Important Things to Consider When Choosing a Care Provider

so, you are pregnant! Congratulations! You either have already chosen, or are currently looking for a care provider for your pregnancy. Even if you have already chosen one, you should look through this list and ask your care provider the appropriate questions to be sure that you will receive high quality care with them.

PROTOCOLS

A competent care provider will have written protocols for everything from infection control to emergency transport protocols. These protocols should be in writing. Do not just take your provider's word for it, and don't just take verbal protocols. See them in writing. This is important.

INFORMED CONSENT

As can be found in the Midwives Model of Care brochure "Full information about any recommended tests, procedures or treatments so you can make informed choices about your care." Informed consent is an integral part of competent midwifery care. If your care provider is providing you with thorough, written or printed information on everything pregnancy, birth and post partum related, from the vitamin K shot, antibiotics, group B strep, to circumcision, breastfeeding, and everything in between and then asking you to sign consent (or decline) paperwork, than she is following the midwives model of care. If she has no paperwork, and only her advice by mouth, and nothing for you to sign, you might want to reconsider using her as a provider.

INFECTION CONTROL PROTOCOLS

INFECTION CONTROL INFECTION CONTROL INFECTION CONTROL!! This is so important I cannot stress it enough!! If your midwife tells you "birth isn't sterile" you might want to reconsider using her!! If she does not sterilize her instruments then your risk of developing potentially life threatening post partum infections is greatly increased!! If she does not use germicide and antiseptic cleaners on everything touched in the birth room after every birth, then you are potentially being exposed to any of the germs that the woman before you left there. There can still be infection where there isn't visible blood! Not sure if she is sterilizing her instruments? There are only a few known ways to sterilize. you can boil them (and use them *right* away..it doesn't count if you boil them days before) you can oven sterilize them (in which case they would be in oven safe packets that are usually wrapped in paper, maybe flannel packs, but certainly not something like a plastic pencil case or anything else that would melt in the oven. The instruments should go in wrapped, and come out wrapped, and not be opened until the moment they will be used) and there is the pressure cooker/autoclave method, which again they should go in wrapped and come out wrapped and not be opened until the moment they are used. IF the provider is not following infection control protocols including sterilizing her instruments, please consider finding a safer place and or provider to use for your birth.

GET INVOLVED

Get involved in your local birthing community before you have your baby. Hear all of the birth stories and recommendations of the local community around you. Take into account that *every* midwife is going to have at least a few people who were unhappy in their birth...no one is perfect! However, if the majority of the stories are telling you to steer clear, then by all means, steer clear! Find out what percentage of clients will (or have) been repeat clients. Try to talk with many of the provider's former clients to get a well rounded, balanced view of it.

HIRE A DOULA

If the provider is telling you not to hire a doula, or telling you you don't need one, I would highly question this. It may just be that the provider does not want to deal with having another witness, someone who is not emotionally vested in the situation as much as the family is, who may stand up to her if she tries using interventions that may not be necessary. Hire a doula, even if she tells you not to, in fact hire a doula ESPECIALLY if she tells you not to!!

NUMBERS

Find out her numbers. How many end in transport? Why are they transported? How many end up in C-Section? How many are induced (artificially or with herbal remedies, castor oil, etc?)? If she induces 2 out of 3 clients with herbal remedies, you might consider that she may be impatient and might "rush" your labor along. If she has a very large transport rate for first time moms, and you are a first time mom, you might want to consider finding another care provider. If she has a very high transport rate for "failure to progress" (as in, if 33% of her clients are transported for failure to progress....) then assume it really means failure to wait, and you might want to find a new provider. You know how they say the proof is in the pudding? Well I am saying the truth is in the numbers!!

I hope this has helped you while trying to choose a care provider. If you have any suggestions on other things to consider when choosing a care provider, please feel free to list them as comments here!!