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checklist for care

You may be planning the perfect nursery or drafting that down-to-the-letter birth plan, but you might want to start your pregnancy by creating that checklist for what to look for in your OB provider.

Now that I am well into my fourth pregnancy and have almost three years working as a labor and delivery nurse under my (maternity) belt, I've realized that there is really one key factor in how a woman's labor and birth will progress:

her relationship with her healthcare provider.

Sure, it might sound silly, but I do firmly believe that the one person in the room, even if it's someone who swoops in at the last moment to do the baby catching, can have a tremendous impact on the course of labor and even the birth itself.

So how can you choose a provider for your pregnancy that will support you and ensure that the choices you make regarding you and your baby's health are respected?

1

Ask your friends for recommendations

Obviously, a doctor's office brochure won't tell you the full story about a doctor or midwife's practice. I've noticed that there tends to be a very different "real-life" approach from what doctors often advertise about how they practice, so ask around from patients who have been there already. They may be able to give you a more accurate picture of what to expect. On the other hand, realize that all of those birth stories need to be taken with a grain of salt, as one friend may extol the virtues of a particular doctor while another may banish him to the deep recesses of you-know-where. Try to be more specific and ask about how the doctor incorporated practices that you're looking for, like tub therapy, epidurals or even anesthesia for circumcisions if you're having a boy and choosing the snip. And one very sneaky tip? Call your local hospital up and ask the nurses who they choose to deliver with. Although they obviously can't tell you if they recommend one doc over another, but if a majority of OB nurses choose a certain doctor for their own babies, it's a very telling sign.

2

Know the difference between a doctor and a midwife

I've had babies with both a midwife and a doctor and let me tell you, there is definitely a huge difference in how they approach care for a pregnant woman. Midwives are much more hands-on and patient-led, while doctors tend to be more "professional" and hands-off, pretty much feeling like they are the ones in control and not having much interaction with you until you are literally delivering. (A general description, as there are exceptions, but there you have it.) For example, when I had a midwife with my first and I came into the hospital, still in early labor at midnight, she bought herself a coffee and plopped down on the bathroom floor while I sat in the tub to get through contractions. She was just there more and I loved that she let me do my own thing.

3

Interview him or her

Don't be afraid to put your potential provider through a little "interview" of sorts; after all, you need to remember that your doctor or midwife is actually your employee, not the other way around. He or she is working for you and you deserve to have someone who is in line with your beliefs and heck, even personality. I would suggest preparing a list of important questions for your first prenatal appointment — doctors schedule the most time for first visits, so it's a great opportunity to learn how they feel about the big-ticket items, like walking or eating during labor, VBACs, breastfeeding, skin-to-skin, etc.

4

Know that you can transfer care

Again, when dealing with pregnancy and you and your baby's health, it's important to understand that you are the one in charge. If you aren't happy with a doctor's care or you feel like something is causing tension that simply can't be resolved, you do have the right to find a new healthcare provider. The only suggestion I would make is to do make a switch as early as possible in your pregnancy, as liability and insurance issues can make it hard to transfer care late in your pregnancy, especially if you are having any complications that put you in the "high risk" category.

5

Don't forget about after the birth

Your relationship with your pregnancy healthcare provider doesn't stop after you give birth; in some ways, it felt like I needed my doctor more after the birth of my third child than I did during pregnancy. From a questionable discharge to endless bouts of mastitis to the ever-important discussions about birth control and postpartum depression, you need to know how accessible your provider will be after your baby's birth as well. Take into consideration how quickly you can get an appointment or if office staff is dependable to help you get the answers you need.

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