Pregnancy & Birth: The right caregiver

Little Bird's Mama Blog_ Choosing the Right Caregiver

I can count the number of friends who had a really positive pregnancy and birth experience on one, maybe one and a half hands. What they all have in common is that they were in tune with their caregiver. Unfortunately,  too often, I hear that the relationship between the mother-to-be and her OBGYN is overshadowed by stress or discomfort, may it be due to weight gain during pregnancy, the size of the baby or the mother’s birth choice in general. Of course, we can all read books, watch videos and be part of groups in social media to do our own homework to navigate through pregnancy and prepare for birth. But what is all this worth when the actual caregiver isn’t the right one and mothers-to-be do not feel fully supported or respected ?

Choosing The Right Caregiver

“The best” OBGYN, “the most amazing” midwife … it’s always good to ask for recommendations and check what friends and acquaintances may have to say before choosing a prenatal caregiver. That said, in general the feedback is based on subjective opinions* which may differ from person to person. However, I believe that what works for one person may not always be right and work for another one and in particular during pregnancy, a time when women’s bodies and minds go through such a big transformation, what counts most is that the mother to be feels good and positive about the caregiver she is going with; other people’s opinions all aside!

Red Flags

Personally. this is something I had to learn during my first pregnancy. At that time, I was seeing an OBGYN who had been highly recommended by various women around me, being “amazing” and just “the best”. Her waiting room was always full and no appointment ever started on time. Women were actually queuing to see this OBGYN. For a while, I kept seeing her in this positive light until I started to ask questions about the actual birth process and interventions such as an episiotomy.  Though I was ok with having my baby in a hospital setting I didn’t want many interventions and in particular not an episiotomy. To my surprise, my OBGYN had actually a pretty positive point of view regarding this procedure …”sometimes when a woman is pushing and pushing and you could just do a beautiful episiotomy to speed things up…” were some of her words when we had this discussion. This scared me a little. However, I don’t know why, but I still kept going with her for some more time. Then, at my 31 weeks appointment – she just had assessed my weight gain which was 16 kg – she asked my man in front of me  “is she eating a lot of crap ?” and then made the remark that “once the baby is born you will loose only 6-8 kilos so with the lack of sleep due to breastfeeding and the sweet stuff that you will certainly eat to cope with that stress it will definitely be a big struggle to loose the rest of the kilos”. Yeah, maybe. Maybe she was right (for me it turned out she wasn’t because I lost all my pregnancy weight within 6 months postpartum thanks to breastfeeding) but what was more important for me in that moment was the tone and the way she had said things. In that moment, I felt so disrespected, talked over like a child and unsupported and suddenly knew that it was time to say goodbye to this OBGYN and look for another caregiver. As a mother- to -be, I was not looking to be treated like a child nor be disrespected nor scared by the person I would choose to birth my baby with.

  • The OBGYN I mentioned was for sure not a bad doctor and I am sure that there are  women who wouldn’t take her words as scaring nor disrespectful. However, for me her wording and approach did not work. For me, this OBGYN did not make me feel respected nor safe so that’s why I decided to end my prenatal care with her.

Not In Tune

Followed by the decision to change caregivers, my man and I decided then that it would be better to birth the baby in Amsterdam where he was based at that time (remember, we were actually still be living in two different countries and cities). With the Netherlands having a very special maternity system led by midwifes instead of OBGYNs, I then had to find a midwife. I didn’t have much time left and finding a midwife on such a short notice turned out to be rather difficult. Luckily, my prenatal acupuncturist recommended a “wonderful” midwife to me who still had space for me, just 3 weeks prior to our baby’s estimated birth date. When I met her I experienced her as a very gentle and calm person. We both were in tune regarding the natural birth process. Yes, I felt that she was maybe a bit too much in the “spiritual birth bubble” compared to me and my man but again, I didn’t have much time left nor a lot of choice so I just waved this feeling away and felt ok to have her be there for the birth of our baby. During the first part of my birth though, I quickly started to see that something was off and not really working well for us. With this being my first birth and not having had as much insights regarding physiological birth as I have today, I was actually looking for a midwife who could guide me and be a bit like a helping hand. Unfortunately, this wasn’t the case as her very laid-back approach excluded any kind of guidance. When I had had regular contractions for various hours and asked her when we should go to the birth centre- the place we had chosen for the birth of our baby – she didn’t make any remark that it was way too early and just said “go to the birth centre whenever you feel like it” – so we went, because we did’t know better. When we arrived and contractions suddenly seemed to have paused, my midwife suggested after a couple of hours to break my membranes to speed up the process. As I thought that I had been in labour for so long already  – I was ignoring the fact that I was still in pre-labour because I didn’t know and my midwife didn’t share any information on this – and my body was failing me, I agreed into the procedure which then led to a short progression during which she insisted that I followed her breathing rhythm and not the one I had been practicing with my hypnobirthing class. And I followed her, because I didn’t know better. Looking back, I see that we were really not in tune and after hours and hours of labour that stalled at 4cm, I decided to change setting and caregivers and transfer to the hospital. There, I birthed my baby in a way that was the complete opposite of what I had wished for (read the whole birth story here) .

  • The midwife was certainly not a bad midwife. I had heard positive stories about her and how delighted women were to have had her at their side. But for me she had not been the right one. Maybe because we were not really “in tune” personally. Mainly though because I met her so late and we didn’t have enough time to really get to know each other and figure out where we were standing in terms of physiological birth and the type of guidance and information that I was looking for…and figure out BEFORE the birth that we were actually not really a match.

Finding the right one

During my second pregnancy, I didn’t want to make the same mistake so I asked in a local mamas group on Facebook for recommendations regarding midwife practices in my neighbourhood. I knew that I had to get it right this time so I went for the practice that had very positive reviews. That said, again what I had read online didn’t correspond really to reality. The fact that I was seeing 3 different midwifes which rotated from appointment to appointment, without being sure which one would then be there for the birth, did not really amaze me. Neither did I like the fact that all appointments were limited to 15 minutes focusing on nothing else than measuring my blood pressure and the growth of my belly. Also, the upcoming birth would only be addressed as of week 31 as this was the practice’s policy. However, with my prior birth experience I felt that it needed a different type of support and more time to properly prepare, especially as I was aiming for a home birth this time. So there again, I had this feeling of not being 100% satisfied so when I attended a traditional midwifery seminar for a project that I was working on, I learned about the work of independent midwifes and the personal and custom care they tailor towards their clients. This felt so much more right to me and while I was sitting in this room filled with birth workers there was one midwife I talked to and it made immediately click. I knew that I could trust her, that she had the experience and right vibes that would fit both with me but also my man who would obviously be present during the home birth of our baby. Hence, I changed again caregivers and had the most amazing care, birth and postpartum time.. I couldn’t have wished for more!

So ? What I can do to find the right one ?

  • First of all: Trust yourself ! You are the mother-to-be! Then, do some research, find out what you are wishing for in terms of pregnancy and birth. If you know what you want it’s easier to achieve that goal!
  • Based on your research, ask questions that are important to you and insist on receiving all the answers you are looking for. You are the mother-to-be, you must be respected and your wishes and wellbeing come first!
  • Do not ignore “Red Flags” – listen to your body when something feels off and if the feeling persists, do something about it.
  • Feeling good, supported and respected by your prenatal caregiver is crucial, especially if he or she will also be present at the birth. This does count for vaginal birth but also for caesarean births. In both scenarios, the mother-to-be needs to feel safe and supported!

…and if I cannot find a caregiver I feel safe with/who supports my wishes or I don’t want to find a caregiver at all ?

There are several options to still get the support you need, even if you struggle to find a caregiver you like:

  • Hire a doula (I am not writing this to promote the work of doulas but to share that one of the main task of doulas is to provide information on pregnancy and birth options and help mothers-to-be advocate for themselves during pregnancy, birth and the immediate postpartum phase.
  • Join one of the various online social media groups that correspond to the type of pregnancy and birth you can best identify with to get information and exchange ideas, thoughts, feelings with likeminded people.
  • If you decide to continue your care with a caregiver you are not 100% sure about, keep talking about the sensitive points that need more attention to clarify your stand and make sure that your birth partner, doula etc is on the same page with you in order to support you throughout your journey.
  • In a lot of countries it becomes more and difficult to find a caregiver who supports women’s birth choices (i.e. VBAC after caesarean birth in a country with a highly medicalized mindset towards pregnancy and with a very high ceserean birth rate) or to find a caregiver per se due to shortage in that profession (i.e. midwifery in Germany) or out of free will to go against the medical pregnancy setting. So a growing community of “freebirthers” is seeing the light. To find more information on what free birthing means and stands for, please check the below websites and podcasts. (Please note that this is not a recommendation nor promotion of freebirth. However, I believe that all types of pregnancies and birth approaches deserve to be mentioned here in order to inform women about ALL options that are out there. Having all the info will help women make an informed choice on what is best for them and their babies.)

How about you ? Can you relate to this ? Did you find THE ONE, the right caregiver for your pregnancy and birth ? Or was this all rather secondary to you ? I’d love to know 🙂

*of course this can be different when dealing with special conditions that need specific medical attention.