How to Choose the Right Provider for Your Birth

I had the pleasure of speaking with fellow doula, Ann Morris, about how expecting parents can navigate choosing the right birth provider. We cover what to consider before you even start interviewing providers, red flags to watch out for, and essential questions to ask during your initial consultation.

Key Considerations Before Interviewing a Provider

When you’re preparing to decide on a care provider for your pregnancy, it’s essential to have a clear understanding of your birth preferences and expectations. Ann suggests there are three primary decisions you should think through before even stepping into an interview:

1. Are you planning for a physiological birth (a more natural and minimally managed process) or a medically managed birth? There’s no right or wrong answer here—your choice should be based on your personal preferences and intuition.
2. Where do you want to give birth? Options include at home, a birth center, or a hospital. Again, the key is to align this decision with your core values and comfort levels.
3. What kind of provider do you want—an obstetrician, a midwife, or another type of care professional? Keep in mind that just because you’ve started with one provider doesn’t mean you’re locked in for your entire pregnancy. You can always switch providers if needed.

Tips for the Interview Process

Once you’ve thought through these decisions, you’re ready to interview potential providers. Here are a few tips to keep in mind:

• Don’t assume a female care provider will be more understanding, or that all midwives support physiological birth. It’s important to ask open-ended questions to understand their philosophy.
• Interview several providers from different practices. You can ask family and friends for recommendations but be sure to ask them both what they liked and didn’t like about a particular provider.
• When interviewing, don’t reveal all your beliefs upfront. Let the provider speak from their own experience and philosophy.
• Remember, it’s okay to change your care provider, even late in pregnancy. If a provider is not supportive of your birth preferences, switching might be the best choice.

Red Flags to Watch Out For

During the interview process, there are several red flags that may indicate a provider is not the best fit:

1. If a provider uses scare tactics, such as saying, “Would you rather have a natural birth or a healthy baby?” they might not be supportive of your birth preferences.
2. If a provider is condescending or dismissive, such as making remarks like, “I’m the one with the degree here,” it indicates a lack of respect for your autonomy.
3. If the provider tries to involve your partner in a way that undermines your choices, this is a significant red flag.
4. If the provider’s office takes an excessive amount of time to return calls or is dismissive over the phone, consider how this might affect your care during more critical moments.

Essential Questions to Ask During Your Consultation

Before you choose a care provider, you have to ask the right questions. Here is a comprehensive list of questions you might consider asking during your consultation to better understand a provider’s approach:

General:

• What is the likelihood that you will attend my birth? A lot of practices rotate care providers and cannot guarantee who will attend your birth.
• How do you support the natural hormones that help my baby and me through labor, birth, breastfeeding, and bonding?
• What would you say if I gained 50lbs in pregnancy?
• What medical treatments or monitoring do you regularly use for all women during labor and birth? If a provider recommends medical treatments for all or most women, you may want to look for someone else.
• How many ultrasounds do you recommend? The World Health Organization recommends ONE scan before 24 weeks for low-risk pregnancies… that it.
• How do you handle long labor?
• What is your policy regarding the routine use of interventions? (electronic fetal monitoring, IV fluids, cervical checks, Pitocin for third stage management)
• How do you manage the birth of the placenta?
• Will you honor my right to informed consent?
• Can I refuse cervical checks?
• How would you handle my care if I went past 41 weeks? 42 weeks?
• Do you think the kind of birth I’m hoping for is possible?
• Do you recommend I hire a doula? Research is very clear that support from a doula decreases negative outcomes.

Hospital Birth Specific: 

• Is there a 24-hour anesthesiologist available? A huge advantage to hospital birth (and maybe the only advantage) is to have these types of services available to you… so if they aren’t available then you might want to reconsider.
• What is the RN to patient ratio?
• Can you tell me what the triage process is like?
• When would you recommend inducing labor?
• When would you recommend augmenting labor?
• What are the reasons you would perform a cesarean?
• How often do you perform cesareans?
• What do you think makes your cesarean rate so high, when the WHO recommends keeping that number below 10% or births?
• How will you help me avoid a cesarean?
• What percentage of women have an epidural?
• What are your recommendations for labor positions, and pushing positions?
• How many people can I have in the room with me?
• Do I have the right to decline any interventions?
• What is the process like to sign AMA (against medical advice)?
• What do you recommend for non-medical pain-coping relief?
• How often do you attend non-medicated births?

Home Birth Specific:

• What situations would lead you to transfer my care to an OB during pregnancy?
• What situations would lead you to transfer me to the hospital during my labor?
• Do you have a relationship with an OB practice?
• What would it look like if I transferred to the hospital during my labor, would you come with me?
• What medical equipment do you bring to the birth?

Postpartum Specific:

• What kind of postpartum visits do you do? (Homebirth)
• If I transfer to the hospital, would you still do my postpartum visits? (Homebirth)
• Can I keep my baby with me at all times?
• What procedures are routine for newborn care?
• What type of support do you offer to breastfeeding moms?
• How soon can I leave the hospital after birth? What if I want to leave sooner than that?

Choosing the right care provider is about more than just credentials—it’s about finding someone who respects your choices, aligns with your philosophy, and makes you feel safe and supported. Trust your intuition, ask the right questions, and remember: You have the right to change providers at any time if something doesn’t feel right. Your birth journey is unique, and you deserve the best possible support along the way!

To learn more about Ann, visit her website at www.annmorris-doula.com. You can also follow her on Instagram and Facebook. Ann is located in Lawrenceville, GA.