Welcome to part two of my series: The Buck Stops With You. If you've not read the previous posts, Stop Blaming Your OB, and Your Health, please be sure to go back and read them!
So, you've taken control of your health to ensure a normal birth.
Now it's time to discuss your care team.
So who makes up your care team? Most people think no farther than a care provider (OB or midwife) but don't forget that during the actual birth your care team will also consist of nurses, apprentices, associates, whoever you choose to bring with you (your husband, mother, friend, etc), and possibly a doula.
- Your Care Provider
Ultimately it's best to have a great care team from the get go. If it's at all possible, discuss your birth desires with your partner, then interview midwives and obstetricians extensively before you even start trying to conceive. Don't let a practitioner just TELL you they approve of natural birth, look at their birth statistics (and those of the hospital they work with). This is especially important when interviewing obstetricians. Remember, if they aren't on call when you go into labor, you will have to deal with the OB who is, and it's a fast road to getting your birth plan thrown out the window if you aren't prepared (this is the voice of experience talking). Working with an OB who has great statistics but works in a hospital where natural birth is not the norm is not reason to panic, it just means you'll need to be more prepared to stand up for your rights if you end up with a pesky nurse or the OB on call.
Choosing WHERE you will give birth should almost outweigh WHO you get to be your practitioner. Look into the policies at the place your practitioner delivers, then do a little investigating into his associates and the nurses that work there. Even if you get the most birth-friendly OB in your town, if you choose to give birth at the most NON-birth friendly hospital, you are most likely going to run into problems. The same goes for your midwife - make sure you like her associates and apprentices before booking her because there is no guarantee she will be the one to make it to your birth.
Of course, you could save yourself a little headache by choosing to give birth somewhere else. Even if it means driving a little further (or staying in a hotel or at a friend's place the week before the baby is due, or even skipping the drive altogether and staying home), it might be worth it. You alone can decide what will work best for you.
Oh, and just because you loved the OB you've seen for years BEFORE getting pregnant does not mean he/she is going to be a good fit for your birth care provider. Be willing to let go without worrying about hurt feelings. YOU have to make the decisions that are right for YOU, not your favorite OB. I myself changed midwives between my second and third births. It meant NOTHING
against my first midwife (whom I adore and still have a great relationship with), she just wasn't a good fit for me for my third pregnancy. Please let me encourage you: IT IS ALMOST NEVER TOO LATE to change your care provider or chosen place to give birth, IF you are willing to put the effort into finding another option.
I realize many people have their hands tied when it comes to finances and insurance and that these things play a huge role in determining your care provider. Discuss where you are going to be willing to make sacrifices. It might require some big ones, but they will be well worth it for the peace of mind. In the end, where you can not make sacrifices in money or distance, you will inevitably have to make sacrifices in your time as you beef up your knowledge with more research, reading, and study. Preparation is a big key to getting the birth you want, and we'll talk more about that in the next post.
So, you've chosen your care provider and you are happy with your choice of where to give birth. Now it's time to think about who else will be there.
- Birth Partner
It's become quite common for women to bring their spouse or partner to the birth (for the sake of sparing my fingers and your brain from too much work, we are going to assume that the birth partner is your husband, although it can be anyone from a friend, to your mom, or life-partner). This works great for some women, but let me give a little word of caution. I can almost guarantee, hands down, that your wonderful, kind, and loving husband is NOT going to be prepared for your birth. Don't worry, that won't automatically make him a bad birth partner, but this is uncharted territory for him, as well as for you, and it's rare for him to be doing as much research, reading, and agonizing over it as you do. He just doesn't have the same stake in things. Most men can't read our minds anyway - even less so when we begin to retreat into that fog that is labor land.
So, here's what you need to do. You need to ask yourself the following questions and be able to answer them honestly.
1) Is my husband READY for this? Has he attended birth classes? Done some reading? Have we talked at length and do I feel like he's on board with this? Does HE want to be there?
- Ladies, trust me, there is nothing you want LESS than a frightened man in your birth room. I can guarantee at some point you are going to want to be DONE with labor, and a frightened man is going to be the quickest to ask the nurse to bring the epidural, or sign the paperwork for a cesarean.
Men are wired to want to FIX things. They know they can't fix birth, but as soon as you start wanting an out they'll be ready to give it to you. If you can, get him to read what you are reading. Definitely get him to a birth class! Good natural birth classes (not the one at your local hospital) usually have whole segments directed specifically at allying the fears of birth partners, as well as giving them the tools they will need to understand the birth process and feel useful (which is a BIG need for most men).
2) Do I really want him in the room?
- There's no hard rule that your husband has to be involved. Some women are more comfortable with birth being an all ladies affair. Subsequently, if you and your husband have not been getting along, well, let's just say labor can be stressful enough on it's own. Do what you can to make your labor as relaxing as possible. If you will be more comfortable, leave him out of the room.
3) Who else will be involved?
- There's a theory floating around the birth circles right now that you shouldn't have anyone in the room whom you wouldn't be comfortable making love in front of. I think that's a mildly extreme scenario, but the point is the same. Birth is hard work. Birth is also very private work. It's absolutely normal for a laboring woman to regress in dilation simply because she's not comfortable in her surroundings or with the people in the room. One woman regressed from an 8 to a 5 simply because her mother came uninvited into her birthing room. When mom left, dilation spiked back up to 9cm.
Seeing a trend yet? Relaxation and comfort are key in giving birth, so be sure that all involved will bring that to the room, rather than any form of stress. Stress is a key way to slow down your birth and increase your pain levels.
- Doula
Finally, there is your doula. I always highly encourage my clients to hire a doula. When it comes to babies, next to a birth class, the car seat and the diapers, I believe a doula is one of the things that really deserves your hard saved cash.
What is a doula? She is a woman who is specially trained to be an assistant during your birth. She will provide whatever it is you need - hands off encouragement, suggestions for pain management, education, and even a support for dads! Her job is in no way to usurp the place of a father during birth, but support, support, support.
For more information on what a doula provides, please feel free to read here.
Want more insight into how a doula can be a help for dad? Check out this video!
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