Top Questions to Ask Your Ob-gyn or Midwife 1 of 12
1: Who will deliver my baby?
Due to the unpredictable nature of their work, doctors and midwives plan for back-up care or work with a team. Ask how often your doctor or midwife is on duty, and try to meet any other care-providers on their team. You can't know exactly when you'll go into labor, but it's nice to know in advance who might be there and get to know them a little.
Top Questions to Ask Your Ob-gyn or Midwife 2 of 12
2: Whats your philosophy of birth?
Broadly speaking there are two main modes of maternity care: active management and expectant management. Active management favors the use of medical technology and procedures from the get-go &mdash we have all these great advances, lets use them! Expectant management involves supporting the woman though normal labor without intervening, only introducing monitoring and medications should the need arise. If you are inclined to have the option of a non-medicated birth, you may be better suited to someone who tends towards the expectant management side of the spectrum.
Top Questions to Ask Your Ob-gyn or Midwife 3 of 12
3: What is the C-section rate at your practice?
One in three babies is born via C-section in America. But the World Health Organization recommends that the C-section rate be somewhere closer to 10-15% of all births. The percentage of C-sections performed by your caregiver's practice is an indicator of how your birth will be handled. If you are hoping for as few interventions as possible, make an effort to seek out a care-provider whose percentage of surgical births is on the lower side.
Top Questions to Ask Your Ob-gyn or Midwife 4 of 12
4: What will you do to reduce the chance of tears or episiotomy?
Episiotomies &mdash 1-2 inch incisions in the perineum to make the vaginal opening larger &mdash used to be performed routinely, but now we know that they do not prevent tears and pelvic floor damage as once thought. ACOG guidelines state that episiotomies should only be done if medically necessary, which should not be that often. Perineal massage, warm compresses, and gravity-friendly pushing positions can help reduce the chance of tearing.
Top Questions to Ask Your Ob-gyn or Midwife 5 of 12
5: Where do you deliver?
Every doctor and midwife has a hospital or birth center affiliation — find out where you will give birth and then research the facility. Go on a tour, ask about the hospital or birthing centers reputation and protocols, and find out what is available to you in the rooms to help you cope with labor: Are there birthing tubs or showers? Are there any requirements for giving birth there? (This question especially applies to birthing centers that cater mostly to low-risk pregnancies). If you are giving birth at home, learn about the hospital your midwife uses for transfers. If the facility is not right for you, you may want to consider another caregiver.
Top Questions to Ask Your Ob-gyn or Midwife 6 of 12
6: What will I owe you?
This is actually a question most often posed to your insurance agency and your care-providers office personnel. If you have insurance, find out if your care-provider is in network. If he or she is out of network, how does the billing work and what will you have to pay out of pocket? If applicable, ask whether Medicaid covers costs. If your insurance is not comprehensive, be sure to ask about specific costs. For example, is epidural anesthesia covered? If you are having a home birth, find out if you are covered by insurance (in some states you are), and if not, what are the fees for prenatal care and delivery and how does the billing work if there is a transfer?
Top Questions to Ask Your Ob-gyn or Midwife 7 of 12
7: At what point past 40 weeks do you induce labor with drugs?
Term is anywhere from 37-42 weeks; some babies are ready to be born on the earlier side, some want to go longer. After 42 weeks theres a risk that the placenta may not be able to support the pregnancy sufficiently; at that point the benefits of starting labor with medication outweigh the risks of continuing the pregnancy. (Induction doubles the odds of a C-section.) Care-providers have very different ideas about inducing labor; some will let you go the full 42 weeks if there are no complicating factors, others will induce much sooner. Elective induction (inducing without medical necessity) before 39-40 weeks is not recommended.
Top Questions to Ask Your Ob-gyn or Midwife 8 of 12
8: What percent of your patients are high-risk, what percentage are low-risk?
The way you interpret the answer to this question will have a lot to do with your own pregnancy. If you have a high-risk pregnancy or any specific medical needs, youll want a caregiver with experience in these areas. If you are low-risk, you may want someone with lots of experience supporting normal, vaginal birth. When asking for your care-providers statistics on things like C-sections, episiotomies and inductions, ask that these numbers be broken down into low- and high-risk categories so you have a better sense of how this data might apply to your situation.
Top Questions to Ask Your Ob-gyn or Midwife 9 of 12
9: How do you feel about women laboring in different positions?
Studies have shown that laboring women who are given no medication or instructions tend to get into squatting positions (a supported squat or all fours) for the pushing phase. They tend not to get on their backs. Changing position in labor can reduce pain and help the labor progress. Women on medications, however, tend to be on their backs — the epidural is numbing and medications require monitoring which limits movement. Some care-providers require that the mother be on her back to push, medicated or not — its more convenient to catch a baby in this position. Others are more flexible.
Top Questions to Ask Your Ob-gyn or Midwife 10 of 12
10: What do you recommend for pain in labor?
In general, the more expansive the answer to this one the bettereven if you know you really want an epidural. Women tend to feel less anxious and more able to cope with the various challenges of labor if theyve been given (and encouraged to seek out) several pain-coping techniques. You might also ask how your care-provider feels about doulas or childbirth education classes to learn coping strategies. Keep in mind most doctors are not present for the entire labor.
Top Questions to Ask Your Ob-gyn or Midwife 11 of 12
11: Will you listen to me and respect my choices?
You'll get a feel for what you can expect from your provider based on how he or she answers your questions. It's important to trust your caregiver and feel that he or she takes your concerns seriously. It's true that the midwife or doctor is a medical authority, but you are the one who will be doing the hard work. Women tend to describe positive birth experiences — regardless of the details — when they were treated with kindness and respect during such a vulnerable time.
Top Questions to Ask Your Ob-gyn or Midwife 12 of 12
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