Are you using the right healthcare provider for your pregnancy?  I just found this great quiz you can take to find out:

http://www.delivermybaby.org/

by, Amy Hoyt, CCE, AAHCC

The month of November had us meeting to discuss choosing health care providers. Knowing how important a health care provider is to a woman’s birth experience, we opened up to freely discuss what each of us felt was important in who we invite to oversee our births.
 
Who you choose to take care of you through your pregnancy and birth experience will shape the way you feel about the experience, and even how you feel as a mother. This critical decision is often left to chance - insurance or location being the deciding factor - rather than a thorough educational decision.
 
Choosing a provider based on who your friend had, who’s on the top of the insurance list, whose office is closest to you, who is female, or who looks the nicest are common, but misguided, ways of finding this critical person.
 
Why Who You Choose is Important:
 
Who you choose to accompany you through birth is probably the most influential decision for your birth outcome. Even if you are well-educated in what you want, if your provider doesn’t support your choices, it’s not going to turn out your way. The provider/patient relationship should be one of mutual trust.
 
This story was shared at the meeting by a mama who felt that her care provider did not have her best interest at heart:

Dr. _____seemed to be a nice doctor until it came closer to my due date. My baby’s due date was estimated to be July twelfth. I informed Dr. _____ that with my first child, not only did she come later than her scheduled due date, but that I had a scary experience with being induced with pitocin, and so I did not want to be induced again unless it was medically necessary. He didn't seem to listen to what I had to say, and scheduled me to be induced a week before her due date. I kept reminding him of my feelings to not be induced and to let the baby come when she was ready. He informed me of the "risks" of the baby staying in too long such as a still born birth etc. I told him that I was aware of those risks but still wanted to let the baby come when she was ready. In my mind, it was just as risky to be induced before my body was ready than the risks of keeping her in longer than he thought was necessary.

Each appointment I had with Dr. ______ he would push me to be induced by scheduling an appointment with the hospital without even asking me how I felt about his decision. On July fourteenth an ultra sound made it clear that everything was fine and the baby was well. After scheduling different dates for me to be induced that I would just later have to call the hospital and cancel, Dr. ______ said that he wasn't willing to allow me to go over 41 weeks. I asked him when the 41 weeks started and he said Saturday the eighteenth. He wanted me to be induced Friday the seventeenth. I asked if I could wait until I was actually at forty one weeks and he then told me that he wasn't delivering that week and a different doctor would be. I felt so frustrated and discouraged because I knew in my heart that my baby would come when she was ready and I wanted to work around her schedule and not his.

This woman was so uncomfortable with her doctor, that she considered switching care providers at 40 weeks gestation, but had trouble finding someone who would take her that late in pregnancy.
 
Another mama at the meeting was lucky enough to see her doctor’s true colors early on in her pregnancy:

Every time I went in for a check up, Dr. ______ would tell me that I was gaining too much weight. I was a vegetarian, I ate real healthy, I went to spinning classes three times a week. What I gained was not due to being unhealthy. Yet, she kept insisting that I was gaining too much and that I “needed to watch what I was putting in my mouth”. I thought that I could just put up with her for those few minutes I saw her during our monthly appointments, after all, she probably wouldn’t even be at my birth. But, I decided I couldn’t take anymore and switched to a different doctor. He was really respectful, and open to the type of birth that I wanted. I was glad I changed doctors.

Many women don’t realize that they can change care providers, even late in their pregnancy! It is the doctor that works for the patient; you are paying them for a service they are providing. It’s a good thing to search around for the one you feel best meets your needs, and the one you feel most comfortable with.
 
How to Find The One:
 
The mom in the first story said that her doctor was really nice and seemed to listen to what she wanted throughout her pregnancy, but when she got closer to her due date, his whole attitude toward her changed. How do you go about finding a care provider that will respect you and NOT pull the “bait and switch” tactic?

• Ask better questions. Instead of asking friends, “Who did you have, and did you like them?” Instead of finding someone who is “nice”, ask what your friends liked about them. See if their birth experience is one that you would like to have. Ask your doctor, and ask the nursing staff at the hospital what this doctor’s record is. Do they have a lot of inductions? How do they handle natural childbirth? It’s important to find out beforehand if they are the type to say one thing and then do something else.
• Ask someone experienced. Ask your local childbirth educators and doulas. These woman have a lot of experience with different types of births with all different doctors in different hospitals. See who they recommend for the type of birth that you want.
• Trust your instincts. They are usually right! The mom in the second story did not like the way she felt when she saw her first doctor. That was her intuition telling her that that doctor was wrong for her! Luckily she listened to her internal voice and switched when it was still easy enough.
• Be educated. Find out about normal birth. Look into the various procedures, the different options, their benefits and risks and evidence-based care. This will enable you to have a much deeper discussion with your provider about what you want from him/her and how you wish your birth to be. It will enable you to make a more educated decision about your care and who will oversee it.

Doing all of the above still will not guarantee a beautiful outcome, but choosing a care provider whom you trust will lead to a birth experience which allows you a greater amount of control, input in the decision making process, and to feel you did the right thing if you need to let your doctor make the choice for you if an emergency arises.

by, Amy Hoyt, CCE, AAHCC

You probably are wondering what the Wiregrass Birth Network is, and what’s our purpose here in the Wiregrass region. We wondered that for awhile too!
 
The Wiregrass Birth Network is a local chapter of a national, non-profit organization called BirthNetwork National. BirthNetwork National was started by a group of women who saw a need for more education and support for evidence-based maternity care in the area they lived. Though the organization has grown tremendously, this purpose has remained the same for each and every BirthNetwork National chapter.
 
Here at the Wiregrass Birth Network, our mission is three-fold.

• First, it is the purpose of the Wiregrass Birth Network to help women and families of Southeast Alabama to be aware of evidence-based care. It is our purpose to help them become informed of mother-friendly maternity care and the rights they have to receive it.
• Second, it is the purpose of the Wiregrass Birth Network to support a woman’s desire for mother-friendly maternity care, support the providers who offer it, and support efforts that encourage it. It is our purpose to support mothers through their hardships and through their joys, and to offer mother-to-mother care and camaraderie.
• Third, it is the purpose of the Wiregrass Birth Network, through encouragement and opportunity, to nourish the desires in women to make a difference. We purpose to do this through encouraging advocacy through letter-writing, speaking out, becoming doulas, breastfeeding counselors, childbirth educators and midwives.

Some people may be turned off by our natural childbirth topics. Do we only support one way of giving birth? We support natural childbirth because it is most often the safest way for moms and babies. We are not anti-drugs, anti-intervention, or anti-cesearean. Our main goal is to help moms and families have a deeper understanding of their choices, to understand the risks and benefits of the choices they make, and to feel confident in their ability to make decisions that are right for their situation. There is plenty of support out there for inductions, epidurals and cesareans. It’s the sad reality of the society we live in. For those moms who are interested in something other than what has become normal, we are here for them.
 
Why are we here? Well, there are not a lot of normal births happening in this area. The normal birth in the Wiregrass region is usually an induction with cervadil and pitocin, lots of fetal monitoring while mom is restricted to the bed, an epidural to ease the pain of the pitocin contractions, pushing with legs in stirrups, or, nearly as often as not, a rush down to the O.R. for a cesarean due to fetal distress, or a baby who just refuses to come down. This may be a cultural normal, but it is far from how birth is meant to be.
 
Evidence is showing that, while most moms say they had a good birth, underneath those words a lot of women have conflicted feelings. A lot of women feel like all of the control was taken out of their hands, that their voice was not heard, and that, while they are so thankful for a healthy baby, there might be more to birth than just that.
 
Why is birth like this in the Wiregrass area?

• Obstetricians are trained specialists. They are trained in all that can go wrong in childbirth, and therefore tend to see childbirth as a dangerous event. When they can monitor and have control over the event, they feel that they can prevent a lot more bad from occurring.
• Midwifery care here is very minimal and so restricted, it is unable to bring balance to the medicalized view of birth.
• Women in this region are not making a fuss about normal birth because they have been taught that induction, epidural and cesareans are normal.
• Obstetricians have such high malpractice insurance rates that they are overbooked in order to gain any profit. They do not have time to wait around for normal birth. And normal birth doesn’t bring in that much money.

What can we do about this? 

First of all, speak up. This is your body, your birth. You have the right to ask for reasonable requests. If you feel your care was not adequate, please let it be known by writing letters to that care provider, the hospital, the Alabama Medical Board, and to your political representatives. If you have been pleased with your care, write letters about that as well! 

Second, support doctors and midwives who respect women’s choice and their opinion. Third, bring in back up. A kind, compassionate, and strong support person can do wonders for making this life event into something wonderful and empowering. Lastly, be educated! Learn about normal birth. Research the risks and benefits of all your options; seek out evidence-based care.