How to Choose Your Birth Care Provider

10 Questions to Help Decide Which Birth Care Provider is Right for You

At Babies in Bloom, our birth center births are assisted by midwives. Moms who register to give birth in our birth center get to choose the right midwife for them. We believe it’s important that you get to work with the birth care provider you have chosen. This applies to not only births at our birth center, but home birth and hospital births too.

Having the ability to choose the right birth care provider is a right, but it’s also a responsibility. It takes preparation, research, and some courage to follow through on this and make sure you’re making the most informed decision. That’s what we’re here to help you with — a series of questions tailored to ensure you get a full picture of the person who will ultimately have your birth in their hands.

Even though every question below might not be the right one for you, you have every right to ask any of these questions. Choosing the right provider to care for you during your pregnancy, birth and beyond is one of the (if not THE) most important decision you can make for yourself and for your motherhood journey.

The answers to these questions will arm you with the knowledge and peace of mind you need to make the best decision for you and your family. Take your time understanding how each question might apply to your personal circumstances.

1. What is your role as my birth care provider?

Choosing a birth care provider comes down to many factors. Whether you realize it or not, a lot comes down to how this person makes you feel. Do you connect with them? Does their personality make you feel comfortable? Or, are you already too intimidated to ask the milder questions on your list? These feelings are answers too! Early into your pregnancy, what might not matter as much will matter a lot if a complication develops down the road. So, first and foremost, take note of what it feels like to be in a room with this provider and get to know how they feel about the field they are in.

Once you’ve taken a read on the energy you get from this provider, ask about what the role of birth care provider means to them. You might have an idea what you are looking to hear back, or maybe just know what you like when you hear it.

Questions to Follow Up With:

• What is your birth philosophy?
• How long have you been practicing?
• How many births have you attended as the primary provider?

2. Tell me about your practice and what makes it unique.

Depending on what type of care provider you’re interviewing — obstetrician or midwife — you’re bound to have some differences in the way the practice operates. It can range from a national medical group to a one-woman shop. This means you really stand to benefit from finding out more about how this practice runs, what sets it apart, and who makes up its team. Chances are you are going to interact with more than just one person within the practice. You may love the primary provider you’re working with, but have a problem with their main assistant. Is this a deal breaker for you or not? You won’t know until you ask the right questions.

Questions to Follow Up With:

• Is there more than one care provider in this practice? If I choose you, will you be the only provider I see, or would it be a revolving team? Do I have a choice?
• How many patients do you regularly have at a given time? How many are due around my due date?
• Describe a typical prenatal visit with you?
• How often will I see you during these next months?
• What happens if I have follow up questions? How can I contact you? What hours are you available in case of an emergency?
• Who assists you with births? What are the qualifications of your birth assistant(s) and/or students?
• What procedures might your birth assistant and/or students perform on me and my baby?
• Who attends births for you when you are away? What is their experience?

3. What are your birth statistics?

This is not an easy discussion topic, but its maybe the most important. Asking your birth care provider about their philosophies and beliefs are great, but without having the data to back it up, you have no way of knowing how likely that will hold up when the day comes. Knowledge is power, remember, and knowing about how many births your provider has attended will tell you more than just hearing about how much they love babies. Knowing that your provider has a number of successful VBAC deliveries under their belt will give you more confidence than going in blind. Chances are these questions are on your mind anyway — would you rather keep them inside and let that worry build, or help dissipate some by speaking up?

Questions to Follow Up With:

• How many births have you attended as the primary provider?
• What is your cesarean rate? Can you explain the factors that contributed to this rate? What is your VBAC rate? How do you support VBAC mothers?
• What is your episiotomy rate? Induction rate?
• Have their been any bad outcomes with a mother and/or baby before? Can you share what happened?

4. Describe how you approach procedures and treatment I can receive during my pregnancy?

There are many ways you can take this question, but ultimately, you want to ask your birth provider who is involved in making decisions during your pregnancy? Do they follow a general guideline of treatments? Are you provided with options each time? What are you allowed to decline under their care? Are there things that you draw the line at receiving? If you know, its best to come out and say it now so you know if your provider will respect this decision. If not, you probably should move on.

Questions to Follow Up With:

• How do you provide information regarding treatments and procedures to your patients?
• How many ultrasounds do you recommend? What are they specifically looking for?
• What tests do you recommend for pregnant women? Why?
• What kind of childbirth preparation do you recommend?
• What is your protocol regarding due dates and when do you induce labor?
• How do you support patients who wish to have natural births?
• Do you provide your patients with alternative treatments, or must we request them?
• If you feel labor has to be stimulated, what methods do you recommend?

5. What happens if there are complications during the pregnancy?

Whether you expect to birth in a hospital, birth center or at home, vaginally or via c-section, things can take unexpected turns. Sometimes complications arise that require an immediate and drastic shift in care, and other times there are opportunities to correct the complications before they get worse. Your care provider will have their own take on how to approach complications, and what to do to prevent them.

Questions to Follow Up With:

• What would happen if I develop a complication?
• What conditions do you consider “high risk”?

6. What are your protocols during labor?

It may be early in your pregnancy, but knowing about what your care provider does when you’re in labor is something to start asking about now! On the day of, you may not have the energy, awareness, or ability to speak up about something and ask questions. Asking about even a general understanding of what laboring looks like under this provider’s care will help you envision if they are the right fit for you.

Questions to Follow Up With:

• 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?
• How long do you recommend I labor at home? When is the earliest I should be admitted?
• What comfort measures do you recommend during labor?
• Do you use a fetal scope or Doppler to monitor the baby?
• What’s the best way to communicate with you when labor begins?
• How often do you perform vaginal checks and do you rely on alternate ways of assessing dilation?

7. In what ways can I personalize my labor and delivery experience?

You likely already have a vision for what your birth will look like. Who do you see there? What support would you imagine having? What are you doing? There’s a chance this thing you have in mind is not allowed in some birth environments depending on the location, practitioner and your pregnancy. Policies can outweigh your preferences if you’re at a hospital, but you won’t know until you ask. The name of the game is don’t make assumptions, and it doesn’t hurt to ask.

Questions to Follow Up With:

• Will I be able to eat and drink in labor?
• Will I be able to choose the position I push and give birth in, such as side-lying, all fours, or squatting?
• How do you feel about a birth plan? How has your practice honored birth plans in the past?
• Is there a limit to the number of people who can accompany me during birth? How do you feel about having doula as part of my birth team?
• Are children allowed to be present at my birth?

8. What happens if there are complications during the delivery?

Chances are your birth will not go the way you perfectly planned in your head. But that doesn’t mean that you just chalk it all up to luck and hope for the best. You want to know that, should something arise during delivery, your birth care provider will act in a way that puts you at ease. If something they say sounds vague or unclear, ask for clarity. There’s no harm in asking “Why?” or needing more explanation.

Questions to Follow Up With:

• What precautions do you take to prevent tearing? Are you able to repair a torn perineum?
• Are you trained in newborn resuscitation?
• What do you do if the cord is wrapped around the baby’s neck?

9. How do you handle postpartum care for mom and baby?

This is where we remind ourselves that birth is just the beginning of our motherhood journey. Those precious moments after birth are vital to setting you and baby up for as smooth a journey as possible. Make sure that you and your birth care provider are on the same page.

Questions to Follow Up With:

• What does postpartum care from your practice look like for me and my baby?
• Do you support skin-to-skin contact immediately after birth?
• Can baby remain with me at all times?
• How do you handle cord clamping?
• Do you have experience with postpartum hemorrhage? What are some precautions you take and what interventions might you administer?
• Do you help with breastfeeding at the birth, or as a part of your care postpartum?
• What procedures are provided for the baby after birth? (Vitamin K, Hep B, PKU test, etc). Are any required?

10. As my midwife, I’d like to know… [midwife-specific questions for birth center or home births]

If you’re having a home birth or giving birth in a birth center, you will have a midwife as your birth care provider instead of an obstetrician. There are many benefits to having a midwife on your team. Still, the change in environment is natural to drum up a lot of additional questions for new parents when interviewing. All of the above questions can also apply to a midwife, but the ones below are questions that will help you get to know how your midwife might be different from the next.

Questions to Follow Up With:

• What are requirements for accepting patients to give birth in this setting?
• How long will you stay with me after my baby is born?
• What drugs and equipment do you have available for births?
• Under what conditions would we go to the hospital?
• Would you stay with me if we transfer?
• What would your care look like if we have to transfer?
• Have you ever missed a home birth and why?
• 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?