Choosing a Pregnancy Caregiver

When selecting a caregiver during pregnancy, it is vital to select someone with a similar philosophy of childbirth. If planning a relaxed natural childbirth with as little intervention as possible, finding a care provider who will support that goal is critical. Before beginning the search, decide on the type of birth experience you desire. Start by making a list of the elements that are most important to you, such as episiotomy, pain control, restrictions on movement, etc or just the general atmosphere or attitude surrounding the birth.


After these decisions have been made, the interview process can begin. This can include physicians, doulas or midwives. Make sure to select a provider whose personality complements your own and that of the birth companion(s). A personality conflict during labor will not be a positive experience for those involved.


Below is a list of possible interview questions:

  • What is your philosophy of childbirth?
  • Do you require an IV?
  • If so, is a heplock or saline lock an option?
  • What percentage of your deliveries are cesarean section?
  • What percentage of your deliveries are inductions?
  • What is your percentage of episiotomies?
  • What methods do you use to preserve the perineum?
  • Do you allow the mother to guide her own pushing?
  • What methods of fetal monitoring are available?
  • Which technique do you prefer-forceps or vacuum extraction?
  • What percentage of your deliveries require vacuum extraction?
  • What percentage of your deliveries require forceps?
  • What positions are available for pushing?
  • If early rupture of membranes occurs, how long before inducing labor?
  • What methods of induction do you use?
  • Do you require routine use of pitocin after delivery?
  • Do you require routine administration of any drug after delivery?
  • What are your restrictions on movement during labor?
  • What are your restrictions on food during labor?
  • Do you put time limits on labor?
  • Do you put time limits on pushing?
  • How many doctors are in your practice?
  • Who takes your call when you are not available?
  • How often are you on call?
  • What are the chances that you will attend the delivery?
  • If you are not available, will the other providers honor our wishes?
  • What are your office hours?


Do not consider this to be an exhaustive list. Think of it as a starting point. Some of these options may not be relevant to your needs. When scheduling an appointment, tell the receptionist you are trying to select a caregiver and wish to schedule a consultation.


If at any time you have doubts about the quality of your care, discuss it with your caregiver. If that doesn't help, then don't hesitate to select a new one. Your family is too important to stay with a care giver with whom you do not feel comfortable. It's worth the hassle of paperwork to ensure you are completely comfortable with your decision.



References

Hodnett ED. Continuity of caregivers for care during pregnancy and childbirth. Cochrane Database of Systematic Reviews 2000, Issue 1. Art. No.: CD000062. DOI: 10.1002/14651858.CD000062.

Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766.pub2.

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