By Stephanie Greunke, R.D.
The information included in this post is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. Always consult your healthcare provider to determine the appropriateness of the information for your own situation, or if you have any questions regarding conception, pregnancy, or your prenatal treatment plan.This post is intended for readers in the United States, as other countries have different policies when it comes to health care providers.
In part one of this series, I presented considerations for choosing the members of your birth team. Today, I’ll provide the six steps for you to follow while on your search. I’ll also give you a list of questions to ask potential providers and a list of questions to ask yourself to confirm you’ve made the best choice.
Check around with your friends, family and women in your community and collect referrals for potential providers. You can also search the Internet to find local options, or check your insurance company’s list of approved providers. Try to compile a list of 3-5 potential providers.
I shamelessly encourage the mamas I work with to Google the providers on their list before scheduling meetings. A quick Google search will provide you with the provider’s associated website, media appearances, and any events he or she may be hosting.
A provider’s website alone may give you enough information to make an educated decision. For example, say you want a homebirth, but your provider only does birth center or hospital births. That makes the provider an easy “no” and is a quick way to narrow your list. On their website, you may be able to see previous client testimonials, review the provider’s credentials, training, and background, and understand their birth philosophy.
Keep in mind that a few factors may make it difficult to determine if a provider is right for you by looking at the website alone. This could be the case if the provider is part of a group practice or if he or she isn’t in charge of the practice’s website. In this case, the website may leave you less than impressed. This doesn’t mean they are a bad provider. It just means you’ll need to visit them in person for an initial interview and tour to make a thoughtful decision.
Although, it’s not 100% fair to judge a book by it’s cover, this initial Google search can be really effective. Your mama instincts are strong, so as you’re scrolling through the provider’s website, listen to what your body is telling you. If something doesn’t feel right or looks suspicious, move on to your next option. On the other hand, if you notice yourself smiling and feeling warm and fuzzy, you may have found a winner. I did this detective work with both of my pregnancies and my instincts led me down the right path both times.
This step is a must for any provider who remains on your list after your initial detective work. I understand it’s a time commitment on your part, but you want to find someone who makes you feel confident, comfortable, and in control. Pregnancy is a vulnerable time in your life. A face-to-face meeting will make it much easier to determine if a caregiver will respond thoughtfully to your questions and concerns, provide you with options, and be willing to work with you to fulfill your birth wishes if medically possible.
Provider interviews typically last between ten to thirty minutes so you’ll want to maximize the time by learning as much about their policies and practice as possible ahead of time. Keep your list of questions narrowed to ones you can’t find the answers to online, or use this time to ask for clarity about a practice or policy you don’t understand. Also, know that most caregivers charge for office visits, so keep that in mind when scheduling an interview.
Personally, I’ve found midwives to be the exception to the generalizations above. Midwives may offer more time for initial interviews and they may not charge. During both of my pregnancies, multiple midwives talked to me for over an hour and the consultation was free. On the other hand, my OB-GYN charged me for the time, and only spent about 20 minutes with me.
During your initial meeting with the provider you’ll want to ask any questions you have about their preferred practices and care during your pregnancy. Here’s a list of potential questions to ask providers. Use this as a guide when creating your list of interview questions, but make sure to include questions that are really important to you. It’s a good idea to ask your provider’s office how long the initial meeting will last, so that you can narrow down your questions and pick the ones that are most important to you. If time runs out, see if they are willing to answer your questions at a different time, through e-mail, or if someone else in their practice can provide answers. Don’t feel pressure to make decision until you feel like your questions and concerns were adequately addressed.
Questions to ask an OB-GYN/Family Physician:
- What are your credentials?
- Are you involved in continuing education?
- What hospital(s) are you contracted with? Are any of these hospitals designated as “mother-friendly” by The Coalition for Improving Maternity Services (CIMS)?
This is a designation assigned to hospitals who promote a wellness model of maternity care that is evidence-cased, improves birth outcomes, and focuses on the health and comfort of mom and baby.
- What insurance plans do you accept?
- Are you part of a group plan or a private practice?
If the doctor is part of a group, you’ll want to meet with the other doctors in the group. This allows you to become familiar with them should one of them end up attending your birth. If you choose a doctor in private practice, he or she will likely be the doctor attending your birth?
- Are there days you wouldn’t be at my birth if I was in labor during this time?
- What percentage of your patients do you deliver?
- What are your (or the hospital’s) cesarean, episiotomy, and induction rates?
- What are your policies for women who go past-due, who have had previous cesarean sections, for permitted length of labor and pushing (or any other concerns or questions you may have)?
- What are your thoughts about natural, un-medicated births?
Important to ask if you want this type of birth as you’ll get a feel for whether or not the OB is on board with your desires.
- Do you support my birth plan?
Bring your birth plan or wishes along with you to the visit to make sure they feel comfortable fulfilling your desires, as much as possible.
- What support is available for breastfeeding?
- Do you support preventative medicine and nutrition?
- What is your philosophy of pregnancy, labor, and childbirth?
Questions to ask a Midwife
- What is your educational background?
- Are you involved in continuing education?
- How many births have you attended?
- What hospital(s) are you contracted with?
- What is your hospital transfer rate?
- What were the reasons for the transfers?
- What kind of equipment do you carry?
- What would classify me as “high risk” and necessitate transfer of care during pregnancy or labor?
- Can you describe your prenatal care?
- How many births do you attend each month?
- Who else may be attending the birth? What is the backup solution if you’re not available?
- Do you collaborate with a physician?
- What are your fees and what do they cover?
- Are any expenses covered by insurance?
- How do you monitor the wellbeing of the mother and baby while in labor?
- What options are available for pain medication during labor?
- Do you offer breastfeeding support and postpartum care?
- What is your philosophy of pregnancy, labor, and childbirth?
- The Natural Pregnancy Book by Aviva Jill Romm, MD
- How to Conceive Naturally by Christa Orecchio and Willow Buckley
If the provider’s office is different from the place where you’ll be giving birth, make sure to schedule a tour of the hospital or center where you’ll be giving birth. Both the practitioner and the location matter when it comes to having an optimal birth experience, so don’t forget about this piece. You might need to schedule a hospital tour weeks (or months) ahead of time as they may only run tours on a monthly basis. Schedule both the interview and hospital tour as soon as you can.
At this point, you’ve narrowed down your list, performed detective work, interviewed providers, and toured facilities. You’re so close to making a final decision and should feel proud of your hard work! The final step, making an educated decision about your provider, may be easy or extremely challenging.
If you are having a tough time making a decision, you can make a pro/con list, take a few days to sleep on it, or schedule another interview. No matter if the choice comes easy or is challenging, ask yourself these questions to ensure you’re making the best choice:
Questions to ask yourself
- How does he/she make me feel?
- Did the provider seem impatient and defensive or caring and open-minded?
- Were they respectful or dismissive when I mentioned my birth preferences?
- Am I confident that they will accommodate my requests (when medically feasible)?
- Am I comfortable with the setting(s) where they offer care?
- Did they address my pregnancy as if it was a special event or did I feel like a number?
- Do I feel excited and empowered about my pregnancy after meeting with the provider?
Of course, every mama is going to have a list of questions that will help her make the best decision. Use the questions listed above as a guide for your own personal reflection.
Once you’ve gone through the steps listed above, you’re ready to pick your provider and be on your way to an incredible experience! If at any point along your journey, you start doubting your choice, don’t feel listened to, or are getting answers you aren’t happy with, revisit your list of providers and/or start looking outside of that list. You deserve to work with someone who listens to you, you feel comfortable with, and who provides you with answers that make you feel empowered. Don’t stick with someone just because it’s easy or because you don’t want to hurt their feelings. This will only end up with resentment that may last a long time.
In the final post of this series, childbirth educator Cori Gentry will provide us with additional insight into choosing your dream birth team. She will share her top tips for choosing a birth provider and birth setting, steps to take to ensure you receive the best care possible, and words of wisdom from her years of working as a childbirth educator and her personal experience with four very different births.