So, you’ve had your suspicions, your cycle is a bit late, your breasts may be tender. Now, the little window in the stick is staring up at you with its two lines, or a plus sign, or happy face, so many stick choices these days. You are all at once elated, scared, dumbfounded, etc. Now what?? What do you do first?
One of the first decisions you need to make is choosing a care provider. There are a number of options (Midwife? Obstetrician? Family Doctor?). This is a big decision. This is a big moment and you want it to be just right. So, to help you make the best choice for you and your baby, here is a list of questions to ask when meeting with your care provider for the first time.
- What kind of services do you provide?
Maternity care providers all offer similar clinical care but may have a different way of doing so. For instance, fewer family doctors are now catching babies so may offer to provide care in the first two trimesters then send you along to another provider. Though prenatal appointments are scheduled at the same frequency regardless of your provider, the time you have with your care provider varies greatly; midwives offer a minimum of 30 minute appointments whereas an obstetrician has quicker visits. If they are a teaching practice, there might be residents or students involved in your care. What kind of call schedule does your care provider have? Some large practices of obstetricians have a rotating call schedule and may only have 1 or two days on call per month. Some share care with a small group and are frequently on call. Some midwifery practices offer shared care and have a team of midwives who will be there to support you. Some midwives are on-call nearly all of the time. Care providers might also be limited in where they can care for you, whether it be a geographic limitation or where they carry their hospital or birth centre privileges. Where they work might also affect what they are able to provide you at an institutional level. If there are gaps in what they can provide and what you are searching for, ask for resources in your community to address your needs, like prenatal classes. What about after the birth? In obstetrical care, your care will return to your family doctor for general care for you and your baby. Midwives provide care for the first six weeks, including home care in the first week. Services provided can also address accessibility needs or language gaps.
- What is your philosophy regarding birth?
This is a tough one to ask, and maybe you’re just trying to figure out yours. But this one is important. If you and your care provider have vastly different ideals when it comes to pregnancy and birth, you might not get the care that you are looking for. Maternity care providers have all had different backgrounds and training and may have beliefs about birth that affect the way they work and the approach that they take. Do they believe birth to be a generally safe process or inherently risky? Should labour be controlled or allowed to flow at its own pace? What about pain management? Some providers might expect you to get an epidural and some might try to avoid it. Others will believe it is your choice.
- What are my birthing options?
Here in Ontario, there are a number of options, depending on the care provider that you choose. OBs can offer hospital births with a whole slew of pain relief options. There may be tubs for helping to cope with labour, or pain meds, if that’s what you are looking for. Midwives can offer hospital birth as well, with the same options. They can also offer birth center services if you are in the right area, or homebirth. Water birth is also an option that midwives provide, and may be an option in all three settings.
- What if I have urgent concerns, or if something goes wrong?
How easy will it be to reach your care provider with an emergency? Some clinics may be able to offer same day appointments for urgent concerns while other providers may have to send you to the hospital to be seen. Midwives are on call for clients in their care and can assess in the home, clinic, or at the hospital depending on what is appropriate. And though we all want an easy, uncomplicated birth, sometimes that isn’t how your story goes. Midwives are experts in normal birth and managing birth related emergencies but will transfer your care to an obstetrician if you require a caesarean section, forceps or vacuum assisted delivery. Often, they work together to provide you with safe and supportive care. With the help of nurses, obstetricians can provide you with the care needed when births require interventions.
- What kind of changes do I need to make, now that I am pregnant?
You are going to have a long list of questions about the pregnancy and all that there is involved in growing a little baby. There is a lot of information out there on the internet and social media, from family and friends, and lots of old wives’ tales and grandma’s old remedies generously shared with people who are pregnant by just about anyone if they are given half the chance. But what do you really need to know about healthy pregnancy? Maybe you have a few habits that need kicking in order to keep your baby well, or you’re a foodie who doesn’t know what is safe to eat. Your care provider can answer all of these questions for you, so ask away. Look for handouts or resources to find out how to have the healthiest pregnancy. Subscribe on our home page to receive notices about an upcoming blog series to help answer some of these questions for you! You should definitely check out the OMama website and App. OMama is a project sponsored by the provincial government that connects pregnant people and families to trusted, evidence-informed healthy pregnancy, birth and early parenting information for Ontario.
Becca Raper is one of the registered midwives at Generations Midwifery Care. Learn more about her here.