It’s OK to be picky about your care provider

One of the first decisions that you have to make as soon as the little stick turns pink is who your care provider is going to be. This one decision can set the tone for the rest of your pregnancy. It can determine if you will get your desires and wishes made for you. It can even determine if you will have a vaginal birth or a c-section!

I feel like, often times, we are super picky about everything AFTER baby comes. We tirelessly search for a great pediatrician that lines up with our views. Finding a day care provider is a rigorous process to ensure that they will care for your children the way that you would. Even our children’s playmates are held to a high standard so that our children aren’t learning things that we don’t approve of (whether that be new fun words or…alternative… behaviors).

But why…WHY…are we not as picky about the providers that will help to bring our little loves into the world? Why do we just accept the first doctor that is taking on new patients? Why do we blindly follow the advice of our friends and family about who they used and loved or hated without investigating further for ourselves? As stated before, this is the first big decision we need to make for our children and it needs to be approached as carefully as all the future decisions will be.

So, what do you need to do? Interview them! Interview potential care providers and see who most lines up with your goals and beliefs about your birth. I’ve even taken the liberty of providing you with a list of questions to ask at your interview (which is sometimes your first prenatal).

Questions to ask your OB:

  • How many births do you attend in a month?
  • How long have you been practicing obstetrics?
  • How can I reach you in an emergency?
  • Do you have a backup or do you work in a group practice?
  • If you are in a group practice, will you be definitively be the one to deliver my baby?
  • What is your birth philosophy?
  • If you are in a group practice, do the other practitioners share your birth philosophy?
  • What is your C-Section rate?
  • How much time do you allow for prenatal appointments?
  • What is covered in a typical prenatal exam?
  • If I have a question between phone calls, will you be the one to answer my questions or would an on-call nurse handle questions.
  • Are you open to birth plans and the use of doulas?
  • Are you open to a drug free and non-augmented birth?
  • Would you be willing to let me go to 42 weeks as long as baby and I were handling the pregnancy well?
  • Do you perform routine episiotomies?
  • Are you supportive of breastfeeding and an undisturbed first hour of life?

Feel free to add any as you see fit or comment if you have suggestions for additional questions.

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Routine Interventions During Labor

This is a short overview of some of the typical interventions that you may be faced with when you are having a baby at the hospital. Some hospitals are more “natural” than others, but in general, most hospitals use these techniques to manage your labor and birth. 

 Pitocin: A synthetic version of oxytocin. Used to induce contractions or speed up labor.

Benefits: Can start or augment labor when mother and/or baby would benefit from managed or immediate delivery. Can also control post birth hemorrhaging.

Risks: Natural oxytocin is produced in spurts; pitocin is administered at a steady rate. Pit-produced contractions are stronger, longer and usually closer together. Because of the rapid and prolonged contractions, uterine blood flow could decrease which would result in lower delivery of oxygen to the baby. Studies have also shown a higher incidence of jaundice in the newborn. Additionally, pitocin usually confines the mother to her bed, which makes dealing with the contractions much more difficult.

Alternatives: Nipple stimulation, walking, prostaglandin suppository

 

Episiotomy: A cut of the stretched skin of the vagina and underlying tissues about 2 inches long.

Benefits: To make extra space in the vaginal opening to allow for the use of forceps. It can also shorten the pushing stage of labor.

Risks: Postpartum discomfort, infection of the stitches, abscess extending to the rectum causing rectal-vaginal fistula, hemorrhage or hematoma, painful intercourse for up to a year following delivery.

Alternatives: Upright or side-lying birth positions (put less strain on perineal tissues), perineal massage before and during labor, short and gentle bearing down (push as it comes naturally)

 

Artificial Rupture of Membranes (AROM):When the practitioner inserts a small, hooked instrument in the vagina and snags or rips the bag of waters.

Benefits: Speeds up labor by allowing baby’s head to make direct contact with the cervix.

Risks: Increased chance of infection, cord prolapsed, put on unnecessary hospital timeline.

Alternatives: Walking, squatting, climb stairs, sit on a birth ball

It is important to remember that birth is a natural and normal process. These interventions should be reserved for cases where mother and/or baby are in distress and would benefit from the use of them. When a new intervention is presented to you, please ask your caregiver for more information. Use ‘BRA’ as a guide. What are the Benefits? What are the Risks? And lastly, what are the Alternatives?

 

Welcome!

My name is Jessica Dresser and I am a Certified Birth Doula serving Casper, Wyoming and the surrounding areas.

I am certified as a birth doula through Childbirth International and studied childbirth education with Birth Arts International. I encourage you to look around this website and check out my services. If you have any questions or comments please feel free to contact me via the “Contact Tab” or email me at jessicadresser.doula@yahoo.com.