The following list of questions can help you to choose the appropriate caregiver based on your personal needs and desires. Think about your questions carefully before interviewing a caregiver. You should know how you feel about each question and what your desired responses to these questions are in order to make the best decision. You may find that not all of the questions pertain to you, and may therefore choose not to ask all of them, and of course you may have other questions of your own to ask.
Try to phrase your qestions in an open-ended manner. For example, rather than asking “I don’t want an episiotomy. Do you do episiotomies routinely?”, (which obviously suggests the answer you are looking for), ask “How many of your patients require episiotomy”, or “How do you help moms to avoid tears or episiotomies?”.
As you discuss these questions during the interview, listen as much to how the caregiver answers as to what he or she actually says. Is the caregiver impatient with you, defensive, or open and comfortable with your questions? Do the answers satisfy you? Do you feel confident and trusting of this person? The responses will help you discover how the caregiver feels about prospective parents who take their responsibilities seriously.
You may think of choosing a care provider much like choosing a new roommate. You would want to learn as much as possible about someone before choosing to live with them, in order to avoid serious problems later on. Unfortunately, many women feel nervous about asking their caregivers important questions early on in the relationship. As a result of wishing to avoid conflict with their potential caregiver, women may wait until birth is upon them to ask hard, specific questions. This is the wrong time to learn that you have major differences with the beliefs and practices of your caregiver. It is difficult to confront your caregiver or leave at such a late point in the relationship.
For this reason, it is the first appointment when the hard questions need to be asked and answered. Otherwise it would be like marrying someone on a blind date and learning about their values and beliefs later on.
What if you have been seeing a caregiver for some time and then, after getting a better idea of his or her practice you feel uncomfortable with your choice? You should listen to those feelings and try to discuss your discomfort or change caregivers. It is a good idea to meet with the new caregiver before making your decison. Although it is an uncomfortable situation, it is better to act than to stay with somone you know makes you feel uneasy.
In countries which are slowly changing their birthing (and general) doctor-patient relationships from one of “Doctor know best” to a more inclusive relationship, it is parents asking questions and expecting honest answers that has lead the way. I hope that by encouraging you to ask your questions it also encourages you to remain actively involved in your health care and the care of your child for a lifetime.
– What do you see as my role and responsibilities during pregnancy and childbirth?
– May my partner attend prenatal appointments with me? Are there any restrictions on my partner being with me throughout labor and birth? During a cesarean birth? During my hospital stay?
– How do you feel about other family members (children, grandparents, and so on), friends and midwife or doula attending prenatal appointments or being present at birth?
– What recommendations do you make on nutrition during pregnancy (for example, foods to eat and to avoid, weight gain)? Do you provide nutritional counseling? Do you have specific recommendations on exercise, sex, and use of medicines and drugs (including over-the-counter drugs, caffeine, tobacco and alcohol)?
– What are your feelings about childbirth preparation classes or natural, unmedicated childbirth? Approximately what percentage of your patients are interested in natural childbirth? How many actually have it?
– Do you have routine standing orders for your patients in labor? What are they? Can they be altered to conform to my needs and desires? Would you encourage and help me prepare a birth plan (a written list of my preferences for care during birth and postpartum)? Will you check my birth plan for safety and compatibility with your practices and hospital policies?
– Does your hospital have Labor/Delivery/Recovery/Postpartum rooms? Do you feel comfortable using these rooms or do you prefer using separate rooms for labor, delivery, recovery and postpartum?
– What are the chances you will be present when I deliver? If you are not there, who covers for you? Will I have a chance to meet that person? Will that person respect the arrangements I have made with you? Will the hospital staff?
– How often and under what circumstances do you find it necessary to use: intravenous fluids; artificial rupture of the membranes; continuous electronic fetal heart monitoring; Pitocin or other medication for induction; episiotomy; forceps; vacuum extractor; abdominal pressure during delivery?
– How often do you find it necessary to do a cesarean birth? What are the most common reasons for cesareans among the women in your practice? Do you think there are things I can do before and during labor to help reduce the likelihood of a cesarean?
– If I should develop complications during my pregnancy or labor, would you manage my care? If not, to whom would you refer me?
– What are your policies regarding contact between parents and their baby immediately after the birth? Does the baby go to the nursery or may he stay with us? Who will examine the baby after birth? When is this usually done? What procedures are routinely done with newborns? What medications are routinely given?
– How many women in your care typically breastfeed after birth? Is the nursing staff trained in supporting breastfeeding?
– What is the usual hospital stay after a vaginal birth? a cesarean birth? How would you feel about my leaving the hospital earlier than that if I wish? Do you or the hospital have instructions for me if I leave the hospital shortly after the birth (early discharge)?
– How would you feel about my staying in the hospital longer than the usual stay to get more rest or to stay with my baby if he has to stay longer?