Checking In
Take a moment to reflect on your journey through pregnancy so far. You know more now about your needs and desires for birth than you did in early pregnancy, when you chose your birth site and provider. Do you feel empowered in your pregnancy? Has your confidence grown in yourself as a birthing woman and mother? Are your needs being met? Do you feel supported by your provider in the decisions you make for your care? Do you feel secure in your choices?
If the answer to any of these questions is “no,” you have good reason to make some changes.
If you have concerns about your care, talk openly with your provider. If you still are unsettled, consider finding a care provider who will better meet your needs. It is not too late to switch providers or place of birth if there is an option that will be a better fit for you.
It’s not uncommon to resist making what feels like a drastic change at this point in pregnancy. But it is wise to explore your assumptions before you decide for good. For instance, you may think…
- I already have a relationship with my current provider. It is more important that you feel supported in your decision-making than have a limited, ineffective relationship with your care provider. Also, remember that your prenatal visits will be more frequent now. You can expect to have enough visits to get to know a different care provider.
- It’s too late in my pregnancy. It’s not too late if a new caregiver or birth setting does not have policies that prevent you from making a change at this time. Many care providers will accept new clients as late as 36 weeks or more, although it is best to make the switch sooner whenever possible. If you are not completely satisfied with your choice of care provider or setting, immediately explore your options. Interview other care providers before making this important decision.
- I don’t feel comfortable “firing” my care provider. Most midwives and doctors understand that their clients’ needs and wishes change during the course of pregnancy, and they don’t take it personally when a woman wants to make a change. Even if your care provider doesn’t react well, know that it is your decision based on what you know is best for you. Why risk having negative memories of your birth experience or receiving care that doesn’t meet your needs just to avoid hurting someone’s feelings?
- My provider knows what’s best for me. This is your birth and only you know best how you will feel supported. Unfortunately, many care providers practice in a way that serves their interests, not yours. Others practice “cookbook medicine”—applying the same care to all women regardless of their individual circumstances. If you don’t feel like you’re getting personal attention, or if you feel more like a “number” than an individual, it’s time to start looking elsewhere.
These resources can help you make your decision:
ASK AN EXPERT
Question:
I recently began reading books about giving birth. The more I read, the more I realize that it will be an uphill battle to have a natural birth in the hospital where I am currently planning to have my baby. When I asked my doctor about fetal monitoring, she said she knows that intermittent monitoring is safe but there aren’t enough nurses on staff at the hospital to offer that option. I also was shocked to hear that the hospital protocol doesn’t allow eating or drinking in active labor. Last week, I took the hospital tour and the nursery was packed with babies. I wondered why so many apparently healthy babies were separated from their mothers. I never thought I would consider giving birth anywhere else but in a hospital, but it seems so restrictive and I’m not sure that all that equipment is necessary for a healthy birth. Is home birth safe? Is it even possible to change my mind this late in the game? I’m almost 28 weeks.
Read a response from Elizabeth Day, BA, CD(DONA), LCCE:
I’ve come across several women in my practice who have the same question. It seems that the more women learn about natural birth, the more they question whether the hospital setting will be the best place for them to achieve that goal. As always, safety is the greatest concern for them as well.
Many of my students have been surprised to learn that a substantial amount of research supports the idea that birth can take place safely at home. In fact, studies of home birth vs. hospital birth show that women who plan to give birth at home are far less likely than similar women planning hospital births to have IV fluids during labor, continuous fetal monitoring, episiotomy and cesarean surgery. Usually, they have the freedom to eat and drink as they wish, move freely and give birth in a variety of positions and stay with their baby continuously after birth. At the same time, studies show that low-risk women who plan home births have just as good or better outcomes compared with similar women who plan hospital births. It makes sense that birth can be safer at home because less is done to interfere with the natural process of labor and birth.
You can rest assured that you are a good candidate for home birth if you:
- are healthy and have not had complications in your pregnancy,
- live within a reasonable distance from a hospital (most experts agree that birth should take place no more than 30 minutes distance from a hospital), and
- have a qualified care provider present (usually a professional midwife).
It also may give you peace of mind to know that professional midwives are trained to handle common complications of labor and birth, such as excess bleeding after the placenta has been delivered or a baby who needs resuscitation.
Remember, your care provider and place of birth are two of the most important factors in your confidence and ability to give birth. It’s never too late to change care providers. Midwives usually are flexible and willing to accept new clients—even late in pregnancy.
Elizabeth Day is a mother of two, a Lamaze Certified Childbirth Educator, a doula and a grassroots birth activist. She teaches Lamaze Childbirth Education Classes in Bentonville, Arkansas, and is a co-founder of the Northwest Arkansas Chapter of BirthNetwork National.
HEALTHY TIP
Say “Please”
Being a strong, empowered woman does not mean you have to be “supermom,” or that you have to do everything yourself. One definition of the word empower is “to make someone stronger and more confident, especially in controlling their life and claiming their rights.” Being empowered means accessing your inner strength to take control of the choices you have in your pregnancy and birth. Part of empowerment is recognizing when you need help and asking for it.
As a mother, there will be times when you will need to turn to others for help and support. It may be getting help with laundry and household tasks after the birth, or having someone look after your older kids while you take a nap with your newborn. Or, perhaps you need help now to get your house organized before baby’s birth. People want to help, but they can’t read minds. You may have to tell them what you need. Remember as a child when your parents taught you to say “please” when you asked for something? Sometimes as adults, we need to relearn that it’s OK to ask for help, and that if we do so politely, others will gladly step up.
Find empowerment in pregnancy and birth. Know your limits and get help when you need it.
TESTIMONIAL
“I switched providers because the practice was big, and while I knew two of the doctors were supportive of my natural approach, others were not. I changed to a group of providers who were fully supportive of my approach to birth and I knew I wouldn’t have to fight to birth the way I knew was right for me and my baby.”
– Susan
RESOURCES
“You’re braver than you believe. Stronger than you seem. And smarter than you think.”
– Christopher Robin in Pooh’s Grand Adventure
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