to your insurance to cover mother-friendly care.

We have had maternity care coverage from major insurance companies during each of our three pregnancies, but none covered our preferred midwifery care. We paid out of pocket each time, which ended up being about the same about as we would have paid in coinsurance for a typical hospital birth. After our second baby, I sent our midwife's bill to our insurance company to ask for reimbursal. It was denied when I sent in the bill, so I sent it to Appeals, along with a printed study showing the safety of birth center births and a letter explaining why we chose to birth out of a hospital, what all was including in my maternity care, ways I improved my chances of staying low-risk and an average of how much money I saved our insurance company. And they sent us a check for a percentage of the bill! I realized then that because out of hospital birth is rare, many insurance companies do not have a written policy for it. It's not that they have actually considered it and denied it- there has not been an overwhelming need to include it in their policies. So, they need to hear from mothers desiring coverage that is not covered. That includes alternative medicine, acupuncture, chiropractic care, lactation consultant appointments- always send in your receipt. Let them know the benefits you experienced, how it possibly saves them or you money and that you would like to continue this type of care in the future. Even if it is declined this time, it may change their answer in the future.

Related Article: Why Don't People Talk About Their Good Birth Stories?

3. Tell your story.

If you had a great experience and loved your care provider, tell other mothers about it. If you had a difficult experience and wish it was different, tell your story. If you saw a policy that helped or hindered your labor, tell your story. If you learned something afterward that you wish you had known sooner, share that with other mothers. Use discretion about whom you can trust with sensitive information and timing when it will be well-received, but it is an honor to pass down your experience. The oral tradition of motherhood grows community and builds confidence and is vitally important to bringing about major changes.