Seeking a Caregiver for your Birth? Critical Questions to Ask...
Part One: Approach to Care
If you’re newly pregnant it can be overwhelming to figure out where you want to give birth and who would be the best type of caregiver for you: hospital, birth center, or home? Midwife, family physician or obstetrician? Why would you not just use the Ob/Gyn that you have already been seeing for years?
Maybe you’re further along in your pregnancy and not sure that your caregiver or hospital is the right match for you? It is never too late to change providers or birth settings. In this three-part blog series, childbirth expert Lena DeGloma (Certified Birth Doula, Childbirth Educator, Lactation Counselor, Licensed Massage Therapist, and Clinical Herbalist) discusses pertinent questions to ask when seeking a caregiver who is right for you.
Top questions to ask a potential Midwife or OBGYN:
How do you approach shared decision making and informed consent with your patients?
This question gets to the bottom line of what allows you to have a positive relationship with your medical caregivers during birth and to know if they are going to be a good fit for you. It’s extremely unlikely for a caregiver to ever directly say, “I don’t believe in informed consent,” so you need to read between the lines with their answer to this question.
Every caregiver believes they practice informed consent and most believe they incorporate shared decision-making. The question is - do they really? Their response to this question should demonstrate a strong ability and desire to communicate with you around shared decision making. They should also be able to give clear examples of ways in which they work with you to help you make the best decisions that are individualized for you. You want somebody who respects your autonomy to make your own choices in birth. While you may value your caregiver’s expertise and unique perspective, the ultimate decisions around your pregnancy and birth are yours to make. This is because many decisions in birth are essentially whether to intervene or let nature take its course. In many cases, the answer to that question has more to do with your goals and values than it does with some objective “right” answer as to what is safest or best. For example, whether to induce labor or wait for things to begin on their own - that is your decision, not your caregiver’s. It may be an easy decision to make if you are faced with a serious diagnosis like pre-eclampsia, but in the absence of that, to simply induce for going past your due date - there is not terribly strong evidence for either choice and you want a practitioner who can help you sort through the evidence, what it means, and how it is actually relevant to you as an individual - taking into account your goals, desires, and values.
In addition to informed consent, you also always have the right to informed refusal. This is a fundamental aspect of medical ethics. Unfortunately, what I see all too often in childbirth are practices that don’t treat their patients as if they have a right to informed consent or refusal. Instead, they talk to patients as if medical consent is being made for them instead of it being shared decision-making.
Bottom line: your caregiver’s answer to this question should demonstrate their willingness to have these types of nuanced and respectful conversations with you. Anything that makes you feel rushed or brushed off is a huge red flag. Finally, pay attention to how you feel when in the presence of your caregiver (nervous? inferior? rushed? confident? comfortable? empowered?). The way you feel in their presence should be a huge indicator as to whether they are the right person to be there for your birth.
Are you interested in learning more about what questions to ask when seeking a caregiver who is right for you? Be sure to follow us on Instagram (@redmoonwellness) to get updates on the release of Part Two: Labor Interventions. In the meantime, click here to book a private virtual birth consultation with Lena DeGloma.
