Your provider makes a big impact on your labor and birth experience. Make sure you are asking the questions that matter to you and remember that you can always choose to switch to someone more in line with your birth wishes. Did you know you can also ask for a nurse when you arrive that is supportive of your type of birth plan? Here is a list of questions that will give a good picture of the provider you are choosing:
HOW MANY BIRTHS DO YOU ATTEND A MONTH? DO THE OTHER DOCTORS IN YOUR GROUP HAVE SIMILAR PRACTICES? Picking a very popular OB may seem like a good way to get the best care, but keep in mind that the busier they are the less likely they will be the one you actually end up with on the day. Make sure you are comfortable with the other doctors in the same practice.
DO YOU REQUIRE CONTINUOUS FETAL MONITORING OR DO YOU ALLOW LIMITED OR INTERMITTENT MONITORING? IS THERE A WIRELESS OPTION? Monitoring limits movement, gets uncomfortable and in most cases isn't necessary to have continually.
CAN I EAT AND DRINK DURING LABOR? While there is growing evidence that eating and drinking during labor improves outcomes, most OBs are still airing on the side of caution and will only allow water and broth.
WHAT PERCENT OF YOUR CLIENTS DELIVER WITHOUT PAIN MEDICATION? If having an unmedicated birth is important to you, ask about their numbers. It will give you an idea of how supportive they are of limited interventions. 10 to 20 percent would be typical of an OB.
HOW DO YOU FEEL ABOUT DOULA SUPPORT? WHAT PAIN RELIEF METHODS ARE OFFERED OTHER THAN MEDICATION? ARE THERE ADVANTAGES OF DOING AN UNMEDICATED BIRTH? If you get a positive and lengthy answer to these questions then you probably have the best possible chance to birth your baby the ways you want. Some hospitals now offer nitrous oxide for pain relief. Some other suggestions would be walking, trying various positions, labor tub/shower, and hot/cold therapies.
HOW OFTEN ARE VAGINAL EXAMS NECESSARY? Hopefully the answer to this question is pretty limited. Vaginal exams can slow things down, cause a lot of doubt in the progress of labor, and increase risk of infection. Sometimes they are necessary and can be helpful, but they should be explained and you should always be given the choice.
UNDER WHAT CIRCUMSTANCES DO YOU RECOMMEND INDUCTION? HOW LONG AFTER MY DUE DATE ARE YOU COMFORTABLE WAITING FOR LABOR TO BEGIN ON ITS OWN? Due dates are rough estimates and more natural minded doctors don't mind letting you go up to two weeks past the date as long as everything is looking ok with you and baby. Some doctors will want to talk induction after your water has been broken for 24 hours, while some will do nothing as long as everything else is looking ok. Choose someone who trusts in bodies and the natural process of labor.
HOW OFTEN ARE EPISIOTOMIES PERFORMED? This number should be fairly low. There is plenty of evidence that shows that they are most often unnecessary and can even cause more tearing. A doctor should always discuss this with you before it is performed.
WILL ALL PROCEDURES SUCH AS STRIPPING OF MEMBRANES, BREAKING OF WATER, INTERNAL EXAMS ETC... BE DISCUSSED AND PERFORMED WITH CONSENT? It may seem like a given that anything done to your body would have to be discussed first, but there are some doctors that go about procedures like any other routine care. Make sure you choose a provider that values and practices informed consent.
DO YOU SUPPORT PUSHING IN DIFFERENT POSITIONS, SUCH AS SQUATTING OR ON MY HANDS AND KNEES? The typical position for birth (laying on your back) is usually not the most productive or comfortable position for women, but is used because it is the most convenient for the doctor. If you have an epidural, this will be the birthing position you use, but if not, it can be way more comfortable to push from wherever you were laboring.
CAN I KEEP MY BABY STAY WITH ME CONTINUOUSLY? Most hospitals have moved away from taking baby to the nursery for evaluation. Now they should be able to perform any assessments or procedures in the room with you. They will usually only take baby if you request some time alone and partner can always accompany them.