After you’ve setup interviews with doctors and/or midwives, you’re going to need some questions to ask them. For this post I want to talk about how to conduct an interview.
Hence Goer, author of Thinking Woman’s Guide to a Better Birth, suggest asking questions in a way that does not give away your opinion. If they know what your opinion is, they may tailor their response to your opinion instead of what their actual answer is. It is important to ask open-ended questions. Begin a question with “When do you usually recommend….?” Using the vision of your birth experience as a guide, ask questions about key elements of your birth vision. If you want to push in different positions than the traditional-hospital-position of laying on your back with legs in stirrups, ask your potential care provider about this. You could ask “What is your opinion of pushing in upright positions?” or “What is your approach to the pushing stage of labor?”
When the care provider answers the question vaguely, such as “I only do that when it is necessary”, follow up with more questions. If the answer they give is “I only do that when it is necessary”, ask “In what situation would it be necessary?” or “How often do you find it necessary?” If it is important to you not to have an episiotomy (when the care provider cuts your perineum), and the care provider says they find it necessary in every first time mom and about 80% of the rest of moms, then this is probably not the best care provider for the birth experience you want.
Is the care provider answering with feelings instead of facts? These types of answers can be very misleading. At first it seems like they care about your experience, when really they are trying to appeal to your emotion rather than using evidence based practices. If they answer with a feeling based answer, follow up with questions to get them to state specifics. In the situation of episiotomies, would you rather hear “Would you rather have a clean cut than a jagged tear?” or “I do them very rarely. It’s been about 3 years since the last time I did one. They are routinely done as part of a forceps delivery”.
Does the potential care provider seem comfortable with you asking them questions? If they seems irritated or impatient with your questions, they may not be the best care provider for you. If they are not comfortable with your interview questions, how would they react if you had a “dumb” question to ask. Think to yourself, “would I feel comfortable asking them a ‘dumb’ question?” There are times during pregnancy or birth that something doesn’t feel right or you unsure about what is going on with your body and you should feel comfortable talking to your care provider about these things without feeling stupid about it.
Here are specific questions to ask a potential care provider:
- Are you board certified (physicians only)?
- Under what circumstances would you transfer my care to an obstetrician (midwives and family physicians only)?
- Do the midwives attend births? (if you are interviewing at a practice that has both midwives and OBs)
- What is the likelihood that you will attend my birth?
- What are your dietary recommendations? How much weight should I gain?
- What is your policy on ultrasounds?
- Under what circumstances do you recommend inducing labor?
- How do you handle slowly progressing labors?
- What are your policies regarding monitoring the baby’s heart rate in labor, IVs, drinking or eating in labor, breaking the bag of waters (amniotomy), epidurals, episiotomies?
- What are your reasons to do a cesarean? How often do you find it necessary? How do you try to avoid the need for cesarean?
The Thinking Woman’s Guide to a Better Birth, Henci Goer, p. 195-196
Henci Goers book has a lot of information about evidence based practices and I would recommend getting your hands on a copy. It may help you define your birth vision. In the particular section referenced about she also has “Red Flag Responses”. Great read!Here are some links to help with questions to ask a potential care provider: http://www.askdrsears.com/topics/pregnancy-childbirth/first-month/interviewing-midwife http://pregnancy.about.com/od/prenatalcare/a/10q4doc.htm http://www.ahaparenting.com/ages-stages/pregnancy/Choosing-doctor-or-midwife