The problem with recommendations…

Photo by Martin Brosy on Unsplash…when it comes to choosing a care provider for your pregnancy and birth.

I see it all the time. Pregnant women in Facebook groups with question after question: ‘does anyone recommend an OB/GYN or hospital in X area’.

I cringe and don’t know where to start answering them. Most of the time I just read the other comments.

Because there are so many variables when asking for a recommendation of this kind.

Emotional questions like: What’s your philosophy on birth? What sort of birth do you envision? How do you want to feel during your birth?

And then more practical ones regarding whether this is your first pregnancy, whether you have any pre-existing health concerns, what hospital catchment you’re in for public hospitals.

But the emotional questions are where I want to sit for a minute.

Choosing a doctor based on the rave reviews of a few people, or one, whether they’re other members of your family, friends, or complete strangers, is generally not the best way to go about choosing your provider. They may have had a totally satisfying experience with them, but are you after the same type of birth experience? Did they have a very natural, low intervention birth and you’re wanting an epidural from the first contraction, or vice versa?

A better way to go about choosing a provider, particularly a private Obstetrician or Midwife, is to really nut out what it is that you want to achieve from your birth, beyond ‘healthy baby and intact mother’. Do you want to feel supported, understood, listened to, heard, treated with respect and dignity? Most people, regardless of their philosophy on birth in general, would say yes here.

So, first you need to do some thinking about yourself. As well as feeling supported and respected, what else do you want to feel? How would you envision your ideal birth going in terms of medical interventions, or lack of? Allow for practical considerations like whether you have an underlying health condition, you’re trying for a VBAC, or anything else that may affect your pregnancy and labour, your own or baby’s health.

Now start researching providers. Google them, read their websites, check which hospitals they’re affiliated with. Then find statistics about their intervention rates and compare that to what your preferences are.

In Victoria, an annual report called the Victorian Perinatal Services Performance Indicators is released. This provides extensive information about hospitals’ performances in key areas, like their caesarean section rates, additional care rates for babies without congenital abnormalities, breastfeeding rates, and rates of VBACs planned vs achieved. This information will help you form a picture of the hospital you’re considering attending for you birth.

The next step is to set up meetings with your preferred providers. Hopefully you’ll have at least 2 that are on your ‘wish list’. At this meeting, act like your interviewing them for the job of being your care provider. Don’t choose which one to ‘employ’ until you’ve met with all your shortlisted providers.

Once you’ve done the self-reflection, the research and the interviews, now finally it’s time to go with your gut. It’s very important that you and your care provider have a similar philosophy on birth, whether that’s a medical view or a natural one. If you’re philosophies don’t match, eventually you’ll run into conflict in some way. You also need to feel as comfortable with them as possible.

If you’re past this point and have already been with a provider for several months, know that it is never too late to change if you’re not happy. If you’re reading this and re-thinking your choice, know that I have heard of families changing providers at 37, 39, even 41 weeks because they didn’t feel their current provider was the right fit.

My above suggestions may seem like a lot of work, and they’re just one part of the process of preparing for and becoming fully informed about birth and postpartum. BUT I promise it will be worth it when you take this one step towards planning for a satisfying and empowering birth, no matter how your birth actually unfolds.

If you’d like to know the other steps I’ve come up with to help you plan for a satisfying and empowering birth and postpartum period, please get in contact.


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