Not all providers are really providing mother-friendly care, and it takes some investigation to determine if a provider is the right match for your family. Here are a few questions that can give you an indication of the type of care you can expect from your doctor or midwife:
1. Ask them about their personal birth experiences.
If your provider is a mother, you can ask about her own birth experiences. If he is a father, ask about his children's births. If the provider is not a parent, ask about why they pursued a career in labor and delivery.
The point is to get a general idea of their impression and philosophy about birth. If you are anticipating a surgical birth or if you expect to need some intervention, it may comfort you to know your provider is experienced, personally or professionally, with those methods of delivery.
If you are planning a birth without intervention, you may be relieved to know your care provider has seen birth uninterrupted often and knows how to support it. Even if a care provider is knowledgeable and experienced, that experience may not match up with your goals. I hear VBAC moms say they would love to have a doctor who has also had a VBAC, or twin moms who are fortunate to find a doctor who gave birth to twins. No, that's not necessary to have a great birth, but it may be an option in your area. The only way to know is to ask.
2. Ask what they consider valid reasons to induce labor.
Medical induction is so common in our culture, sometimes for valid reasons, sometimes invalid. But induction can drastically change the outcome and is not a decision to take lightly. When inductions are offered at early prenatal appointments as a matter of convenience, that should be a red flag, especially for a first time mom, since inducing labor can increase the likelihood of a cesarean. One of the most common reasons for induction is in pregnancy that continues past the mother's due date.
However, according to ACOG, women are not considered overdue until after 42 weeks. ACOG also says patients should be provided with clear Due dates are not always exact and in fact can be off by more than a week, depending on the method used to determine them. What we do know is that the baby's body actually signals the onset of labor, and there are health benefits to moms and babies when that process occurs naturally. This is something important to address early in pregnancy to anticipate how the last days and weeks of pregnancy will be managed or observed.
3. Ask if they promote movement in labor.
It only makes sense that for a baby to move down, wriggle and squirm through the pelvis and shimmy through the birth canal, the mother needs to be able to move her body and use gravity. I know from experience that just being able to walk, sway, lean forward and squat helped alleviate a lot of discomfort in each of my labors.
Staying upright helps keep the weight of the baby on the cervix and makes each contraction more effective. Often movement is restricted just for the sake of policy, but laying in a supine (flat on your back) position can be the most uncomfortable and least productive position. There are so many other options for labor and birth positions. Talk with your provider about using movement as pain management and to encourage progression.
4. Find out if you will be allowed to eat or drink in labor.
This may be more of a hospital policy, but your care provider should be able to let you know the expectation of your birth place. The benefits to eating and drinking have been well documented. Labor is a seriously workout for the body and needs replenishing. Even the American Society of Anesthesiologists has acknowledged this. Find out if your care provider will support this basic need in labor, for you and your baby.
5. Talk about the golden hour immediately following your birth.
You may have heard by now the first minutes after birth are magical, even on a physiological level. Not only are your emotionally linked and connected to your baby and your baby to you, but your body responds to having uninterrupted skin-to-skin time with your baby, especially during the first hour. As oxytocin rages in the mother's body just by touching and smelling her baby, milk production begins, the uterus can contract more to expel the placenta and stop heavy bleeding, and the mother's emotional response can be more favorable from these happy hormones.
Babies may nurse more effectively, have better blood pressure levels and body temperatures and be less stressed in general. The benefits to enjoying this "golden hour" together are well documented and this is something worth discussing for your recovery and long term health.
Try to think of each prenatal appointment as an opportunity to build trust with your care provider. Bring your questions, concerns and insecurities and consider how they respond. It is never too late to switch care providers and you will not regret feeling at peace with your birth team when your birth date arrives.