5/7/09

When choosing a Obstetrician...



Adapted from: Your birth your way blog
If you are thinking of choosing an Obstetrician as your care provider for pregnancy and birth, it is essential that you choose someone who is the right fit for you. You will remember your childbirthing experience for your entire life.

Interviewing at least 3 OB's is vital in discovering whether that person will respect your wishes for the birth you want. You might form a really good opinion of OB #1, but when you interview #2 you may discover that the first was really not on the ball with current evidence-based care.

Be informed of what is acceptable and safe obstetric practice before you begin interviewing, otherwise you won't know if what you're hearing is myth or reality. Unfortunately there are many OB's who would rather do a cesarean for their own convenience than wait and give you time to birth your baby naturally. However there are also some fantastic OB's who will not rush in to perform un-necessary surgery, and will give the birthing mother the respect, time and support to birth the way she wants to.

But, how do you work out who is good and who should be avoided?

Firstly, work out what you want your birth to be and why you want that. Do you want a completely natural, drug free birth? Do you want a natural birth, but are open to the idea of drugs if you decide to use them? Do you want every drug under the sun? Do you want a cesarean? Do you want to be able to move around & eat & drink during labor? Are you basing these decisions on what is best for you and your baby, or are you making decisions based on fear? Have you considered and researched all the options for maternity care? Don’t forget that although some women may need obstetric care, for the vast majority of women the very best maternity care you can receive is from a midwife.

Secondly, take responsibility for your birth. It is not the OB's responsibility to make the decisions and tell you what to do. It is your responsibility to accept this birth as yours, and make wise well thought through decisions about what you want, and then tell your OB what will be done. If they try and push you to do things a certain way that is against what you want, then they are not the right one for you, and you should take your business elsewhere. Do not forget that you are the client, you have the business they want, and they need to be respectful.

Thirdly, inform and prepare yourself well. Read the good books, not the ones written just for a laugh.
My birth recommended reading list:
  • Ina May's Guide to Childbirth
    by Ina May Gaskin

  • The Thinking Woman's Guide to a Better Birth
    by Henci Goer

  • Childbirth Without Fear
    by Dr Grantly Dick-Read

  • The Birth Book
    by William Sears

Remember that knowledge is power, and if you are well informed you will make wise decisions. Speak to people who can help you find answers to your questions, not just your your mom or girlfriends, as helpful as they may be. Talk to midwives and Doula's. Even if you would never consider home birth, talk to the independent midwives, they are highly trained, experienced and a wealth of knowledge, they will offer a different perspective which can only ever be helpful in giving you a more well rounded understanding of birth.

Fourthly, hire a Doula to support you and your partner throughout your entire labour and birth. Doula’s, unlike hospital based midwives and obstetricians, will stay with you throughout your entire labour and birth. Having that continuity of care makes an enormous difference to your ability to cope with labour and both mother and baby’s well-being.

Write down all your questions, so that you won’t forget them at your appointments. It’s all too easy to get distracted by listening to baby’s heartbeat and the myriad of other checks, and forget the questions you’ve been waiting all week to ask.

Here are some Interview questions for Obstetricians.
Under what circumstances do you consider Induction necessary?
If my waters break but I do not go into labor immediately, how long would I have before you would want to intervene?
What is your policy on breaking the waters, epidurals, episiotomies?
What is your episiotomy rate?
What is your policy regarding monitoring of the baby?
What is your policy on eating and drinking during labour?
What is your policy on Vaginal Breech Birth and Water Birth?
What is your caesarean rate for first time mothers?
What is your VBAC (Vaginal Birth after Caesarean) rate?
Under what circumstances would you consider doing a caesarean?
How do you try to avoid the need for a caesarean?

If an Obstetrician is very vague and dismissive of your questions, or if they patronise, ridicule or try to use scare tactics to convince you of their reasons, go somewhere else. It is better to choose a new care provider than to try to fight for what you want while giving birth. It is never too late to change care-providers. I know of women who felt unsupported by their Obstetricians, and they changed care-providers and had the wonderful births they wanted.

Remember this is your birth and your baby, and you deserve to be supported and cared for in the way YOU require.

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