Monday, January 14, 2013

Who Will Attend Your Birth

Did you realize this the birth of your baby?? The people there should be those chosen by you!  You hire your doctor/midwife, you hire your doula, you invite whoever else you please and restrict anyone you like.  I've already mentioned the benefits of a doula here and be sure to read up on what the American Pregnancy Association has to say about having a doula. 

If you're wondering whether or not to have your mother or mother-in-law present, have a chat with her.  Let her know what kind of support you will find beneficial at your birth and decide from there.  Do you have a sister who offers too much unsolicited advice?  A best friend who loves updating her facebook every contraction?  You may want to kindly ask them to wait in another room and invite them to visit your new little bundle whenever you're ready.

An OB or a Midwife- which is right for you? 


An obstetrician/gynocologist is a phsycian who provides medical and surgical care for women, with specialize training of the female reproductive system and pregnancy.

This OB/GYN link specifies their training requirements and more.  An OB is a great choice if you are high-risk because they are trained to find complications and manage them. OB's attend hospital births which typically cost $16,000-$21,000 for an uncomplicated vaginal birth.

When deciding on an obstetrician get an idea for their view of childbirth with these questions:
1. What is your philosophy about childbirth? What do you feel your role is?
2. What is your cesarean rate?  (The WHO recommends no higher than 15%)
3. How do you feel about parent written birth plans?
4. How do you feel about unassisted childbirth? (This isn't to say your planning on one, it's just to get a feel for how much this particular care provider trusts birth.)
5. What is your episiotomy rate?
6. What do you do to reduce the chance of tearing or the need for an episiotomy?
7. How do you feel about doulas?
8. (If they are female) Do you have children? Tell me about your birth experiences.
9. What happens if my water breaks before labor begins? What kind of time-frame am I restricted to?
10.  Do you practice active management of labor? Do you routinely intervene or allow labor to progress normally?
11. What hospital(s) do you practice in?
12. What happens if I go past 40 weeks? 41 weeks? 42 weeks?
13. What is your induction rate? Under what conditions to you advice an induction?
14.  What natural induction techniques do you recommend?
15. What percentage of your "patients" are high-risk / low-risk?
16. What conditions do you consider high-risk?
17. How do you handle fetal monitoring?
18. Will I have freedom of movement during labor?
19. Can I try alternate birth positions?
20. Do you have any plans or interferences around the time my baby is due?
21. What prenatal procedures do you typically do?


A midwife is a person trained to assist women in childbirth. 

There are different types of certification and training for midwives, the most common of which I'll cover. 
There are direct-entry midwives, who do not require prior education as a nurse.  These are CPM's, or a certified professional midwife who has met the standards for certification set by the  North American Registry of Midwives or licensed midwives, LM, who practice in a specific state.  These midwives work in out of hospital settings. A typical home birth varies in cost by location.  After midwife fees, supplies and labs you can probably expect to pay $4000-$5000.

Some questions to ask a potential midwife:

1. What is your philosophy about childbirth?
2. What is your training and experience?
3. Do you routinely perform vaginal exams or only by request?
4. What other methods do you use to assess dilation?
5. What happens if I go past 42 weeks?
6. What do you do if the baby is breech?
7. Regardless of whether you will attend a vaginal breech birth, how do you feel about them?
8. What do you consider high risk?
9. When in labor do you come to my home?
10. How often do you check baby's heart rate and what do you use?
11. What is your episiotomy rate?
12. What do you do to help prevent a tear? 
13. What kind of equipment and medication do you have at a birth?
14. How does a transfer work? What is your transfer rate?
15. What are your fees? What is included/not included?
16. Do you offer placental encapsulation?
17. What happens if my water breaks before labor begins?
18. What is your experience with shoulder dystocia? Cord prolapse? Postpartum hemorrhage?
19. Do you work with doulas? Birth photographers?
20. Do you recommend or work with a doctor in case of emergency?
21. Who will attend my birth if you are sick or unavailable?
22. Do you offer or recommend a particular childbirth education class?
23. Can I have a water birth? Do you supply the tub?
24. Can I eat while in labor?
25. What do you normally do during labor?
26. Can my partner catch the baby?
27. Under what circumstances would you artificially rupture the membranes?
28. What newborn procedures do you typically do?

A CNM, or certified nurse midwife, is an advanced practice nurse who attends your birth in a hospital or home.  They work with a doctor who backs them up should complications arise.  I like to think of CNM's as the in-between- you don't want a doctor but you still want to birth at the hospital. Or possibly you'll choose a CNM because they are covered by your insurance provider.  No matter who you choose, remember you have hired them! You can change care providers at anytime if you determine they are not the right fit for you!

Getting ready for your baby's Journey of Life can involve making a lot of decisions; it's important to have people beside you who will support you in positive ways and empower you in your childbirth experience.  

What questions do you ask potential care providers and doulas?  Share your experiences here!

No comments:

Post a Comment

Contact info

Jennifer Valencia | Labor & Postpartum Doula | 928.300.1337


Blog Directory