|Rachel Zimmer, DNP, CNM|
If you want a hamburger, do not go to a vegan restaurant. If you do choose to go to a vegan restaurant, arguing with the chef about making you a hamburger will do no good. Therefore, do not be surprised if you choose to stay at the vegan restaurant if you do not get a hamburger. You just set yourself up to be disappointed. Sounds silly right?
If you are an expectant mom who wants an un-medicated birth, or a birth without interventions, this is exactly what you are doing by staying with your current provider (assuming your current provider is not supportive of your birth preferences). Let me tell you how it goes. Mom says to her OB: I would really like to have freedom of movement during my labor and deliver in a position other than my back. OB says: “OK, we’ll see how it goes. We want to have a safe delivery.” So what is the reality here? The reality is mom has done some reading and knows that changing positions during labor and birth can help promote a good position for baby as well as decrease her discomfort… This OB does not care one way or another what mom does during labor and believes she will be just like 90 percent of the moms in the practice and end up with an epidural and on her back anyways. Want to hear a response from a provider supportive of your low intervention birth plan? How about: “That sounds like a great plan, intermittent monitoring is part of my routine practice. Let’s talk about ways to help keep this pregnancy low-risk so that you can avoid an induction and meet your birth goals.” So moms I am here to tell you, if you don’t get the answer that you are looking for……FIND ANOTHER PROVIDER! So why do women stay? These are some answers I hear… “I’ve seen my OB since my very first pap smear…” ie loyalty. I guarantee that this means nothing to your provider. They will still check out at the end of the day and let one of their partners catch your baby. I am not saying there is anything wrong with that, no one can work 24/7. The point is, so what? Your provider does not remember any of the pap smears that they have done for you and will not miss doing them in the future. That is assuming they will even notice you are gone, which they probably will not. Most OBs see 150-200 women every week and you are not special to them. “I need to deliver my baby at such and such hospital because it is closest to my house….or because they have a special postpartum suite that I want to have”. Most first time moms are in labor an average of 18-24 hours. Unless you are planning to deliver in El Paso, you will have time to get there. Your baby will benefit from the decisions you make surrounding your birth and none of this has anything to do with the size of your postpartum room, color of the walls, or if they serve you lobster after your birth. “My OB delivered my last baby…..or all the babies in my whole family”… This is great, you know what to expect! If you were happy with your previous birth experience then by all means stay right where you are! If you are looking for something different, go elsewhere! Your OB has not changed their practices recently. “It will be fine, I have a doula this time who will make sure my birth plan is followed”… I LOVE doulas and I think all 1st time moms, if not all moms should have one! BUT most OBs don’t understand the role of the doula and don’t like them let alone respect them. Nor will they pay any attention to them as they advocate for your birth plan. It’s like arguing with the vegan chef to make you a burger… pointless. And, why do you want to fight to get what you want???? Birth should be a time where your birth team is supporting you and working with you, not against you. Doulas are truly amazing BUT your birth experience will be a million times better if you also have an OB or midwife who is ALSO on board with your plan! “My family is not supportive of me seeing a midwife”… No one said you have to switch to a midwife. There are some great OBs out there who will support your plans for birth. It is absolutely true that midwives are generally less interventional than OBs and more supportive of practices that promote un-medicated birth. But, there is something different for everyone! Ask about interviews, many midwives will offer “meet and greet” visits or interviews that are free and are an opportunity for you and your partner to meet them, see that they’re not crazy witch doctors, and find out if they are right for you. If not, keep moving on!
As OB providers, we attend anywhere from 50-300 births per year…sometimes more! You as an expectant mom, will experience childbirth once, twice, or sometimes more in your whole lifetime. This is YOUR experience. Don’t let any of the above reasons stop you! Choose people to be part of your birth team that want to help support your goals. C’mon moms! YOUR BIRTH MATTERS! Your OB provider MIGHT remember if the baby they put onto your chest (hopefully) was a boy or a girl. You will remember your birth experience for the rest of your life…