Tips for: How To Find a Good OB or Midwife...

This is an important topic to me and one that we just waded through ourselves, so I thought I'd write about it just a bit on here.  I should definitely qualify this post though by saying that we have become only moderately educated about childbirth (through a Bradley Method class and our own experiences).. we are certainly not professionals!   As a result of really looking into birth and all of its complexities and options, we have decided to pursue natural, un-medicated childbirth because we feel like it is the safest route and has the best chance of leading to healthy mama + healthy baby (which is our #1 goal).  No matter what kind of birth you're hoping for though, I hope this post helps you select a good care-provider for you.

Finding the right doctor or midwife is very important!  Just like you don't buy the first pair of shoes you pick up in the shoe store without noting size, style, and comfort, you don't want to just "go with" the first care provider you meet (or the one closest to your doorstep or the one all of your friends rave about).. You first need to decide what you're looking for (no chaco sandals in the winter time for this girl!) and then you want to determine which care providers in your area best meet your needs.

Here are some questions that I recently asked our care providers:  

• Walk me through a typical, natural birth with you as the care-provider…
• How much of the actual labor & delivery do you attend?
• What are the chances that you will be there for my labor/delivery?
• How often do you like to check dilation?
• Do you recommend routine 3rd trimester ultrasounds?  Why?
• Is eating/drinking allowed during labor?
• Will I have the ability to labor in different positions, with birth ball, and freedom to walk?
• Is intermittent monitoring okay?  How many minutes per hour (and how does it change as labor progresses)?
• Is a heplock okay instead of an IV?
• What are delivery positions are you comfortable with? (squatting, side lying, hands and knees, etc.)
• Do you or the nurses do perineal massage? 
• What would cause you to use an episiotomy?
• How do you handle decels in baby's heart rate and how do you tell the difference between true  fetal distress and normal decels?  
• How do you handle a cord around the baby's neck?  
• Are you willing to delay cord clamping?
• What is your process for placenta delivery?
• What is your process for clamping the uterus down after placenta is delivered?  Are you okay with avoiding pitocin, unless medically necessary?
• What is your policy on induction?  When and how would you induce?
• What is your policy on premature rupture of membranes (before labor begins) and how long would I have to deliver the baby before you suggested a C-section assuming no signs of infection were present?
• After my water breaks, how much time do I have to deliver and am I limited to bed?
• Does the hospital provide labor tubs in room?  Can I labor AND deliver in the water?
• Does the hospital provide in-room care for newborns?  If not, when will baby need to go to the nursery and for how long?
• Does the hospital provide family centered c-sections (daddy keeps baby skin to skin until mom is in recovery, nursing asap, private transition)?
• Where is the closest NICU?
• What is the hospital’s C-section rate?  What about yours?
• Do you encourage VBACs (vaginal birth after cesarean)?

It would be wise for you and your husband to discuss these questions together and decide which ones are important for you both. You might even add to the list of questions as you think through other important issues based on your personal history, your current medical conditions, and your knowledge of the doctor/midwife/hospital you're looking into.  There are certainly many other issues to be considered than the ones I brought up here.  You should also think through the type of answer you're looking for on each question as well as possible follow-up questions before interviewing your care provider.

Remember, it's unlikely that you'll find any one person (whether doc or midwife) who will perfectly fit all of your needs/desires to a "T"... that's why it's important to decide which of these issues are most important to you and why.  Having an ultimate goal is helpful in this... our ultimate goal (again) is to choose the best option for a healthy mama + a healthy baby.  That's #1 for us.

Hope this helps!  If you have any questions about what types of answers we were looking for on any of these questions, feel free to comment below or email me, and I'll try to get back with you ASAP.   I'd also love to hear some of your own concerns/questions you asked/will ask your care provider!