Most providers are part of group practices, which means that you will be attended at birth by whichever provider is on call at that time. In addition, the provider on call will respond if you have any concerns during pregnancy that come up outside regular office hours. This can be frustrating if you have a good relationship with a particular provider but are offered care by another whom you do not know as well. On the positive side, working in such teams can give midwives and doctors read predictable, limited work hours; this entails less fatigue and can reduce medical errors.
Some groups have you see one doctor or midwife for the whole pregnancy, while others rotate you through the group so you get to meet everyone. If you will be working with a group practice and have a choice, look for one in which all members have comparable philosophies of care that are well matched to your needs and preferences. Some practices host public events to introduce all the providers.
Setting up a counseling visit before you become pregnant or early in pregnancy is one way to get to know a doctor or midwife you might consider for your pregnancy care. Ask your friends and family who they recommend. In addition, doulas and childbirth educators can provide excellent guidance about caregivers in the community. Interview the people who you think are most likely to be a good fit for you. (Some insurers will cover an interview visit, and some practices will not charge for the interview; this varies.)
Questions to Consider Asking:
- What is your philosophy of childbirth?
- How long have you been practicing? How many births have you attended as the primary attendant?
- Do you practice alone or with others? If with others, what is their experience? Do they share your beliefs and manner of practice?
- Who attends births for you when you are away?
- Where do you attend births, and can I take a tour?
- How can I reach you?
- How often will I see you during these next months?
- What kind of childbirth preparation do you recommend?
- What tests do you recommend for pregnant women? Why?
- How do you define and handle complications?
- Do you provide labor support and stay with women throughout labor? If not, do the nurses provide one-on-one care for women during labor?
- How do you feel about doulas, labor assistants, or family and friends being present?
- Do you support moving around during labor, changing positions, and eating and drinking?
- Will I see you after the birth takes place?
- If I want to hold my baby right after birth, breastfeed, and not be separated, will that be supported?
- If I plan to breastfeed and experience problems, what support will you offer?
- Under what circumstances do you recommend IVs, continuous electronic fetal monitoring, Pitocin, episiotomy, forceps or vacuum, cesarean section, or immediate clamping of the baby’s umbilical cord? What is your cesarean rate? Episiotomy rate? Induction rate?
- What is your protocol for the birth of twins and breech births?
- Do you attend vaginal births after cesareans (VBACs)?
- How much do you charge? Are your services covered by my insurance?
Additional Questions for Care Providers Who Attend Home and Birth Center Births
- Are you licensed and certified?
- What are your requirements for accepting patients to give birth in this setting?
- What drugs and equipment do you have available?
- What are the qualifications of your birth assistant?
- Do you have a formal agreement with an obstetrician-gynecologist to provide care if complications occur?
- Do you recommend that I meet the physician who will assist me in case of a complication?
- What hospital will I be transported to if a complication occurs during labor? What about in an emergency?
- Under what conditions would we go to the hospital?
- Would you stay with me if we transfer?
- What percentage of your clients transfer to a hospital during labor?
- Are you trained in newborn resuscitation?
- What kind of postpartum care can I expect? Do you provide follow-up care for the baby as well?