When I was pregnant with my first baby, one of my closest friends was pregnant with her first baby as well. Back then I did not know that hospital midwives existed and so I asked her if she liked her OB and would recommend him to me. She said: "he is ok - definitely competent and knows what he's doing, maybe he's not the most talkative -- but he has great office hours that start before we have to be at work."
Back then I was working full time for a graphics developer and my boss was kind of a jerk. I knew that it wouldn't fly if I took an hour (plus travel) off every month for a prenatal visit.
So what did I do?
I made the mistake of I prioritizing my boss's preferences over my own needs.
Compromising on my own needs is something I learned later on down the road never to do. I did not realize it back then - that in addition to wanting a medical provider who was competent, skilled, educated and esteemed in the birth world, I also really wanted and needed a provider who would be compassionate. Someone who would make the time to sit and listen to my concerns, fears, and help me address and dispel them. Someone who would take the time out of their busy schedule to answer every question I had prepared over the last few weeks since I had seen them last.
I realized, I wanted to play a role in my pregnancies and births.
I did not only want to be the pregnant woman who's baby this person had to deliver safely.
I wanted to be an active part of the team.
The team that would help me birth my baby into this world.
I did not realize back then, that not every single medical provider is capable of including a woman as an active part of the birth team.
The OB I chose to hire for my first birth did not include me as an active part of my own birth team, and that is why I am writing this blog post. To include as much information as possible in what to ask an OBGYN or Midwife before you hire them, so that families can make their own informed decisions and have the best birthing experiences possible.
We all know that sometimes birth takes an unexpected turn. But how you remember your birth (whether you remember being supported and positively encouraged by your provider or not) -- that is one thing we can control by choosing the right provider we hire.
I cannot tell you how many women tell me that their doctor dismisses their concerns and fears, and tells them that we'll cross that bridge when we get to that point. That they'll answer their questions when they get closer to the birth. Doctors who are rushed during every prenatal visit. Mothers who wonder if this is normal or if they should be worried.
Mothers who wonder if anyone ever changes their OBGYN during pregnancy? Would that make their doctor mad? What if no one else is available and they've left their doctors practice? What if the grass only seems greener on the other side of the fence and they regret their decision to leave their doctor? They've already paid all their fees, what do they do now?
If you don't know that something exists, (like episiotomies or perineum massage), then how can you make an informed decision about whether this is something of importance on the day you birth or not?
31 QUESTIONS TO ASK AN OBGYN OR HOSPITAL MIDWIFE BEFORE YOU HIRE THEM:
The most important questions are going to be the Questions to Yourself. Because no matter how recommend a medical provider is, they won't be the right one for you unless they meet your personal criteria. As an innately wise woman, I urge you to consider the following:
How did the things she/he said make you feel? Did she/he let you feel heard and not rushed? Did their personality help you to feel connected and instantly safe and supported?
Take note of what feelings may rise from your instincts.
Those feelings will always be 100% right.
They will become unavoidable during birth. It is impossible to hush the roar of your maternal instincts without compromising your peace.
The following questions depend on your preference of birth plan. Some may interest you, write them down or print out this list. Others you may naturally skip if they do not apply.
Are you open to birth plans?
What hospitals do you have privileges at?
How many vaginal checks do you do during pregnancy and during labor? Should I get them, how necessary are they, what are the benefits/downsides and when do I need to have them done?
Under what circumstances during pregnancy would you recommend an induction? How can an induction affect the outcome of my birth (vaginal / cesarean). What type of inductions do you do?
What percentage of your patients use a doula? What % get an epidural?
Under what circumstances during labor would you recommend to administer medications such as cervaidil or pitocin?
How do you handle past due dates?
What is your percentage of vaginal births? / percentage of c-sections?
Under what circumstances during pregnancy would you recommend a scheduled cesarean?
How many people are in the practice?
Who is your back up Midwife or OB?
Who is the OB covering doctor? How is he/she during labor? When can I meet them?
What is your opinion of doulas? Are there specific doulas you prefer to work with/would recommend?
Delivery & Cord Clamping
What are your feelings on the dad catching the baby, or me catching my own baby? Will you deliver the baby? Or will you assist me in birthing him/her/them?
What are your feelings about delayed cord clamping? How long do you delay for?
Do you continue to see clients with Gestational Diabetes, or do you refer them to an OB?
Do you routinely administer Pitocin post birth as a preventative measure against post-birth hemorrhaging?
Are you planning any vacations, trips, major surgeries, or other events 3-4 weeks before my due date, or up to 2 weeks after my due date that would interfere with your attendance at the birth?
How do you feel about hypnobirthing? Are you experienced with delivering babies for moms who are using hypnobirthing?
What is your percentage of NICU transfers?
If I change my mind about an unmedicated birth, how will you respond?
What positions do you feel comfortable delivering in? (on back, squatting (using a squat bar), on all fours (knees and elbows)?
How does it work if I am GBS positive - how often do you administer antibiotics during labor and do you do specific procedures with the baby after birth
Do you do IV/Heplock? Are you ok with laboring tubs, (or hydrotherapy by standing in the hospital shower), eating small snacks during labor?
What are the pros and cons of vitamin K shot and eye ointment
Do you offer or suggest taking specific childbirth preparation courses?
During labor, how close together should my contractions be before I head to the hospital?
If my water breaks before labor (contractions) even begins, how long can I labor at home for before I am required to go to the hospital?
What happens in the event of pre-term labor before 38 weeks?
Under what circumstances, if any, do you perform episiotomies? Do you recommend doing perineum massages throughout pregnancy leading up to birth?
How long will you and/or your support team stay with mom and baby after the birth?
Is breastfeeding support offered?
Is your practice VBAC friendly?
Do you deliver breech? [Most babies will move into delivery position a few weeks prior to birth, with the head moving closer to the birth canal. When this fails to happen, the baby's buttocks and/or feet will be positioned to be delivered first. This is referred to as “breech presentation.”]
Do you recommend trying to turn the baby if the baby is in breech position during labor or in the last few weeks of pregnancy or do you recommend a cesarean birth?
Follow this link to read 20 Questions to Ask a Doula