Changing Prenatal Care Providers
By Tine Reese
September 2, 2009How do pregnant women and their partners go about choosing a prenatal care provider? Often, they have not given it one bit of thought until they see two pink lines on a pregnancy test. Then it’s a mad dash to find someone you can trust to care for you during your pregnancy and give you guidance about how to birth your baby. You are not alone if somewhere down the line you realize that maybe you hadn’t initially given enough thought to who that person should be (I’ve been there!). Perhaps half way through your pregnancy you have become more educated about birth than you were when the baby was conceived. You may have changed your own views about what type of birth is right for you and now require the guidance and care of a provider who will support your vision.
Melinda Mardon, one of Spokane’s Bradley Method childbirth educators, raised this topic when we recently started corresponding. She said, “One of the first assignments I give my classes is to read and respond to an article by Joseph William Hazell, M.P.H. titled “Parental Decisions and Neonatal Health.” The article’s main point is that your birth experience is a reflection of your birth attendants birth philosophy—what they believe about birth. I think the most important thing to know about your doctor is how many of their patients have experienced an unmedicated birth. That will answer a whole lot of questions right up front.”
Melinda goes on to say, “In my third class I show the video “Giving Birth” by Suzanne Arms which illustrates the differences between having a hospital birth with an OB, a hospital birth with a midwife or having an independent midwife attending a birth center or home birth. It’s a real eye opener! After my students see this video they may only have 10 to 12 weeks before their babies are born…but now they are thinking. Some couples decide to stay with a hospital birth, but change from an OB to a Certified Nurse Midwife (CNM). Others decide to have a home birth with an independent midwife. Some wait too long to change and really wish they had, while others decide to stay where they are. Every couple is different.”
“We talk about many things in class that challenge the students’ beliefs about birth and then they can discuss those things with their providers. “Having A Baby? 10 Questions to Ask” (listed in the Natural Birth Section), is a good place to start. I try to make sure that the students have facts they can refer to rather than just saying that they learned it in their Bradley class. The sooner couples learn what questions to ask their providers, the sooner they can make a change if they need to. I encourage them to talk to other mothers about where and who they birthed with and make some appointments just to talk to the provider before making a decision. Some may not take new patients after a certain week of pregnancy.”
I asked Cathy Weston, a home birth midwife in the Spokane area, about her experiences with women and their partners who come to her late in their pregnancies. She told the story of a woman who contacted her ON HER DUE DATE because she was suddenly unhappy with her OB who said he would not do things according to her wishes—like wait to cut the umbilical cord until it had stopped pulsating. Cathy says she agreed to be her midwife because “the inner strength and determination of the mother (and couple) meant that a natural home birth was possible…no matter when she made that decision during her pregnancy.” This mom had her baby at home a week and a half after first meeting Cathy.
In regards to accepting new patients late in pregnancy, Cathy says, “I have to make sure they’ve been getting prenatal care and are in good shape. Then I have to educate them about natural birth.” Obviously, the more time your new provider can spend with you before your birth, the better prepared you’ll be for the experience. However, if you come to a new realization about birth at some point during your pregnancy, you might have to pursue a new avenue of prenatal care to get the birth experience you want. Cathy says, “As a mom you have to make decisions for your child and that begins in pregnancy, deciding how you will bring them into the world. We have lost our ability to trust our intuition. Women should hold on to what they know is best for them and not trust other people to decide what is best for them. That first journey into birth cements your ability to know your own power. Follow your passion!”
I have done my own research, trying to find good articles online about choosing a prenatal care provider and changing providers. I like “Choosing a Prenatal Practitioner” because it describes, in full detail, all of the options available including OBs, family practitioners and midwives. The author writes, “The difference in the prenatal practitioners lies not only in the way they treat you as a patient, but also the kind of delivery they prefer and the knowledge base they have in terms of pregnancy.”
I also like “Five Reasons to Choose a Midwife for Your Pregnancy Care.” It simply states the reasons a woman would want to have a midwife, like:
- A midwife is more likely to be your partner in your care, rather than the director.
- You enjoy longer prenatal care visits.
- Midwives tend to have much lower intervention rates, like a lower cesarean and induction of labor rates.
- You have more options of where to give birth.
Remember that the person you choose to oversee your pregnancy and birth will influence where you give birth and how your experience will play out. Be educated about birth, decide what’s important to you, research providers carefully and choose wisely. If you have a change of heart about the kind of birth you want, even late in pregnancy, you do have options. It’s never too late to at least talk to someone else who may be a better fit for you.
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Comments
Great article! I had 3 un-medicated births, 2 of which were home births. My first birth was in the hospital and FAR more controlled (even with my 2-page birthplan) and manipulated…and frankly, more unpleasant, than my 2 subsequent home births. I ALWAYS tell moms my birth stories because they are GREAT…what every expectant mom should hear (that, and all mom’s should have a doula
My births were not without their challenges, but the underlying theme throughout each birth was that I COULD DO IT. I KNEW I could do it. And I did. I was strong and capable. This is what women need to hear…and what we need to do is empower women with the truth of their individual strength and power. Hallelujia TINE! “Bloom” is exactly what we need!
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