February 8, 2008

Playing the Field

Last weekend I did a private in-home childbirth education class with one of my students and her husband. It was really more of a refresher class, since she has already given birth to two beautiful children. I asked her a bit about her past birth experiences to get an idea of what we needed to go over. She proudly told the story of two relatively quick, medical intervention-free births. Then I asked her about her care provider. She moved to NYC recently and was seeing a doctor to whom she was referred by her previous care provider. I was surprised, given the nature of her previous births, to find out that her new doctor is rather conservative and heavily intervention-based. Armed with the knowledge of what she wanted for her birth and what her doctor might suggest, we spent a lot of time discussing how to avoid common routine interventions that may not be necessary in her case.

This meeting led me to thinking about the importance of choosing a care provider who best aligns with your philosophy of birth. There is not one right way to birth. I believe that the ‘best’ birth possible is one in which a woman is making informed, educated decisions – whatever those are. And not every care provider is a good match for every woman – care providers will tend to have their own opinions, based on their experience (and other factors) about what is best. Selecting a care provider for your upcoming birth is probably one of the most important choices you will ever make. It will set the tone for much of your pregnancy and birth. If you and your doctor are not on the same page about your options, you may be in for an uphill battle when it comes time to give birth.

Unfortunately, many women wait until too late in the game to educate themselves about their many options, especially with regard to medical interventions, and find out at the last minute that the hospital and care provider they have chosen will not honor their choices. Ironically, almost every mother I know spends a lot of time researching and interviewing pediatricians they will soon rely on for the care of their new baby. I urge expectant moms to have the same zeal when choosing the care provider who will be assist them in delivery. And don’t just rely on the recommendations from friends and family – Do your homework. Ask questions. Get answers. Find a care provider who gives you confidence about your pregnancy, listens to you and acknowledges your concerns, and respects and supports your choices. And don’t assume that you should stick with the care provider who you’ve been seeing for your ‘well-woman’ annual exams. Even if you feel you have a very good relationship with your current provider, you may find that his or her ideas about childbirth are not in line with your own.

On a personal note, I have been seeing an OB/GYN (Dr. Lee- he is really great!) for my yearly exams for ten years. To be honest, I chose him when I first moved to NYC because he was right off the A train and so it was convenient for me. Luckily, he turned out to be a great doctor. When I started talking to him about getting pregnant, I was very honest with him and told him that I would be switching to a home birth midwife. He was totally supportive and not defensive about it in the least. Actually, he said he expected that from me. The reason I bring this up is this: Even though I think Dr. Lee is fantastic – he gives me lots of time in my exams, answers all of my questions (even my doula questions) – he is much more routinely intervention-based than I would feel comfortable with when it comes to childbirth.

Childbirth is a challenge in and of itself. You don’t want to put yourself in the position of having the extra-added challenge of battling your care provider. He or she should be your teammate, not your adversary, and so you should align yourself with someone who, after gathering all of the pertinent information and thoughtfully considering it, will be there for you – not just with you – and certainly not against you.



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