Choosing your birth provider is one of the most important decisions you will make.
Yet for many women, even those in high-income countries, care provider choice can be limited.
Women who live in rural or remote areas might have little to no access to any type of maternity care.
The maternity system in your country could limit you to a certain hospital; health insurance might reduce your choice to a certain list of providers; and certain options (such as private midwives) might be illegal.
How Do I Choose A Care Provider?
Your care provider and birth setting will influence the kind of care you receive during pregnancy, the choices available during labour and birth, and your birth outcome.
Here are 5 ways to choose the right care provider for you:
#1: Decide What Kind Of Birth You Want
You have a choice about how you give birth. You can decide to go all natural, be open to what happens on the day, or you might have special circumstances (such as a previous c-section or traumatic birth) to consider.
How you want your baby’s birth to be will help determine who is the right care provider for you.
Create a list of birth preferences that detail all the ‘must have’ or ‘must do' things on your birth wish list. This will help you later, when it’s time to decide on your care provider, and you need to know which one is a good match for you.
Not sure where to start with your preferences? Check out BellyBelly's Birth Plan – Why Write One? for more tips.
#2: Decide Where You Want To Give Birth
Many people assume birth needs to take place in a hospital, but there are other choices, such as birth centres or birth at home.
Where you want to give birth will determine who is going to support you. Very few obstetricians will attend home births. Not many private midwives have clinical practice rights in hospitals.
If you have private insurance and want to utilise it for the birth setting, it pays to be informed about what that means for you during labour. Research shows low risk women are more likely to have interventions under private obstetric care than in public hospitals.
Choosing to give birth at home also means you can choose the people to support you, as most private midwives operate independently of hospitals.
If a birth centre or hospital is your preferred choice, you might be able to access a midwifery program. This means your pregnancy and birth care is offered by a small group of midwives who work within the birth centre or hospital.
Choosing to give birth in a public hospital generally means you will be cared for the staff available on the day, rather than having a choice of staff.
#3: Ask For Recommendations
It’s pretty standard practice for a pregnant woman to be sent to her local public hospital, or be given a referral for an obstetrician, without really looking further than those choices.
Your best friend or sister might have seen Dr X, or birthed at Hospital Y, and think you should too – but they mightn’t have had the sort of birth you want or are planning for.
A good way to find out more about your options is to join a local online group or page. If you are looking for a VBAC friendly obstetrician, or want to have a positive induction, or need to find a private midwife, ask those who’ve been there before.
#4: Interview Each Option
If you owned a business and needed to hire staff, you'd want to know you were getting the right person for the job. The same analogy applies to your decision about a care provider. You are the birthing woman (the CEO) and it’s up to you to hire the person who best fits the job description.
Once you’ve decided how and where you will give birth, and have a list of recommendations, contact each care provider to set up an appointment. When you meet them, ask plenty of open-ended questions (what? where? how? and when?) so they will provide information about their philosophy and practice.
Take your list of birth preferences with you, and go through each point with the care provider. You should be comfortable, and have a good feeling that the care provider is on board with your birth wishes.
You should be feeling listened to and supported. The care providers you are considering should see you as the decision maker rather than place themselves in that role.
If you feel dismissed, patronised, or defensive at any point, that’s a signal to reconsider whether a care provider is the right person for the job. You don’t want to be in ‘fight or flight’ mode during labour, so keep interviewing until you find the right person.
Read more about what you should be asking in The Question All Pregnant And New Mothers Should Ask Their Care Providers.
#5: Choose The Expert In The Type Of Birth You Want
You want a natural, intervention-free birth? A safe and positive c-section birth? Choose the person who is an expert in the type of birth you want.
An obstetrician is a specialist in high-risk pregnancy and birth. In today’s birthing culture, many women choose to see an obstetrician, even if they are low risk. Obstetricians aren’t experts in natural, unmedicated birth. If you have health complications, or if your baby will need medical assistance after birth, then an obstetrician might be the expert for you.
Women seeking a natural and intervention free birth will be more successful with a midwifery-led model of care (home birth or birth centre). Women who are worried and anxious about giving birth are more likely to have a positive birth experience with support from a known midwife, or group of midwives.
Remember You Can Change Providers
Ideally, from the time you discover you are pregnant, you will invest in finding the right care provider for you. It might take some time, but if you do the hard yards early and create a relationship with a care provider you can trust to support you, you should have a positive birth experience.
Unfortunately, like in many relationships, things don’t always work out. At some point, you might realise you’ve changed, or you might discover the care provider you'd chosen wasn’t the best person for the job after all.
Or you might have had very limited choices during pregnancy, and had to go with what was on offer, but a better option came up at the last minute. It sometimes happens that a care provider can seem like a perfect fit, and then you find later on you were simply being told what you wanted to hear.
Just remember you don’t have to stick with a bad choice. You can fire the care provider you have and seek another at any stage during your pregnancy, even if labour is under way.