Some Like It Hot
Meet Kristin, Jenn and Sarah*. All three are first time mothers. Here's what they have to say about choosing their birth attendants:
"I love my OB! He delivered me, and my mom loved him, so he's delivering my baby, too!" -Kristin
"I'm just looking for someone covered by my insurance. I'd like to have a midwife, but my insurance won't cover that." -Jenn
"I've had the easiest pregnancy and I feel great. When I ask my doctor about the birth she's really laid back and tells me we'll cross that bridge when we get there. I like not having to worry about a thing." -Sarah
Until you're in labor. Or processing your birth after the fact. Then, often times the story changes. Same three mothers, this time after their births:
"My OB didn't listen to a word I said. He was only in the room for the last 20 minutes and then he cut an episiotomy. I didn't even know that was something OB's still did." -Kristin
"I found out that a quick letter to my insurance company to ask for GAP coverage would have gotten me coverage to see a Licenced Midwife (LM) at the birth center. Nobody told me that during my pregnancy, or maybe I just never thought to ask." -Jenn
"My OB told me I could be induced at 40 weeks and I signed right up, I really trusted her. My hopes for a natural birth quickly turned into a Pitocin induction and I had an epidural, which means I couldn't move, stand or walk. I didn't know how an induction would change the course of my labor and birth, how could I have known? My pregnancy might have been easy but my birth was definitely not. I feel like I was duped, and I feel foolish for that." -Sarah
We can't go on blaming mothers for what happens in their births. The conversation is changing from when our mothers/aunts/friends gave birth, and I want to let you know that it's OK to ask questions, it's OK to not be "super laid back" about your upcoming birth, and it's OK to choose a different birth attendant if you have any nagging feelings about the one you have currently. It's OK if you feel that you're being a nuisance. It's OK if your current birth attendant gets upset that you choose someone else (but really, they won't. It's business). Sometimes we're so worried about being liked that we silence our questions, or let them float around in our minds for fear of coming off as controlling, a worrier, or untrusting. In short, we want to be a "good patient". But girls, you are on your way to your first task of being a good mother.
Birthing From Within has taught me many things, and one of my favorites is a story, titled "Ask Questions Before Your Chile is Roasted." The following story is reproduced with permission from Pam England, Birthing From Within, page 78:
"When Autumn comes to New Mexico, the aroma of green chile being roasted fills the air. Locals buy big burlap sacks of chile which are poured into a big drum that turns over a fire until the chile is charred (which then allows the skin to be peeled off).
Chile is mild, medium, hot, or very hot!! Locals know enough to ask, "How hot is your chile?"
One day a newcomer to New Mexico stopped at the Grocery Emporium on Girard Boulevard and bought a bag of roasted chile. The aroma made her mouth water all the way home. Using her chile, she prepared a traditional New Mexican dinner. A few bites into the meal, her eyes began to water and her tongue burned painfully.
The following day she marched up to the chile roaster and began complaining that the chile he sold her was too hot. "Look lady," he replied, "I just roast and sell chile. If you don't like your chile hot, you should've asked me about it."
Like the chile customer, you need to ask your birth attendant exactly what he/she is selling. Birth attendants and hospitals sell a "product" day in and day out. It's your responsibility to learn more about this product (philosophy and services), and decide whether or not you want to end up with a bag of it."
Are you getting it?
Maybe you want a natural birth; do you know your birth attendant's cesarean rate? Or that of the hospital you intend to deliver in? Have you asked their rate of episiotomy, or under which circumstances they might perform one? What about inductions? What if you're still pregnant at 41 weeks? What will they do if your induction "fails"? What is the next step? Or your midwife; How long will she be with you during labor? Will you get to meet her Birth Assistant prior to your labor? Does she help with pain-coping or should you look to other labor support? What does she recommend to get labor started if you are nearing 42 weeks? If you transfer to a hospital, will she come with you?
Ask your questions BEFORE your chile is roasted. If you like it hot, and so does your birth attendant, great! Just make sure you're not the one getting burned.
There's no right or wrong answers here. This isn't about medicated vs. unmedicated birth; it's not about vaginal or cesarean; it's not about hospital vs. birth center vs. homebirth. This is very practical advice that is a crucial first step in your birth preparation, one that you should take very seriously and mindfully. Don't let yourself wait until you are in your 38th week before you work up the nerve to ask your provider these tough questions. Engage early (and tell your baby to do the same!).
If you found this article helpful, leave me a comment below and share around with your pregnant and birthy friends! Here are some other articles you might find useful, too: