Hiring an OB or Midwife: 10 Things That Are NOT Deal Breakers

1.  The office/hospital is beautiful.

A beautiful office sure makes for a nice place to sit. I'll give you that.  But, are you going to labor and birth in that office? Are you moving in? Is there a correlation between wonderful, respectful health care providers and new/modern/spa like space?  nope.  This might be a great way to choose a nail spa or even a spot for dog grooming, but not your health care provider.  This is NOT important.  Bring a book and take off on a fictional journey while you wait and snack on raw nuts.  

You want to birth in a beautiful space? Who can blame you.  But you know what - when the day comes you won't be aware of the color of the walls or how fine the linens are.  It's a wonderful bonus if you get a beautiful birthing space and an awesome motherbaby friendly provider in one birth-perfect package.  But, a well designed room won't matter much to you if you're not happy with how things go down.  Your provider has a greater impact on this than a room color and fixtures.

2.  The staff is so nice!

So, the office staff isn't making the calls on game day.  It sure is nice to work with pleasant people, that's for certain.  I prefer to eat at restaurants with great wait staff and stay in hotels with amazing service.  When it comes to making the big calls concerning your health and birth - it's the provider that matters.  However rude or nice the staff, ultimately they make up a very small part of your pregnancy experience and none of your birth experience.  

3.  Appointments are always on time or have short wait times.

How is it that some providers always run on time or close to?  I'll tell ya- they're not at their births and if they are their induction and/or cesarean rate is likely high.  Health care providers who are patient enough to allow labor to start and continue as it is intended and attend their clients' births rather than relying on the on-call doc and scheduled births, have clinic-scheduling difficulties.  Add to this the fact that they are told how many appointments to take/hour, appointment scheduling is out of their hands, and this amazing provider is probably spending more time with you than the 5 minutes you are truly allotted.  When it's your time to labor and push you're never gonna feel bad for those people waiting and you will be gratful to have your patient, skilled provider caring for you.

A caviat to this is that it's unfair to compare those in private or shared practices to those working for a group/hosptial and midwives to OBs.  Midwives, by the nature of midwifery, allow for longer appointments and have fewer patients.  In shared practices it's easier for the person not attending births on a given day to keep up with clinic appointments.  This is great!  But a provider's ability to run an on-time office is in no way a measure of his/her quality of care. 

4.  He/She makes me laugh.

Laughter is the best medicine, of course! While bed-side manner is awesome and definitely a plus, being funny and/or super polite does not equate to being an awesome health care provider.  This is just not reason enough to hire someone. 

It's great to have a connection with your provider.  But ultimately this is a professional relationship and you aren't looking for a bestie - you are looking for someone that you can trust to leave you alone when it's appropriate and to only intervene when needed.  You need someone that will be there for you when you are ready to birth your baby.  Someone who will trust your own ancient birth wisdom and support you while you labor and push as your baby and body tell you - not to say "sure you can do whatever you want so long as you and baby are safe" then procede to flip you over to a standard stirrup position to "make things easier."  If and when this person looks in your eyes and says "I think we need to move to an induction/augmentation/cesarean" you know that all else has been exhausted and you can move forward in this direction with confidence in the decision and respect and honor for your birth.

5.  My sister/friend/cousin/mom/friend's-cousin's-mom uses him/her.

This is probably a great way to choose a hair dresser.  A health care povider, not so much.  Unless of course your sister/friend/cousin/mom/friend's cousin's mom and you have a lot in common in regards to your motherbaby care birth plans. You may like the same jokes, love the same music and read the same books, but have very different ideas about optimal motherbaby maternity care.  Take a good childbirth class and look for red flags.  Hire a doula and listen to what your doula has to say.  What care providers are doulas choosing?  Who do her clients see?  You hire a doula because of the knowledge she holds, because of what she has seen - this person has had far more experiences with birth than your sister/friend/cousin/mom/friend's cousin's mom (unless of course that person is also a doula).

6. I don't want to cheat.

There is no cheating in health care. If you feel uncomfortable with the care you have received in the past, with the suggestions your doctor or midwife is making and the conversation that takes place there after, if you find you and your provider have different comfort levels with pregnancy gestation, baby size, natural labor, inductions, pitocin, skin-to-skin contact, vaginal breech birth, etc. . . this isn't a reason to cheat - it's NOT cheating. It's your RIGHT. Get another opinion, transfer care to another health care provider, you have options! It's important you are a good match with your provider. This will allow you to trust this person's suggestions and decisions regarding your care rather than questioning him/her the whole time, which, truly, is frustrating for everyone involved.

7. The office/hospital is so close to my house.

Okay, if you live in the woods and have a history of precipitous labor, this might be important. But for the average woman with an average labor there are at least two hospitals within a half hour of her, even in traffic. Proximity to your house at a place with a 50% cesarean rate vs. drive 30 minutes further for a care provider with a much lower cesrean rate . . . even in transition this mom of three would choose the 30 minute drive.

8. He/She says "whatever you want to do" when I ask questions.

See number 4 above. Be sure you are actually hearing what is said and what isn't said, not what you want to hear.

9. My partner says this is best.

YOU are a strong, intelligent and capable woman. In a perfect world you, your partner and provider will have an actual discussion. You CAN and SHOULD BE making decisions about your health care and while your partner may have valid input and legit concerns, ultimately you are the one going through this and your input and concerns are not invalid. It is you that will labor and birth this baby and you are capable of that AND choosing your provider.

10. I NEED my toes painted in the hospital the day after I've had my baby.

It's no secret, postpartum isn't always when we look our best. New moms are tired, swollen and sore after a vaginal birth. Add a major surgery on to that and yah, some pampering might be nice. A pedicure is a great way for mom to grab some alone time and treat herself - but let's revisit that section rate, your birth options, your provider's availability for your labor and birth and faith in your body to grow and birth a healthy baby - would you give all that up for pretty toes? Maybe you work it out where you get it all. Maybe not. But don't let some polish, even organic formaldehyde-free polish, be the deal breaker when chosing a health care provider.

Amanda Devereux is founder of Nola Nesting, a Doula, Birth Boot Camp Instructor, and mom of three breastfed babes.