|Posted by kate.herzel on February 25, 2012 at 11:00 PM|
It's not your fault! When we are made to feel like "patients who will be delivered" instead of "women who will birth," it is automatic for us to assume that our midwife or doctor has our best interests in mind and will guide us down the right path when it comes time for the big day. While this is somewhat true, unfortunately there are other factors pulling at a provider that can cause them to recommend things that might not be in the best interest of a (soon-to-be) mom.
Here are a few questions that I recommend you write down and take with you to your next appointment (even if you don't know what they mean just yet):
1. When I go into labor, would you like me to call your office or just go to the hospital?
-This is a non-confrontational starter question that can give you some insights into just how hands-on your provider is. If she tells you to call the office first, it's a good sign that she wants to be a part of your labor and not just show up to catch the baby! Also, it might mean that she would like you to labor at home for awhile, and hopefully not have unneccessary interventions in your labor by showing up at the hospital very early and being put "on the clock", so to speak. Bonus points if she takes time to discuss some of the signs of labor with you. If she suggests heading straight for the hospital, you may want to start asking more questions about how she would like for you to labor.
2. When do you consider inducing a labor? What methods of induction do you prefer?
-This is a slightly more subtle way of asking your provider if she practices a medical model of care or an expectant model of care. Many women assume that doctors are medical and midwives are expectant, but that certainly doesn't hold true with our local providers! If you are unsure of the circumstances she describes, write them down and do some research. Your childbirth class will probably explain the pros and cons of induction as it relates to some specific conditions, and your childbirth educator will be able to answer your questions about others if you have them. There are pros and cons to both the medical and expectant models of care, depending on what kind of birth you want, which will also be discussed in your class.
3. How do you handle tearing?
-This is a chance for the midwife or doctor to discuss episiotomy rates, and whether she practices supporting the perineum during pushing, or whether she uses purple pushing (nurses counting to ten while you bear down) or lets you push when you feel the urge. A good follow up question is, "in what circumstances do you find it necessary to cut an episiotomy? How often do you cut them?" if she does not bring it up specifically.
4. How do you feel about food and drink during labor?
-All the local hospitals have a "policy" that you cannot eat or drink during labor. But, your provider can override that policy. This question will help you gauge whether your provider is willing to go against the grain, or if she does things by the book. It may take some prodding because she is likely to say "the hospitals have a policy of NPO, meaning nothing by mouth," so you might have to ask more specifically if she makes exceptions or thinks it is beneficial to eat and drink during labor (research shows that it is, but old habits die hard--your childbirth educator will explain more).
5. What will you do during my labor?
-This is a pretty straightforward question. Some providers do not show up until you start pushing, and may instruct nurses to call once you are ready and keep you from pushing until they arrive. Others may be more free to come in and out during your labor or will come when you are, say, 7 cm dilated (or more, or less). This is also a good time to discuss who would attend your birth if your provider is unavailable, and whether they practice with a similar philosophy.
Let's face it--most of us spend more time researching what digital camera to buy than who will be at our births! Hopefully these questions give you a jumping-off point for getting to know your provider better. You will learn in your childbirth classes the importance of this information, so don't worry if you don't understand it 100%. If you later learn that you are not comfortable with one of the answers, you may be able to negotiate something different. Otherwise, it is never too late to change providers if you suddenly realize that you want a type of birth that is not likely to happen with the provider you have been seeing.
***Bonus question: Do you find that a doula is helpful to a mom during labor?
-A doula is PROVEN to be helpful to a mom during labor--I can show you the statistics from all of the studies that have been conducted!