Hellobee Boards

@ElbieKay: First, Congrats & Welcome to HB!!! Not sure if you're a March momma or not (I'm 6wks 3d) but if you are you should totally come join our March 2014 thread!

Next, even if you like your current obgyn you really want to make sure that they have the same perspective on birth that you do & that they're practices support that (there are providers that say they're supportive of natural birth & their practices clearly show they aren't) I posted a list on the March 2014 thread of things to ask your doctor concerning your prenatal care & birth to see how they really line up (page 2 of March thread). definitely check it out! (it's really long so I didn't want to repost it here).

I also think it's great that you're looking into hiring a doula! Having one can greatly decrease your risk of having an avoidable cesarean (like from a cascade of interventions) and increase you chance of having a success natural birth!!!

Lastly, FWIW homebirth has been found to be just as safe (mortality rate wise) for both moms & babies as hospital births but come with a significantly lower morbidity rate (lower tears, episitomies, assisted births, & cesareans). So *if* homebirth isn't for you, that's understandable, but the decision really should be based on the evidence & not the misinformation that most have. It's sad that so many talk about it being dangerous. :(... Fact is, in most all cases problems that arise in a natural homebirth with a closely attending trained midwife are addressed MUCH earlier than in a hospital b/c midwives don't have "we can just quickly take them for a cesarean" as a solution (they can't just let things go), and b/c your provider is right there with you the ENTIRE time. It's really very very different.... Here's a link with the evidence that gives the safety of homebirth:
http://www.scienceandsensibility.org/?p=5628

For my natural birth I read alot of Ina May's materials & a ton of homebirth stories (I chose homebirth stories vs hospital birth b/c having a successful unmedicated birth was something I needed to see as possible AND normal & most hospital birth stories just didn't provide that). I learned to trust my body & have a good support team in place. Trusting your body really is key though.... regardless of you having done this before or not, you're body does know what it's doing. GL

I decided it was probably easier just for me to post the list here as opposed to you going & finding it. tehe..

Prenatal care:
1. How long do you set aside for each patient each visit?

2. What if a birth emergency comes up during office hours? How long does your office wait for your return before rescheduling, or will I see another physician in the office?

3. What standard tests do you order & are they absolutely necessary, or have alternatives (some providers can administer diet alternatives to the cola drink GD tests)

4. How many standard u/a will I receive? If you order standard 3rd trimester u/s how often do those affect ones birth, at what point will you suggest induction for baby's size? (Note that acog only recommends induction if baby is suspected to be over 11lb)

5. What foods should I avoid AND, even more importantly what do you suggested for a pregnant mom nutrition wise (how much protein, etc)

6. How much weight are you okay with me gaining so long as my vitals are still good (some providers make a real stink about weight gain)

Birth: (the real important stuff)

1. Who will deliver me? Do you have a scheduled vacation around my edd? If your office does an on call rotation can I meet the other physicians that may be delivering me as well?

2. Where will I deliver? Do you have attending rights at more than 1 hospital or the hospital of my choice? (You should check out the cesarean rates of your hospital choices)

3. What is your....
*Induction rate AND augmentation of labor rate. How often do your inductions end in cesarean births vs vaginal
*Cesarean rate (primary, meaning 1st not repeats, scheduled vs emergency, multiples/high risk moms vs. low risk moms)
*how often do you perform episiotomies & how often do you see severe or 2nd degree or worse tears?
*Rate of assisted deliveries (vacuum or forceps)
*rate of shoulder dystocia & what training/maneuvers are you skilled in should the need arise (You can easily look up shoulder dystocia maneuvers to research some)
*rate of vaginally delivering patients birth without pain meds vs pain meds

3. What is your offices policy on going past my edd? Will non stress tests &/or biophysical profiles be ordered once I hit 41 weeks? (Given you & baby look fine there is no medical indication for inducing just bc a passed edd)

4. Are you or your colleagues skilled in breech birth (the facts are a skilled breech birth provider is safer than an automatic cesarean). What will you recommend in the case my bub is breech & at what point will it concern you?

5. What if my water breaks before contractions start, when will induction be recommended? (Minimizing cervical checks reduce risk of infection & you can easily monitor symptoms without rushing to induce... The 24 hr time cap is not evidence based)

6. Will I be able to move in labor (the halls, shower, birth tub)

7. Will I be able to deliver in the position that best suites me? (Lithotomy position closes the pelvis so it isn't the most advised position)

**8. What is your birth philosophy? And what constitutes a healthy baby & healthy momma... Is it just physical health or is there concerned with my mental well being as well, trying to minimize a traumatic birth experience? (rate of ppd in your mommas)

It is long, but I think it's pretty comprehensive & will give you a good idea of how your doctors births usually go & if they match with how you'd like your birth to go

I really enjoyed Birthing From Within, in addition to Ina May's book. There are others out there as well, if you're like me and read waaaaay too much about these things. ^_^

Also, have to say, I'm with you on the no homebirth. I would love to be able to do it, but I would be too afraid. And since, according to Ina May, fear is the main cause of things stalling and not progressing, it wouldn't work for me. I made the mistake of reading *every* story on Hurt by Homebirth (http://hurtbyhomebirth.blogspot.com/), and even though I know those are the extreme cases, and there are just as many stories of preventable deaths in hospitals, I just can't do it.

Delivered at st Luke's in may with a midwife! Not in the birthing center, though i wAnted to be...long story, but did go med free! My experience made me re-evaluate my stance on unmedicated childbirth, a little bit--I was dead set on med free beforehand and asked for meds once the pain got bad, but by then it was too late and LO came right after. Definitely made me realize that everyone is different and that pain meds exist for a reason. That said, I found childbirth classed and prenatal yoga to be priceless for preparing me; learned a lot of great pain management strategies that got me through! Feel free to message me if you'd like to talk more via email! I have a lot of thoughts on st Luke's and birth classes, etc!

@ElbieKay: Sounds like your doctor is great!

From what I know (not experience) having a doula is key. My husband and I are also taking natural birth classes - have you considered that as well?