How to get information and make decisions with your care provider during pregnancy, birth and postpartum.
Pregnant women want their ideas, opinions and questions to be heard so that they will ultimately be an integral part of the decision making process in regards to their care. Plain and simple, if those things are not done women will likely be unhappy about their experience giving birth, which can have long lasting consequences in the way they mother, their self-esteem and future pregnancies (among other things).
Communicating with care providers is a two way street and sometimes both parties lack the skills to come to the desired outcome. This post will go over a step by step process to ask questions and get good information in order to make the best decision for each individual.
Before asking questions, sometimes it’s helpful to take a step back from a particular situation and look at it from a bird’s eye view. I find it to be helpful to assume a doctor, midwife or nurse’s positive intention. Most of the time an OBGYN, midwife or nurse is not out to ruin your day or your birth. They are doing their best with what they know in the dream they live in. Just as we are living our own dreams and lives that we know, they are doing the same. Try this and see if you can look at your care provider with new eyes.
After we assume their positive intention, our next step is to determine the problem. So, say your doctor or midwife suggests a medical induction it’s a good idea to clarify the problem, if any. Upon asking what the problem is you might find out that your perception of the problem and what your care provider thinks might be two totally different things. You might think that you or your baby is in danger, where your care provider might simply think that you’re sick of being pregnant and are anxious to get the show on the road. Upon further investigation, it would seem that your care provider is simply trying to be compassionate in their own way.
The next step in this communication model takes us through the acronym B.R.A.I.N.
B stands for benefits. A question you may ask for benefits could be “How would this be helpful?”. Going along with our induction scenario, your care provider might answer, “You will no longer be pregnant, uncomfortable and will be able to hold your baby.”
R stands for risks. You may ask your care provider “What goes along with this?” or simply “What are the risks of this procedure?”. Hopefully, some of the risks your care provider might mention are an increased risk of cesarean birth, fetal distress and vacuum extraction.
A stands for alternatives. This is by far my favorite question to ask, and the question we might impatiently skip to without doing the important work I have already discussed. So now, let all the Birth Without Fear Mamas say, “What are my other options?”. At this point, your well meaning care provider might hesitantly suggest waiting another uncomfortable week before re-visiting this topic.
I stands for intuition. At this point you and your partner should check in with yourselves and each other to see what your gut is saying. It might be helpful to ask for five or ten minutes alone to talk and express yourselves freely. If you want to clear a room quickly, just spread the word that you’d like a few minutes to pray about your decision. You’ll find that to be quite effective.
N stands for negotiation. Now that you’ve had a moment to take in all the information you’ve gathered, this is the moment where you and your care provider negotiate a decision that is as close to a win-win as possible. In our scenario the woman might have decided, after discussing with her partner, that she would rather wait for two more weeks to see if she would start labor spontaneously. Her care provider might say that waiting for spontaneous labor will be ok, but would be more comfortable only waiting another week before re-visiting the prospect of induction. Both parties were heard, perspectives and opinions were taken into consideration and a decision was made that both parties were happy with. Success!
Sometimes, despite our most valiant efforts of effective communication, it becomes apparent that the dynamic between care provider and mama is just not working out. The red flags and warning bells you have seen and heard should be noticed and addressed. If this is your situation, please read this post I wrote about switching care providers in mid to late pregnancy.
What I just covered is something I teach in my Birthing From Within childbirth classes and it has been a fantastic conversation starter. So, let’s not end the conversation here. I’d love to know what you think. So tell me, what is something that worked well when communicating with your care provider? How did you know it was working for you?