Thinking about Your Provider

© thevalleydoula 2018

Considerations...

Since you will be working closely with your provider, you will want someone you trust.  You’ll want to consider the setting of your birth, the kind of experience you want, the condition of your pregnancy, and what your insurance covers (and how much that matters to you).

A Few Types of Providers

General Practitioner

• Works with healthy pregnancies
• Is (typically) already familiar with you, your health history, and personality
• Not all GP's have obstetric training, so you may need to choose an OB or midwife for specialized care

 Obstetrician

• Treats high-risk pregnancies
• Has access to epidural and other assistive technology
• Approaches birth with routine approach

 Midwife

• More individualized, holistic approach
• Intervenes only when necessary
• Can transfer you to an OB if a complication arises
• Provides personalized care (and generally has more time to do so)
• Attends births in a variety of settings (hospital, birth center, home)

6 Questions to Consider

1. Is a vaginal birth your priority?

Midwives are ardent supporters of vaginal birth, if you choose an OB or GP, make sure he/she is supportive of striving for a vaginal birth.

2. Do you want your caregiver with you during labor?

While none of the primary care providers are guaranteed to stay by your bedside, a midwife generally spends more time with a laboring mother, while the OB/GP generally let the mother labor on her own, if they are on-call when she is in labor.

3. What are your plans for pain management?

Frequently midwives encourage and support medication-free methods to manage pain first, while OB/GPs regularly provide near-immediate medicinal pain relief, though this does increase the occurrence of interventions and complications (though having a doula decreases these chances).1

4. What are you hoping will happen at the hospital?

Keep in mind OB/GPs have strict protocol to follow whereas midwives are able to have more flexibility with their policies.  It is worth considering your priorities in your birth experience and inquiring.

5. Do you want (or need) more support and advice for your transition to parenthood?

Midwives are known for their holistic care, covering topics such as nutrition, emotional changes, and role transitioning.  OB/GPs are able to refer to specialists in each of these areas, as needed.

6. Are you considered high-risk?

While midwives are a great option for someone experiencing a healthy pregnancy, OBs are trained to manage complications. It is possible to have both, but it will depend on your medical circumstances.

What if I want a doula AND one of these?

Great news!  As the saying goes, you can have your cake and eat it too!  A doula is trained to work with a variety of medical professionals in different settings, so she will not only be compatible with any provider you choose, but SHE will be the one by your side supporting and advocating for you during your entire labor and delivery.  Incidentally, if you’re having a tough time choosing your provider, a doula can help you determine your priorities as well as refer you to suitable providers.

What if I am 38 (or 20, or 6) weeks pregnant but I feel like my provider and I are not entirely on the same page?

Your provider works for you! You have the right to feel comfortable and at peace with your provider. Sometimes we worry about hurting our provider's feelings if we decide to seek care from someone else, but let's remember: this is like any other relationship, professional or personal: it is important that both of your goals are aligned and may be easier for both of you if you are with someone who shares your goals, preferences, and values. Don't be afraid to spend some time researching this. And above all: trust your gut!

Sources:

www.evidencebasedbirth.com/epidural-during-labor-pain-management/.

fitpregnancy.com; The Nurturing Touch at Birth (Perez); Homebirth in the Hospital (Kerr);

The Birth Partner (Simkin)