Friday, December 5, 2008

But I: A List of Reasons Why Women Don't Change Careproviders

There is a great list of reasons why many women resist changing careproviders during pregnancy in the Week 27 Lamaze newsletter:

"It’s not uncommon to resist making what feels like a drastic change at this point in pregnancy. But it is wise to explore your assumptions before you decide for good. For instance, you may think…

  • BUT I already have a relationship with my current provider. It is more important that you feel supported in your decision-making than have a limited, ineffective relationship with your care provider. Also, remember that your prenatal visits will be more frequent now. You can expect to have enough visits to get to know a different care provider.

  • BUT It’s too late in my pregnancy. It’s not too late if a new caregiver or birth setting does not have policies that prevent you from making a change at this time. Many care providers will accept new clients as late as 36 weeks or more, although it is best to make the switch sooner whenever possible. If you are not completely satisfied with your choice of care provider or setting, immediately explore your options. Interview other care providers before making this important decision.

  • BUT I don’t feel comfortable “firing” my care provider. Most midwives and doctors understand that their clients’ needs and wishes change during the course of pregnancy, and they don’t take it personally when a woman wants to make a change. Even if your care provider doesn’t react well, know that it is your decision based on what you know is best for you. Why risk having negative memories of your birth experience or receiving care that doesn’t meet your needs just to avoid hurting someone’s feelings?

  • BUT My provider knows what’s best for me. This is your birth and only you know best how you will feel supported. Unfortunately, many care providers practice in a way that serves their interests, not yours. Others practice “cookbook medicine”—applying the same care to all women regardless of their individual circumstances. If you don’t feel like you’re getting personal attention, or if you feel more like a “number” than an individual, it’s time to start looking elsewhere.

  • I have had several clients change careproviders mid-pregnancy - one as late as 36 weeks, but most of the others earlier in their third trimester. One changed from a hospital setting to a birth center, others from OB care to midwifery care. I think that, for many women, birth does not necessarily feel REAL until late in pregnancy. We realize we are growing a baby, and that is our focus, not how that baby will actually come OUT! I think this also might partially explain why I have so many moms wait until 32-34 weeks to call me for classes!

    Once moms start thinking more about how they will give birth, they start to ask careproviders more specific questions (will I be continuously monitored? what happens if I ______________? how often do you perform episiotomies? can I eat and drink during labor? can I labor in the water? give birth in the tub?). If the answers they get don't feel comfortable, some women start an internal dilemma around "what would it be like to change careproviders??". And that is when the "But I"s come in...

    If you find yourself in this kind of dilemma, carefully consider the information above. Put yourself and your baby first. Ask lots of questions - ask yourself, your partner, your careprovider, your potential careprovider. How does the care provider respond to your questions? Is this type of response what you would want during birth? Think about the setting where your doctor or midwife will attend your birth (hospital, home, birth center). There is some especially useful information on the Childbirth Connection website under Choosing a Caregiver.

    By the way, if you think it's too late to call for classes - call or email me anyway. I've always found a way to fit in someone who was motivated to schedule a class or classes!

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine

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