Let Your Feet Do the Talking (er, Walking): Did you choose the right care provider?

I can’t count the number of times I’ve watched the scenario play out or read what seems to be the same birth story over and over only with different women playing the starring role. It never ceases to amaze me that women duplicate the same choices as another and yet expect an entirely different birth experience. If you pick the medically-minded doctor, expect that he’ll want to medically manage your birth.

“Oh, I know that Dr. So-and-so doesn’t have a great reputation for being supportive of natural childbirth but he’s so nice that I’m sure he’ll be supportive of me.” Pleasant conversation and kind looks aside, actions speak louder than words. If Dr. “Nice Guy” has a track record of inducing most of his patients as early as a week before their due dates or thinks he’s doing women a favor by slicing up their genitals with a “generous” episiotomy, guess what kind of “care” you can expect? Do you want that?

Be smart. Figure out the kind birth experience you’d like to have and choose a care provider that normally attends that kind of birth. If you knowingly choose a doctor who has a high c-section rate, believes that any intelligent woman would choose an epidural, thinks episiotomies are necessary, regards a woman’s body as very likely to kill her baby at any moment, and induces woman all the time for psuedo-medical reasons to outright convenience, I have to call you very unwise or even insane. There’s a quote about the definition of insanity being doing the same thing over and over and expecting a different outcome. Learn from the mistakes of other women who have gone before you. Learn what other women have done to successfully create their joyful natural birth experiences and do what they did! Imitate the good choices and ignore the bad.

Keep in mind that most doctors and nurses in a hospital setting have never, ever seen a truly natural birth. It is an entirely foreign concept to many of them and few of them think natural childbirth is any kind of worthy goal. These providers are not trained to sit by and let a very safe natural process unfold. They have a high regard for technology. They are trained to use it. And they do.

Red Flags

Does your care provider discourage birth plans by saying things like:

  • “You can’t plan a birth. Women who come in with birth plans end up having c-sections.” This comment speaks volumes about the care provider’s beliefs regarding birth. They don’t trust birth. In their view, birth is an emergency waiting to happen. They believe that at any moment something can go drastically wrong. They fail to see the connection between their interventions and the resulting complications since very, very few of them have any experience with normal, natural birth.
  • “The only birth plan a woman should have is ‘Go to hospital. Have baby.’” Unfortunately, some doctors or nurses are so hostile toward the idea of a woman being in control of her birth experience and being an active participant in the decision-making process that they will sabotage her efforts. This can be subtle “you’re still 6 cm” to overt “I don’t know why you’re wanting to suffer like this. Why don’t you just get an epidural?”
  • “We won’t accept patients who write birth plans (or use a doula or whatever).” Is your doctor the one giving birth? Oh, that’s right. Only YOU can give birth to your baby. At least with this comment you’re alerted well in advance that this provider is definitely not open to supporting you in your birth choices.
  • “We’ll work with you.” This comment is a tactic to string a woman along until she’s so far into her pregnancy that she feels like it’s too late to switch to a more supportive provider. Sadly, some doctors will tell a woman what she wants to hear, fooling her into believing that he will be supportive when it comes time for the birth. It’s a shocking and hurtful surprise for her to discover that he’s actually quite disdainful of her personal beliefs about birth and may even go so far as to teach her a lesson about who the expert really is when it comes to birth.
  • “You’d better plan on having a small baby because your pelvis is too tiny for an average or large baby. We should induce you a couple of weeks early to be safe.” Keep in mind that there is NO way to accurately measure the inside of a woman’s pelvis to determine whether or not the opening is large enough for her baby to fit through. When a woman is on her back (as she is during a pelvic exam) her pelvis is closed to the very smallest it could possibly be. Squatting opens the pelvis by about 30%, which during pushing can mean the difference between a vaginal birth and a c-section. The ONLY way to know if a baby is indeed too large to be birthed vaginally is for a woman to have a spontaneous (not induced) labor during which she spends a lot of time in upright positions. During a naturally started labor her body’s natural hormones do the wonderful work of softening the ligaments in the pelvis, which allows it to expand and open. This does not happen with an induced labor. Inducing for a big baby increases the rate of c-section and poses significant risks to both mother and baby.

What’s a mama to do?

Women have a strange loyalty to their doctors, even if they are certain their doctor is not a good fit for them. Don’t let that be you. If you’ve discovered that Dr. “Nice Guy” may be someone you want to invite over for dinner but you no longer want him to come to your birth, what can you do about it? You have two feet. Walk away! Ask independent (out-of-hospital) childbirth educators, doulas, and La Leche League members who the supportive care providers are in your community. Believe me, they know. And it’s never too late to switch! Some mamas have even fired their doctors while in labor. Of course, it’s much more peaceful to know in advance that your doctor or midwife has a proven track record of being supportive of your ideal birth.

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