Monday, November 11, 2013

A New Pregnancy = A New Care Provider?

Have you ever heard the story of the woman who always cuts the end off her pot roast before cooking, thinking it must be done to cook properly?  She did it because her mother had done it, so she assumed that it was necessary, never questioning why her mother did it.  Later, she discovered that her mother cut the ends off because the roast never seemed to fit in her pan!  Think of all that wasted meat!

I was thinking about this last week.  Something came up and I found myself thinking “Why are we doing it this way?”  Sometimes we get things in our head and just keep trucking along with life, even if it’s inconvenient or not the best way to do things.  Even if we are unhappy with the way things are.  (I am pretty sure the woman hated to throw away all that meat!)

Often, women stick with a care provider because it’s “comfortable” - even if it’s not.  They already had a baby with that OB or midwife, so it just seems logical to stay.  Or, you just know what to expect, and that feels… comfortable.  The fear of the unknown sometimes causes people to stay where they are too.  What if change is made and it is worse than before?

Personally, I have had 4 different care providers at my births.  But I truly needed different care each time -- not necessarily physically, but mentally and emotionally, I was at a different place each pregnancy and birth.  

With my first pregnancy, I trusted my doctor.  I wanted him to take care of everything.  And he did.  I wanted no responsibility.  I turned it all over to him. I narrowly escaped a c-section.

I had a CNM present for my second birth, someone who trusted the process, willing to let me labor and birth how I wanted, but also available to intervene if necessary or desired. I birthed in the hospital because I wanted that "safety."

Y'all know the story of my 3rd birth. I changed care providers from a group of CNMs in a hospital to a homebirth midwife who specialized in water birth. This was 12 1/2 years ago when I didn't know anyone who had had a water birth. My best friend had had a home birth a few months before and I wanted to do that. I had confidence that I could do it without the drugs since I had done it with baby #2. I still needed a confident midwife though, and I found one. She was the kind of person that steps in and takes over a situation or conversation. At the time, I needed that. I found myself over-confident in my ability to give birth and didn't prepare at all for the birth. Ironically, in many ways I did the same thing I did with baby #1 and turned over much of the responsibility to my midwife.

Four years later, baby #4 came along. I was in such a different place. I had been teaching childbirth classes for a couple of years by then and had learned many lessons from my three previous births. The midwife I chose was soft-spoken in her confidence. She also was a trained EMT but didn't advertise it the way my other midwife had. She asked me a lot of questions that helped me get in tune with myself and where I was and where I needed to be. After several appointments, she'd lead me into another room where there was a table to lay down. She'd put on relaxation tracks, cover me with a blanket, and tell me to relax. She knew I was teaching it, but needed to be sure I was also doing it! I felt so... nurtured. I hadn't experienced that before with any previous care providers.  

She was teaching a simple childbirth class one afternoon at her house and wanted me to come. There were 3 couples, a table of lovely snacks (which I never do in my classes!), and the sun streaming in through the windows. I let myself be taught by this wise woman who had been practicing midwifery for over 30 years.

When my baby was born, it's like she knew exactly what I needed - physically and emotionally. It was such a great birth. I have often reflected on changing care providers and how important that has been for me. If I had stayed with the "water birth midwife" my birth would have been very different. I wouldn't have owned it the same way, mostly because I wasn't encouraged to do so. She would have taken charge, and while I needed that with my first homebirth, I certainly didn't want or need that with my last birth.

All this reflection on my own experience to say this: Ponder what it is you want from your care provider. Their experience is important, obviously, but what other characteristics do you value? Do you anticipate wanting to be talked to in labor, or even told what to do? Some women want this. Or do you want her to be hands off and quiet? Of course, no one truly knows what they will want in labor (touch, quiet, music, etc.), but there is value in thinking about it and discussing it with your partner and care provider. Asking others who have birthed with your care provider can be very helpful. I have spoken with many women over the years that wish that their midwife had been more hands-on. That's probably the number one "complaint" I hear. Is she "hands-on" at appointments? Is she nurturing? Does she greet you with a hug when you come to appointments? There are a lot of signs during pregnancy that indicate how you will be treated in labor? If not -- and that is important to you -- consider hiring a doula if you do not want to change care providers.

When I switched care providers with my 4th baby, I was so worried that my previous midwife would be upset. We were both birth professionals in the community and word travels. My midwife had to request my records from her, so there was no getting around it. I never talked to her again, however, but we moved to Texas just 3 months after Darcy was born. It doesn't really matter anyway. It was a good choice for me and my family. It gave us the perfect last birth, rounding out our family.

I hope this post gives you courage to switch care providers if you feel that you need to do so. Like I always say, you will only give birth to this baby one time. Every birth counts. Seek out those people that are perfect for you at whatever stage you find yourself.


Shannon said...

I completely get this. I changed care providers with each pregnancy also.

Joy de Vera said...

Hi Donna,

I'm a devout reader of your blog. I was wondering if you've seen this article: