Five steps to hiring the right care provider for your birth

1. Decide how and where you want to give birth

If you don’t know, start doing some serious research. You have lots of options: Natural or medicated? Hospital or home? Water or dry land? OB or midwife? Do you want to be actively involved in all decisions and choices or will you allow your care provider to take control? If you’ve had a previous cesarean, are you interested in a VBAC (vaginal birth after cesarean)? Will you have a doula? What interventions / medications / procedures will you accept or refuse? A good, comprehensive childbirth education course will help you navigate these decisions confidently, without imposing a dogmatic bias about what type of birth is best. The best birth is the one that is safe, healthy and joyful for you and your baby. Don’t necessarily allow yourself to be swayed by what your best friend or your mom or your college roommate thinks is right.

Here is a simple meditation and journaling exercise you can practice with your partner or a friend to help you decide what you want. Sit down in a quiet space, turn off all technology and close your eyes. Have your partner read the following questions to you, giving you lots of time to think through each one. If you like, you can have a journal and pen on hand to record your responses:

• Take a few deep breaths and begin to visualize yourself giving birth, safely and joyfully. What does that look like and feel like to you? Your joyful birth story is completely unique to you.
• Imagine how you would like to feel on your birthing day, emotionally and physically.
• What is the lighting like in the room?
• Is there music playing, or some other sounds in the background?
• How would you describe the atmosphere in the room? Calm? Celebratory? Social? Intimate?
• What level of routine medical intervention do you prefer? Some women feel safer with more intervention, others prefer less. (If you don’t know, find a comprehensive childbirth education class which will help you explore all of your birth options.)
• Who is with you? How involved is your partner? Is there another support person or doula there?
• What is the energy and personality of your ideal care provider? Are they upbeat or mellow? Calming or energizing? Quiet or assertive?

2. Get recommendations from local Doulas, and talk to other moms in your area who had the type of birth you are hoping for

If you are planning an unmedicated VBAC, find moms who have had unmedicated VBACs. If you know you want an epidural, find moms who had great epidural births. I have found Facebook birth-related groups to be most helpful in this task. When bringing up this topic with friends, you can say something like “I am looking for a care provider who will support my ________ [natural/hospital/home/birth center/VBAC/surgical/medicated/water] birth. Any suggestions?”

Doulas are really your secret weapon when it comes to finding the right maternity care provider. An experienced doula has seen many different care providers in action, and they can tell you who’s great and who isn’t. Look up local doulas and pick their brains. Most of them will be happy to talk to you and point you in the right direction on your search. Even better? Hire a doula as your own personal birth-guide.

You wouldn’t ascend Everest without a Sherpa who knows the way and has been to the summit many times: Doulas are Birth Sherpas! Experienced Doulas have worked with care providers to support a great variety of birth scenarios, and they are really good at facilitating cooperation and communication between mom and her provider.

3. Create a birth plan

Now that you know what kind of birth you want, you can begin putting those preferences down on paper. Again, a good childbirth class will be a great resource for you. Our class session #5 is Birth Choices night, and will give you all the tools you need to begin creating your birth plan. Read books, ask questions, talk to your doula and listen to your intuition. Two books I recommend that couples read as they create their birth plans:

• Gentle Birth, Gentle Mothering — Sarah J. Buckley, MD
• The Birth Partner — Penny Simpkin

Two downloadable resources that will help make this whole process much easier:

• Healthy Birth Your Way
• The Bump: Birth Plan

4. Interview the recommended care providers

Once you’ve got your list of recommendations, contact each care provider and set up an interview. Just to be clear: YOU are interviewing THEM. You are the CEO and your job is to hire the employee you like best. Bring your birth preferences sheet with you to the interview, and go through it point by point. If the care provider is a good fit, this process will be so smooth and easy. You’re gut will tell you if it’s a good fit or a big mistake. Throughout the interview, you should feel listened to, understood and supported. If you feel like you have to defend or “fight for” your choices during the interview, can you imagine how you’ll feel on your birthing day? You, as CEO of this birth, have the right to find an employee who will provide you with the level of service and performance you require. Keep interviewing until you find that employee.

5. Know that you can switch care providers at any time, even late in your pregnancy.

You can change your mind and “fire” your care provider if you feel you need to. The latest I’ve ever heard of a mom firing her doctor was (believe it or not) at six centimeters dilation! She was tired of how she was being treated during labor, so she signed herself out of the hospital, contacted a local midwife, drove to a birth center, and had a victorious VBAC in the water, no tearing, not trauma, no complications. AND her baby weighed 11 and a half pounds…

It’s best to choose your ideal care provider much earlier than that, of course. It’s incredibly beneficial for an expecting mom to have a relationship of trust with her doctor or midwife that she can call upon whenever she needs support or reassurance. So don’t put this off, get it done! Do your childbirth classes, read your books, ask your questions, hire your doula, get some recommendations, and start your search for the best provider for your birth journey.