What To Ask Your Ob Gyn
Choosing an ob gyn can be a pretty daunting experience for some women.
According to a BellyBelly forum poll, over 47% of women choose their ob gyn based on recommendations from their friends.
However, something important to recognise is an ob gyn who was ideal for your friend’s birth may not be ideal for yours.
Not everyone will want the same experiences and preferences for childbirth, nor appreciate the same personality traits in the people who care for them.
After doing lots of research and learning about birth, you may even decide that giving birth with an ob gyn is not right for you.
In order to achieve the best possible outcome for your birth, it’s important to do your own research. Of course, you should definitely take into account the experience and feedback from others. But ultimately, you need to ask yourself about how you feel and if this is what you want.
Before you decide on which ob gyn you want to care for you during this all important time, you should interview several ob gyns and not just one. This is because ob gyns are all so very different. They have their own, unique bedside manner and beliefs about the birth process. They have different “rules” — for example, how happy they are for you to go beyond your estimated due date (or guess date for a better word!) before they will push to schedule you for an induction. It's not black and white — they are all different.
If you choose the first ob gyn you meet, you wont know what else is available to you. While one ob gyn may sound pretty good — as will ending the search and just going with it — you may find someone even more awesome or flexible with your wishes. For example, some ob gyns will happily support a vaginal breech birth and do so frequently. Others will go straight to a caesarean because they have no experience with breech birth. It's not always about safety, but having the skills to support the kind of birth you want. If they do not have skills in breech birth, only then it becomes dangerous.
Why You Shouldn’t Feel Stupid Asking Questions
Don’t feel embarrassed or silly asking an ob gyn lots of questions. In fact, it's a perfect way to know if you've found someone who could be a top contender. The way they treat you and how they react to your need to be informed should form a decent part of your decision making process.
If the ob gyn becomes impatient or dismissive, then you have your answer already. If the ob gyn doesn’t have the time or inclination to listen to you now, do you think it will be any different during your pregnancy, labour and birth? At some stage, you will probably need to ask them some very intimate and personal questions, which wont be so easy if you don’t have that trust and connection with them.
If your ob gyn makes you feel fearful of the birth process or frightens you about poor outcomes, then you simply say: “NEXT!” If they don’t believe in you or your body’s ability to birth, then you should not believe in their ability to help you achieve the best birth possible. Because, you deserve it.
Ob Gyns – Experts in Complications
First and foremostly, it’s important to understand that ob gyns are surgeons. They are specialists in obstetric surgery and complications, which is fantastic should a woman or unborn baby need it. I am so grateful that we have ob gyns to treat and support women who are high risk.
On the other hand, independent midwives (also known as homebirth midwives) are experts in normal birth. They aren't surgeons, but they are highly skilled in their specialty of normal birth. They are perfectly capable of caring for a low risk woman, and if any warning signs come up during pregnancy, a midwife will refer you to an ob gyn. But, that's not the end of your all important relationship with the midwife – she'll still be around.
To help demonstrate the difference between the two options, I often make the comparison of a person seeing a respiratory specialist for a cold rather than their local doctor. The vast majority of the time, the cold is absolutely harmless and doesn’t develop into anything dangerous in a normal, healthy person. When the doctor does their usual investigations, in the odd case they will pick up something that could be troublesome. Or you may have a history of serious respiratory problems. In both cases, only then will they deem it necessary for you to seek the services of a specialist.
You may be thinking – “But if I have an ob gyn, I will be protected in case of any complications!’
More often than not, birth is normal. It becomes complicated when we interfere unnecessarily. Engaging a health professional that looks at birth as normal — and not a possible minefield — from the beginning may prevent you from unnecessary interventions. It's like in any job, you have an insight into things that others don't, even if they are not terribly common. So if you’re trained in what can go wrong and what tools you need to fix it, it can be hard to look past the training. Every new woman's journey should be seen as having the potential of being beautifully normal.
This is how I strongly believe we should approach maternity care. It would save millions of taxpayer dollars each year, while providing the nurturing, continuity of care women are looking for (but mistakenly think an ob gyn provides). When you choose your own ob gyn, you may end up shocked (usually while in labour) that your lovely ob gyn doesn’t do any hand holding during your birth. He or she is not there for you to do any regular monitoring (hospital midwives who are unknown to you do this) and the ob gyn only pop in to catch the baby — if they make it in time — or if there are any complications.
But for now, it’s commonplace to skip that step of seeing a midwife first and go straight to the specialist, despite the process of birth being a normal and healthy event for the majority of women. Evolution has done us well – clearly birth does work, and very well at that for the vast majority of the time! But it’s unnecessary interference in that normal process which can result in the complications that so many women fear. In the birth world it’s known as the cascade of interventions, which is sadly all too common after you begin an unnecessary induction of labour.
Not all ob gyns are like this. Of course, there are some fabulous ob gyns out there. But sadly, they are not in abundant enough supply to turn things around. Ob gyns are fantastic when things go wrong, their skills are designed for that – and thank goodness! But while you may think you would want the most qualified person possible to cover any scenario, its important to understand what can come with that. Better technology is not the best care. The United States is a perfect example of this. The amount of money invested into obstetric care compared to the outcomes the country achieves, is pretty dismal. In fact, they have one of the highest newborn and maternal death rates in the developed world. Technology is not always the answer.
The ideal trained person to care for a low risk pregnant woman, is a midwife (the word itself means ‘with woman’). The only reason I have included this aspect of care in this article is because of my own experience. I fell pregnant and wanted the best of everything for my unborn baby. I researched the best hospitals and best doctors. But my experience left lots to be desired – and I know many women go through this exact same thing. It's understandable to want the best when it's your baby you're talking about. But compare the care – consider interviewing a midwife too, they you'll be truly informed about your options. Because if you don't understand your options, you don't have any.
You can hire your own midwife no matter where you give birth, to help keep your birth as normal and respectful of your choices as possible. Alternately you could use a doula if a midwife isn't for you. But in Australia, if you want to give birth in a private hospital, you need a private obstetrician. Click HERE to read our article on birth place options.
What About Your Fertility Specialist As Your Ob Gyn?
Many women who were able to get pregnant with the assistance of a fertility specialist feel obligated or inclined to continue on with the specialist for their pregnancy and birth care.
However, it’s still important to see how they feel about your birth philosophies and preferences. If they aren't in alignment, it's okay not to continue with them. It’s fantastic if they have helped you to get pregnant, but just like any other ob gyn, their beliefs and opinions about birth can be as different as any other.
Sometimes a fertility specialist's views can even be more medically focused, especially when medicine helped you get pregnant. Women have been told things like, “Well you’ve gotten pregnant now, no need to risk it, lets book you in for a caesarean just to be sure.” In a low risk pregnancy, a caesarean section — major abdominal surgery — carries much more risk to mother and baby than a normal vaginal birth. Make no mistake, a caesarean is major surgery – you're not whipping your tonsils out.
One woman I supported chose to continue with her fertility specialist during her first pregnancy. Her baby was found to be breech and showed no signs of moving based on many weeks of checks and scans. The woman’s ob gyn was not skilled in breech birth (as many no longer are) and wanted to perform a caesarean. However, the woman wanted a vaginal birth. I provided her with some names of ob gyns who supported breech birth. As a result, and with her specialist's blessing, the woman made the decision to change ob gyns, and was able to be supported in the birth she wanted.
It turned out to be a great decision – she went on to have an empowering, drug-free, breech vaginal birth. She has since gone on to have a second vaginal breech birth! You can only imagine what that would do for the confidence of a new mother — to have an experience of taking a big leap of faith — which resulted in finding someone who could make her birth wishes come true.
BellyBelly Forum Administrator, Rouge, shares a similar story:
“We started seeing a fertility specialist for PCOS (polycystic ovarian syndrome) to help conceive our second child. We had been trying for nearly 12 months with no success. I had lots of tests done and it was conclusive that the PCOS was causing the problems. I was put onto Metformin and Clomid, and after 2 miscarriages we fell pregnant with my son. I was very happy to be pregnant, and because I had a caesarean with my first, I was determined to have a VBAC (vaginal birth after caesarean). I raised the question of a VBAC with my fertility specialist, to which his reply was, “No way. Your last baby was 9 pounds, there is no way you are going to push this baby out. It’s going to be huge.” Riiiiight I thought.
I was quite adamant and asked him if he was sure he wouldn’t consider it. He said he would give me an ultrasound at 36 weeks and tell me then. So I went home feeling torn because I knew I wanted to have my VBAC, and I guess a part of me felt loyal to this fertility specialist because he had helped me to conceive. But I realised that I did deserve the chance try again. I got in contact with some people who knew some VBAC friendly ob gyns. I found the ob gyn of my dreams, who very much believed in letting nature take its course. He was true to his word – I managed to birth my son the way I had dreamed of.
My advice to others is that when your fertility specialist asks you, “Will you be needing me as an ob gyn?,” be straight with him or her and say, “I’m still looking at my options.” That way you can leave it open, and you won’t worry about it if you do decide to go with another ob gyn, or even a midwife.”
11 Questions To Ask Before You Choose Your Ob Gyn
Here are 11 questions which will help you to uncover if the ob gyn you are considering is best suited to you and your baby. Other more general questions are listed at the end of this article. However these specific 11 questions are designed to help you choose someone who is going to have your best interests at heart. You'll have a much better experience than just choosing the first one you find who is available around your estimated due date.
You may think all you need is an ob gyn who is available on your guess date and has a good bedside manner. But later on, when you've learnt more about birth and have started to make decisions about what you want and don't want, if you haven’t factored this in with your choice of ob gyn, you may find yourself in a quandary. You'll have to decide to either stay with who you chose, compromising on what you want, or having to change last minute and hope someone else is available, which can be very difficult.
When speaking to an ob gyn, always try to ask open-ended questions, to find out how the ob gyn really feels. Encourage discussion rather than ‘yes’ or ‘no’ answers.
Click here to download a FREE interview sheet to use when interviewing an ob gyn for the first time. If you are unable to open the document make sure you have Adobe Acrobat Viewer which you can download for free. Alternatively, you can download the document in Word format HERE.
#1: What Are Your Philosophies And Beliefs About Birth?
This open ended question is the most important question you could ask an ob gyn, as it will give you an idea as to how they see birth and how they may try and control the process.
Do they see birth as:
- A medical process which needs to be monitored and managed continuously?
- A process which is fraught with potential minefields and requires preventative procedures? Or;
- A natural process where nature should take it’s course before interfering?
#2: How Much Choice Do You Feel I Should Have In The Decision Making Process?
Women (and their partners) tend to have much better experiences of birth when they are involved in the decision making process and are given options. Those who feel that they have no control over or are not informed or involved with decision making tend to have a less positive experience of birth and may even end up depressed or with post traumatic stress disorder. So it’s very important to choose someone who you feel will involve and inform you throughout your pregnancy and birth, without wanting to race you out the door in five minutes.
#3: What Are Your Thoughts About Pain Relief During Labour?
Another great indicator on how they view the birth process.
- Do they just assume that you will have pain relief or will they support and encourage natural pain relief methods?
- Will they openly tell you the side affects for you AND your baby?
- Will they encourage you to accept pain relief in labour, or recommend against it if you are close to birthing your baby?
What they say about pain relief and if they think you will quickly succumb to it says much about what they think of the birthing process and how supportive they will be.
(As a side note, the reason I use the word birthing/birthed as opposed to delivered, is because I think babies are born and pizzas are delivered! I also think mum does all the hard work birthing her baby and deserves the credit, not the obstetrician! Language is so important and can be empowering or disempowering)
#4: How Do You Feel About My Birth Plan? Do You Forsee Any Problems?
If you haven’t yet put together your birth preferences (birth plan) it’s a good idea to take a rough one with you when you interview an obstetrician. It can always be altered later, closer to the date, but it’s important that the person who is to be your primary carer can see what you have in mind for the birth – and its important for you to find out what he/she thinks about it before it’s too late. There’s nothing worse than being in a situation where you need to make a quick decision and feel like you don’t have enough time to discuss it.
Ask the obstetrician to tick or initial each point in your plan and/or sign the end of your birth plan in agreement, so when you present it to the hospital or when you face deviations to your plan, you have something signed to show the hospital or the obstetrician.
Don’t forget to read the BellyBelly article about birth plans, which includes a free downloadable birth plan template which you can edit and print out here.
#5: What Are Your Thoughts On Electronic Monitoring, And When Do You Think It Should Be Used?
Intermittent doppler monitoring is standard care during labour, however some obstetricians and/or hospitals prefer to use more restrictive and invasive procedures of monitoring which can affect the way you plan to labour and give birth. Continuous CTG monitoring which involves you being stuck in one position, usually on the bed, and can be detrimental to the progress of labour. The Cochrane Library, a regularly updated collection of evidence-based medicine databases, concludes where continuous CTG was used, there was:
“…no significant differences in cerebral palsy, infant mortality or other standard measures of neonatal well-being. However, continuous cardiotocography (CTG) was associated with an increase in caesarean sections and instrumental vaginal births. The real challenge is how best to convey this uncertainty to women to enable them to make an informed choice without compromising the normality of labour.”
“Data for subgroups of low-risk, high-risk, pre-term pregnancies and high quality trials were consistent with overall results. Access to fetal blood sampling did not appear to influence the difference in neonatal seizures nor any other pre-specified outcome.”
You can read the full report HERE.
Being armed with this sort of information can really help you prior to meeting an obstetrician, as you will know a bit more about the facts, feel more confident and can respond or make a decision accordingly. Researching all the choices you make for your birth plan is the key, it shows understanding and dedication to what you have planned. You are less likely to stick to a plan if you haven’t researched the reasons why you want those choices.
#6: What Is Your Induction Rate And When Do You Think Induction Of Labour Should Be Considered?
Obstetricians will have varying protocols on induction, from inducing only days after your guess date, some 7-10 days post-dates, some 2 weeks, and some will allow more if baby and mother are well.
The problem with unnecessary inductions is that they start off a cascade of interventions, so while it might sound harmless to start labour earlier with a little bit of artificial hormone, you might change your mind when you start asking for an epidural (and a catheter and i/v fluids come standard with that), forceps, vacuum or a caesarean section – read more about the risk of inductions.
Knowing an induction policy before you choose an ob gyn can help you avoid interventions that you perhaps aren’t hoping for. At the end of the day, you have the ability and power to refuse an induction, but it’s much more pleasant if your obstetrician is in agreement with your choices.
#7. What Is Your C-Section Rate And In What Situations Will You Recommend One?
This is a question worth insisting on if you can’t get an answer – they may not be forthcoming with offering a figure but finding out the answer to this can be very helpful, as well as save you from a 6-week recovery from a caesarean. The World Health Organisation states that around 15% of caesareans are probably needed, as a case of medical necessity.
However, many hospitals are now sporting c-section rates of 30-50%, and scarily enough, some even higher. So it’s worth knowing if your ob gyn is performing c-sections at a rate of 15% or 50%.
You might like to know what percent are elective and what are emergency. To clarify, an elective c-section is where labour has not yet started. So this is where a woman has requested a c-section, or if baby is in an unfavourable breech position and a c-section is performed before labour starts.
An emergency c-section sounds pretty dire, but it simply means labour has already started. So a mother may be tired after a long labour and ask for a c-section, or if the baby is in distress after an induction of labour, that would be an emergency c-section. It doesn’t automatically mean a life threatening situation.
If the obstetrician isn’t telling you their c-section rate or can’t give you an estimate, then I would think it's a rate they didn’t want you to know.
#8: How do you feel about mothers being separated from their babies after a caesarean? What about immediate skin to skin contact if all are well?
Many decisions about what happens in theatre is up to the anaesthetist and/or the obstetrician, for example if you can have one extra support person present, a video recorder, if you can have skin to skin contact after the birth, delayed cord clamping etc. So if possible, it’s good to meet the anaesthetist prior to the caesarean or find your own if you are having an elective caesarean.
In order to perform a caesarean as quickly as possible, things are often done to save time which may not be how you would envisage a caesarean to be. Once your baby has been born, the normal process is to give you a quick look of the baby (after someone else has checked over the baby and wrapped it up) and then baby is given to dad to do all the weighing and other procedures while you are stitched up and sent to recovery, alone. However, if you find the right obstetrician and if it’s not a life threatening situation, you can have a more special, bonding experience.
There are some obstetricians who allow some or all of the following in a caesarean where mother and baby are not in danger:
- No screen to obstruct the view or the screen lowered for the birth
- The cord left to stop pulsating before being clamped and cut so baby can have it’s valuable cord blood
- Lotus birth (no cutting of the cord at all)
- Immediate skin to skin contact after the birth
So once you have figured out how the obstetrician feels about mother/baby separation, you can clarify with specific points that are meaningful to you. Be prepared to get knockbacks from some obstetricians on all of these things, but on the off chance you need a caesarean, it’s nice to know you have chosen an obstetrician who will allow you to have a special one, so it’s worth doing your homework. With consumer demand comes the service, so hopefully more women will ask for these things.
#9: What is your episiotomy rate and in what situations would you perform one?
These days it is not common to find an Obstetrician who will do routine episiotomies, however they are still being performed during the birth. It’s a good idea to get an idea of how many episiotomies are being performed by the Obstetrician and how they feel about it’s use.
#10. Do You Support Vaginal Breech Birth? If So, What Conditions Do You Have?
This is something you might not have thought about. However for some women, their babies will be breech during pregnancy, and some of those babies will want to stay that way.
Most ob gyns will want to perform a c-section before your due date (usually around 38 weeks) if your baby is breech, but there are some skilled ob gyns actively supporting vaginal breech birth – you just have to do your homework to find them.
Some breech babies do decide to turn head down days before birth or even just before labour. My mother told me about when she was pregnant with me, I was born nine days post-dates, and was breech until 8 days post-dates. Luckily, I was given a chance to turn on my own. But if I was born in today's birth climate, I would have likely been a c-section baby, born over three weeks early. That is scary – I wouldn’t have had a chance to turn and be born when I was ready, potentially having breathing difficulties or other problems.
It’s also good to know that on the Royal College of Obstetricians and Gynaecologists website, there's a statement about vaginal breech birth, which is supportive of vaginal breech birth. It has it's conditions and is not perfect, but it’s a great start. It's a sign that more obstetricians need to ‘skill-up’ in breech birth and should be taught at ob gyn school.
It is also important to find out what conditions an ob gyn will attach to a vaginal breech birth. Some will want to do an episiotomy, continuous monitoring, epidural etc – not that they have the final word in it, you can negotiate. Some breech positions are more favourable for a vaginal birth, and the position may be the factor in getting that vaginal birth or not.
The best ob gyn for a vaginal breech birth is one who is skilled and experienced in breech birth. It becomes more risky when it's managed by someone who doesn't have much experience with breech birth. Breech birth ironically requires a more ‘hands off’ approach to the birth.
An ob gyn who is supportive of breech birth is likely to have a better philosophy of birth, so even if your baby chooses not to assume a breech position, you are probably on a winner with the ob gyn anyway. Just make sure the other requests you have line up too.
#11: How Do You Manage The Third Stage?
The third stage is the birth of the placenta. It may seem like something irrelevant, but there are some very important things here that affect your baby, remembering that the placenta has been the baby’s life support system for nine months and contains building blocks for your baby’s body.
Firstly, in order to streamline and hurry things along after your baby is born, just about all hospitals and obstetricians will clamp and cut the cord right away, then give you an injection to expel the placenta (and also prevent haemorrhage which is an increased risk if you have a high intervention birth or induction). You can ask to be given this only if you do show signs of excessive blood loss or if you have had an induction, but for normal, healthy birth, haemorrhage rates are low.
In a normal pregnancy and labour, there is no reason to hasten delivery of the placenta either. When you are given this injection, which is similar to what they use to induce labour with a drip (syntocinon) and make the uterus contract, it means that the cord needs to be cut straight away. Why is that undesirable? Because there are several studies now which show that where the cord is left unclamped until it has stopped pulsating (i.e. all the blood has gone from the placenta to the baby), there are less cases of babies with anaemia, blood transfusions and other blood conditions. The baby will get months of iron stores from this valuable blood supply and of course, all it’s precious cord blood and stem cells. If you cut the cord early or donate the cord blood, your baby doesn’t get to keep those super valuable cells – and it’s alot of blood volume for a baby.
Read our article on cord blood here, to see what the studies say, and why it's recommend to be made a standard procedure to leave the cord alone. The United Kingdom is already in the process of doing this after 10 years of lobbying by a midwife.
A physiological third stage is something you can ask for if you want the third stage to be completely natural.
Click here to download a FREE interview sheet to use when interviewing an Obstetrician for the first time. If you are unable to open the document make sure you have Adobe Acrobat Viewer which you can download for free.
The Practical Questions
Other practical questions you might like to ask a potential obstetrician are:
#1: Which hospitals do you attend?
This is so you can choose a hospital – obstetricians only work in certain hospitals, so you need to either choose an Obstetrician and have your baby at one of the hospitals they work in, or choose a hospital first and then one of the Obstetricians who work in that hospital.
#2: Who is your back-up and will I get to meet him/her?
Of course you would want someone sharing the same philosophies and to meet them if there is the chance your Obstetrician may not be there, which is a fairly common occurrence.
#3: When are you planning holidays in the next 12 months?
You should find out if he or she may be unavailable in the future.
#4: How do you feel about waterbirth?
Many ob gyns — and hospitals — wont support this, while some have no issue with waterbirth at all. If a waterbirth is something you think you might like to consider, choose an ob gyn who will support you, so you actually have the option. If an ob gyn doesn’t mind waterbirth, it tells you more about their philosophies about birth – normal, natural, safe. Babies don’t breathe under the water, as they are still attached to the oxygen-supplying umbilical cord. A reflex will make them breathe when they hit the air.
#5: What do you think about doulas?
Some ob gyns refuse women the right to have a doula present at birth. No matter if you want a doula or not, it's a great question to gauge how much the ob gyn supports the normal birth process. Studies have repeatedly shown that the support of a doula helps to reduce the incidence of intervention (caesarean, forceps, vacuum, pain relief and more) while having no adverse effects. Some Ob gyns have had bad experiences with doulas — like any profession, there is the good, the bad and the great — so if the ob gyn says no, ask why. Because a doula is worth their weight in gold, and can help you to have a more informed and empowered journey into parenthood.
Questions If Seeking A Vaginal Birth After C-Section
If you have had a caesarean previously or have a scar on your uterus (e.g. from fibroid removal, abnormalities repaired or any uterine surgery which leaves a scar) and would like a vaginal birth, here are some extra questions you might like to ask:
- How do you feel about me going past my estimated date and how long before you will recommend a caesarean?
- When I go into labour, what monitoring will you recommend?
- What do you think about time limits for labouring?
- Will I be required to have an epidural or an I/V bung?
- Will you support my desire to breastfeed my baby right away, no matter if I have a vaginal birth or caesarean?
- Will you support me if I want a natural third stage?
Other Things to Bear In Mind
When asking these questions there are three main things to realise:
#1: Your Ob Gyn May Have Their Hands Tied
The hospital which your obstetrician attends will have their own policies and procedures, which all staff need to adhere to regardless of individual preferences. Some will not allow breech birth or waterbirth. So while your preferred obstetrician may be fully in favour of your choice to have a waterbirth, VBAC or breech birth, the hospital you choose may have policies which are not in line with what you are wanting. So if you can choose an obstetrician who’s philosophies are closest to your own, you can also ask them to recommend a hospital which is most compatible with the birth you want.
If the obstetrician doesn’t or can’t recommend one to you, then you will have to do her own homework, ringing around and making appointments with the individual nurse unit managers and discussing your birth options and preferences.
#2: There Is Policy, But It’s Not Law
While there may be policy, there is no law to say you must do anything during labour – let alone have your temperature taken. Everything requires your permission. So if the hospital is insisting on continuous electronic monitoring and you do not want this, you can just say no and it will be noted on your file. You can say no to an internal on admission – anything at all. I have been to births where some women have been told by hospital staff that, ‘We want to do xxx because we don’t want you to end up with a dead baby.’ They aren’t afraid to use the ‘d’ word which can be very distressing no matter what your plans may be. So please make sure you do your research on the specific things you do and don’t want, so you wont be swayed by such comments and will know that ‘x’ procedure has little difference in preventing a such a thing, of which the rates are very low anyway.
#3: It’s All Open To Negotiation
Many ob gyns and hospitals can be negotiated with. Sometimes it can be wise to meet them halfway, depending on what you are happy with. Their concern is for safety, so even just acknowledging that can help. One woman I supported had ruptured membranes (broken waters) for over 24 hours with no signs of active labour. The hospital was keen for induction to begin, but the woman was not. So had done her research and acknowledged their concerns, before negotiating regular check-ins with the hospital and a session of monitoring. She monitored her temperature at home — to look for signs of infection — and kept them updated. When your waters break on their own, infection risk is less than when your waters have been artificially broken. This is because a hand and a tool have been placed close to your baby.
VBAC is another situation where negotiation may be necessary, as an ob gyn may not be happy with a woman going too far past her guess date. Negotiations have resulted in the women able to go into labour naturally, despite much pressure to be booked in for a caesarean date. The outcome being a healthy baby and healthy mother.
While it may not be exactly as you wanted, sometimes meeting halfway — as opposed to giving in — can relieve the tension between yourself and your caregiver.
Please Educate Yourself!
I can’t stress enough: make sure you choose sufficiently educational books and classes. Often, friends and family pass on outdated or ill advising books to pregnant women. If you hire a doula, she can support you to word towards the birth you hope for and can direct you to quality educational resources.
Hospital based prenatal education often does not prepare you well enough. They may tailor the classes to what the majority of their clientéle want to hear (as I heard directly from a midwife) and many don't provide sufficient education on coping with pain without drugs. Many hospital classes cover medicated pain relief in great detail, but not natural pain relief options and birth support techniques for your partner — there is so much more you can learn.
I remember one time when I was a back-up doula, and was called in to support a woman in a private hospital. She was having a really rough time coping with the pain, and she told me that her birth education classes were mostly about pharmaceutical pain relief. Later, I asked the midwife what the birth education classes were like. She said it was true that they only really presented information on medical pain relief, because most women walked through their doors wanting an epidural. I wonder why?
There is a recommended birth books article on BellyBelly, which is a fantastic starting point. Also, invest in independent childbirth education – it’s very different to hospital based classes and opens up your options and gives you more tools for birth. Because if you don’t know your options… you don’t have any.