Essential Questions for Your Obstetrician or Midwife & Doula

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.)

Ob-GYN

Now that you’re pregnant you probably have a million questions. You’ll have an opportunity to get a lot of them answered at your first OB appointment, which will likely be one of your longest. Call your doctor when you get that pink plus sign to let them know and they will let you know when to come in—but keep in mind that first checkup may not be scheduled until you’re eight or nine weeks along, and that’s totally normal.

• How many babies do you deliver each month?

• How do you accommodate patients’ birth plan preferences?

• What is your c-section rate?

• Do you perform VBACs (vaginal birth after c-section)? What’s your VBAC success rate?

• Are you comfortable working with a doula if I decide to hire one?

• What “high risk” situations do you have experience with? Twins? Breech? Advanced maternal age? Pre-eclampsia?

• At what point would you recommend inducing labour? Do you use forceps or vacuum-assisted delivery (ventouse)?

• Should I write a birth plan?

• Do you support moving around during labor, changing positions, and eating and drinking?

• 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)?

• If I want to hold my baby right after birth, breastfeed, and not be separated, will that be supported?

• Have you ever lost a baby or a mother? If so, under what circumstances?

Midwife or Birthing Center

It is important that you feel well-informed about your antenatal care and have accurate expectations about what will happen when you go into labour. Ask about how they work and the fees they charge when you meet them so you can make an informed decision.

• What happens if there’s a complication in my pregnancy?

• How are my baby and I cared for postpartum?

• What Are Your Philosophies And Beliefs About Birth?

• Do You Support Vaginal Breech Birth, Do you attend vaginal births after cesareans (VBACs)? If So, What Conditions Do You Have?

• How Do You Manage The Third Stage Of Labour?

• How long have you worked as a midwife?

• What is your training? For example is their title CNM, CM, CPM, etc.

• What is your birth philosophy? What inspired you to become a midwife?

• How many home births have you performed?

• How many births do you attend each month?

• Do you work alone or in a team during labor?

• Is any portion of the cost refundable if care is transferred to an OB at any point prior to the birth?

• What is your hospital transfer rate?

• What “high risk” situations do you have experience with? Twins? Breech? Advanced maternal age? Pre-eclampsia?

• Have you ever lost a baby or a mother? If so, under what circumstances?

• How many postpartum visits are offered under your care and on what days do these visits occur?

• If I must have a preterm or postterm hospital birth, will you be present to offer support?

• Do you work with specific OBs? Do you have a good rapport with OBs at the hospital? How does the hospital view you and your practice?

• What are your fees? Do you offer payment plans? Accept insurance?

• Can you offer me some references from mothers who have had to transfer?

• Will a student midwife be involved in your care?

• What kind of medical malpractice insurance does the provider have (if any)?

• What hospital privileges does the provider have? If OB-- does the OB have surgical privileges.

• What has the provider's experience been like working with medical professionals? Adversarial or collaborative?

Birth keeper/ Doula

Once you have a list of candidates, start scheduling interviews. To make the right choice, have an idea of what your needs are: What’s your budget? What qualities do you value most in a doula? Then have the checklist below with you at your meeting, so you’ll be sure not miss asking these crucial questions. Don’t be shy about jotting down a few notes. Finally, make sure to notice not simply what they are saying but how they say it.

• What is your experience with herbs, homeopathy, and alternative medicine as pregnancy and labor support?

• How many births do you attend each month?

• Do you work alone or in a team during labor?

• What is your birth philosophy?

• How long will you stay with me and baby after the birth?

• Is breastfeeding support offered?

• What happens in the case where two clients are laboring simultaneously?

• What kind of training do you have?

• Have you taken part in any continuing education programs?

• What is your philosophy about birth?

• How would you describe your doula style?

• Why did you become a doula?

• How do you most often support women in labor?

• How many births have you attended?

• Do you have experience with birth complications?

• Do you stay for the entire labor and childbirth, or do you have a time limit for long births?

• Do you offer any postpartum care or follow up? Does that require an additional fee?

QUESTIONS TO ASK YOURSELF

After you’ve met with a candidate, take some time to write down a few immediate impressions. Here are some questions to ask yourself to get the process started:

• Did you feel as if they where really listening to you during the interview?

• Did you feel comfortable with them? Did they seem compassionate?

• Did they ask you any questions?

• Did you feel they where interested in you and what you want?

• Did they communicate well?

• Did they seem knowledgeable?

• Did their views on pregnancy, childbirth and medical care align with your own?

• Did they take the time to answer all of your questions or did you feel rushed?

• Was it easy to make the appointment?

Conclusion

Pregnancy and childbirth is an incredible time in a woman's life. OB or midwife that you choose, along with a Doula, will have a significant influence on your birth experience. Take the time to consider your options and interview potential caregivers. By making this an intentional decision, you’ll improve your chance of having a safe and satisfying birth.