It’s the aim of the majority of women to have a natural, hassle free birth.

There are any number of classes and techniques you can undertake to learn how to relax and prepare for a positive birth.

Yet, all the preparation in the world can only go so far when you’re in labour when you realise your care provider isn’t interested in your natural birth plan.

Unfortunately for many women, they may have realised during pregnancy that their maternity care provider isn’t as supportive as they first believed. But it’s too late to change – isn’t it?

Breaking Up With Your Healthcare Provider

Here are 5 things you need to know about breaking up with a maternity care provider:

#1: It’s Never Too Late To Break Up With Your Maternity Care Provider

Changing care providers during pregnancy is your right. Who you have chosen to care for you and support you during labour is one of the most important decisions you’ll make.

While many people tend to think of labour as ‘just a day’, what happens on that day will impact the rest of your life. Not only yours, but your baby’s and your family’s as well.

The person you choose as your maternity care provider will influence your labour and outcome of your birth. Choosing a care provider who is not supportive of birth as a natural process is more likely to result in you having some form of intervention. Or their attitude during labour may affect you emotionally, and you’re left feeling very negative about your birth. These experiences can lead to feelings of depression and trauma.

Over time, you may come to realise your care provider or the place you’re giving birth in isn’t supportive of your birth choices. If you have tried to resolve your concerns without a positive result or feel dismissed, follow your instinct and seek a care provider who will support you.

Remember: you are the customer and they are the service provider. Would you feel embarassed and accept a broken piece of furniture from the furniture store, or would you return it?

#2: Your Maternity Care Provider’s Intervention Rates Matter

There are accepted levels of interventions when a life-threatening situation occurs. In many countries, the c-section rate is more than double the rate recommended by the World Health Organization, which is no more than 10-15% of all births.

In many countries, obstetric care results in higher rates of intervention than other types of care (birth centre, midwifery led models of care). Private hospitals have higher rates of intervention than public hospitals, although public hospitals can have high rates as well.

Low risk pregnant women choosing obstetric care are forgetting their care provider is a specialist of high risk pregnancy disorders — they are also a surgeon. This sort of care may be necessary for women who do have pregnancy complications and need specialist care. However, low risk women tend to have better and more positive outcomes with other care.

Your care provider or hospital should be able to tell you their intervention rates. This includes induction (particularly with medications like Pitocin/Syntocinon), assisted birth and c-section. If they don’t keep track of this important data, it might be worth looking for a care provider who does.

#3: Your Maternity Care Provider’s Language Matters

It seems like a small matter, but next time you’re in a prenatal appointment, ask your care provider a few questions and listen to their answer. Do they use the word ‘let’ or ‘allow’ when responding to your queries? If so, this is a red flag that your care provider has assumed the role of the decision maker.

Let’s be clear – as the pregnant person, you’re the one responsible for making informed decisions for yourself and your baby. It’s the role of your care provider to support you with evidence-based care, and to respect your role as the key decision maker in the process.

If a care provider is asking you to agree to an intervention on the basis of, ‘Because I said so,’ women feel they are unable to refuse. We’re conditioned to believe doctors are the experts and we should leave medical decisions in their hands. Not enough information is provided for us to understand we have the right to ask for more information or to refuse.

Your care provider doesn’t have the right to allow or let you do anything with relation to your maternity care. Ask your care provider to discuss the risks and benefits of any procedure before making a decision, and be aware this is your legal right. If you can’t come to an agreement, seek support from a care provider who will respect your rights.

#4: Your Maternity Care Provider’s Birth Philosophy Is Important

Why did you choose your care provider? Perhaps a friend or relative recommended them. Or their location is convenient. Maybe you prefer a certain type of post-natal care and they offer that. Or your GP mentioned the local hospital and that seemed easiest.

Around 96% of women give birth in a hospital setting. The remaining women who choose to birth at home or in birth centres do so after careful consideration of the following:

Their care provider’s practices support, rather than interfere with, the natural process of pregnancy and birth.
They’re able to form a strong relationship based on mutual trust, respect and open communication.
Care which is consistent with the best available research on safety
They will receive individualized care, taking into account their health needs and those of their baby, as well as their preferences and values.
Their care provider is accessible and provides support and information as well as comfort, and can access other services should complications arise.

We invest a lot of time in many other life choices, such as buying a house or car, or the guest list for a wedding. Spend the same or even more time to reflect on what you really want for your pregnancy and birth care. Interview care providers before making a decision. If your care provider is not a good match for you, the chances are you will end up dealing with it at some point during pregnancy — or even worse, labour.

#5: Know What Birth ‘Rules’ Your Maternity Care Provider Follows

Estimated due dates, big babies, speed of labour, monitoring, water birth, vaginal examinations… There seem to be a lot of rules surrounding birth these days. Most women will find themselves at some stage being told they aren’t doing something right, whether they are growing a baby too big for their pelvis or they aren’t having contractions often enough.

The vast majority of women enter pregnancy while healthy, with no major medical problems. They grow a healthy baby and expect to have a stress free, normal labour and birth. Yet it’s believed 97% of all women giving birth in hospital have some form of intervention. Is so much going wrong?

Modern maternity care is based on active management. From the moment pregnancy is detected, a woman and her baby are under constant scrutiny to ensure they don’t deviate from the very narrow limits of what is considered normal. It’s not individualized or personal care.

During labour there are rules as well. Women can only labour on the bed, or aren’t dilating fast enough, or need to move out of the birth pool to push. There is a distinction between what women want during labour and the preferences of their care providers. If your care provider is all about the rules, your care provider is not working with you to support you in a positive birth experience.

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Your choice of a maternity care provider and birth setting will affect the care you will receive. It will impact the choices and options you will have available during labour and birth, as well as the involvement you have in decisions regarding your care. Take the time early in your pregnancy to figure out what your ideal birth experience is, and find out which care provider and setting can help you achieve it.

If you’re having second thoughts about your current care provider, don’t ignore your gut feeling. It’s great practise for becoming a parent, because your instincts and gut feelings are your best friend. A positive birth experience needs trust and respect, as well as support. It’s never too late to find a care provider who will honour those values and become an integral part of your birth team.

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