This is one of the most frequent questions I receive. As our culture sets doctors up to be authority figures (something that can be comforting in many cases), we often feel like we’re stuck with the first person we receive treatment from after we pee on the stick. Most of the time, that person is the OB we started going to because our insurance covered it or a few friends recommended them. But then we start learning about pregnancy and childbirth and might find we’re feeling less aligned with that OB — feeling less comfortable asking questions or expressing how we want to navigate pregnancy and childbirth. Under normal circumstances, we would find a new care provider, but discomfort at the thought of firing the person who’s been administering those lovely Paps for so long can seem more than our pregnant emotions can handle, especially when we’re nearing the end of pregnancy. But the alternative is often a birth experience that is a far cry from what we actually want.
In addition, most of us feel incredibly vulnerable during pregnancy, so when we have a care provider talking with great authority on what we should do, we wonder if we’ll be doing ourselves or our baby a disservice if we change care providers. So we stick with them. But this decision is often based on fear rather than on a genuine desire to receive care from the person in question. It’s also important to note that some care providers present opinions as fact. They state their views on induction, for example, as gospel, making some women feel silly for having a differing opinion. If you conduct the care provider interviews recommended in the following pages, you’ll find that almost every candidate will have a slight (or significant) difference of opinion on almost all pregnancy and childbirth topics. In many cases, a lot of what they say is based on their personal experiences, not on science-based research.
I have a birth story packed with disappointing moments because I didn’t feel comfortable being open with my care provider. At the time, I didn’t have the courage to find a new one. When I discovered a fertilized egg had landed in my uterus, I went straight to the lady who had given me a painful endometrial biopsy the year before. She was an authoritative grandma type and a high-risk OB. I knew nothing about pregnancy and childbirth and figured it would be good to have a doctor who was well trained in everything that could go wrong. What I soon learned was that she seemed to always be looking for something to go wrong.
I started feeling unsure of my body and my ability to make decisions, and I rarely shared my thoughts on what I wanted my birth to look like. The one time I summoned some courage and told her I didn’t want to be induced and didn’t want an epidural, she just stared at me. Fast forward to labor. I had not developed any special circumstances that warranted the watchful eye of a high-risk doctor, so I was primarily left under the care of the L&D nurses, who were happy to let me birth without intervention. Things were moving along fine when my doctor came in and decided to break my water. There was no medical indication for this — she just wanted to speed things up. And of course, I didn’t talk back. So that happened . . . and soon after I was ready to push. I began trying out positions I learned in my birthing class and did a combination of deep breathing and pushing to avoid the burst-a-blood-vessel, high-octane pushing commonly recommended in hospitals. My doctor stood in the corner and watched skeptically for about ten minutes before telling me to put my feet in the metal stirrups and push the way she wanted me to push. Three exhausting hours later Hudson was born. We were healthy, and I had my unmedicated birth, but I didn’t feel empowered. I felt like I had been railroaded.
Looking back, I recognize my doctor wasn’t “bad,” she just wasn’t the right fit for me. I wish someone had told me what I’m about to tell you . . .
What to do
If you’re not jiving with your current care provider, find a new one. I can guarantee you won’t be the first person to move on from them, and you won’t be last. I can also (almost) guarantee they won’t be offended. They have plenty of patients and likely prefer those who happily follow their suggestions, not someone who seems hesitant about their care. So really, you’re doing both of you a favor. To find a care provider you gel with, consider the following:
- Conduct interviews. These interviews can be done fairly quickly, and sometimes over the phone. You can usually find good suggestions for candidates by asking friends or family members who had the type of birth you’re hoping for, or your childbirth preparation educator.
- Meet with your top choices. After the initial interviews, have consults with three or four of your favorites, sharing the type of birth you want and paying attention to how they respond. If they seem like they could maybe, possibly support what you want, they might not be a good fit. If they’re enthusiastic about your birth preferences and talk about things you can do to set yourself up for your ideal birth — if they make you feel like they’ll be your champion — they might be a really great fit.
- Check in with your gut. The most important indicator that someone is the right care provider for you is feeling instinctually comfortable with them and excited at the prospect of receiving support and guidance from them. They should be someone you feel you could trust, ask anything of, and tell anything to.
This process can be done at any point during your pregnancy, even a few weeks before your due date. I know a midwife who started caring for a mother the day she went into labor. I also know a woman who had a breech baby and one week before her due date decided to switch from a doctor who was insisting she have a cesarean birth to a care provider who performed breech deliveries.
Above all, you deserve to have a care provider who makes you feel empowered, safe, and capable. And you have every right to hire and fire as many care providers as you need until you find that golden match.