(Please note: for the purposes of this list, I use they/them pronouns to refer to care providers in order to make the language open to all possibilities.)
- You feel anything less than SEEN, HEARD, AND RESPECTED in your visits.
You deserve to be treated as if your time, concerns and questions matter. Do you have time to ask your doctor or midwife all of your questions or do you feel rushed? Do you feel satisfied and confident with the responses to your questions or are you met with disapproval for asking them? Examples of “red flag” responses to questions might include: “I’m the one who went to medical school. Why don’t you let me decide that?” or “You don’t need to ask so many questions. I’ve been doing this for a long time,” or “You think you want a natural birth now but just wait! You’ll be begging me for the epidural when you’re in labor.”
If someone so readily dismisses your desires or insults your values in a prenatal visit, this is not a good sign that your wishes will be respected in labor. (A related sign of disrespect is the use of the word “let”, as in “I don’t let my patients go over 40 weeks.” You are the consumer and this is your body. Your care provider’s job is to provide you with information and recommendations based on their education, experience, and the evidence so that you can make the best decisions for you. It is NOT their job to decide whether or not you are allowed to do anything!
2. They do not practice evidence-based care.
You deserve care that is based on what the best evidence shows is safest and healthiest for you and your baby, not just care that is most convenient or routine for your care provider.
A care provider’s rates of interventions (such as induction, episiotomy, or cesarean) tell a story about the sort of birth they routinely attend and the mode of care with which they feel most comfortable. If these rates are not within recommended guidelines or if your care provider tells you they are unwilling or unable to provide statistics on these things, then it’s red flag time.
An independent childbirth class can help you understand how to find and use evidence, and how to ask questions about your care in the moment. Some wonderful resources for researching evidence include:
Responses like, “This is just how we do it in this practice because we’ve found it works best,” or, “Sure, I’ll let you do whatever you want as long as the baby isn’t in danger,” don’t answer the actual concern or show a willingness to make a real change in the way of practicing. Look for specific details on how they plan to support you in having the safest and most satisfying birth for you, and a willingness to work on a solid plan with you for following through.
Outside of a provider’s statistics, the stories you hear from others about care received from them can also help paint a picture of their routine of care. I’m not suggesting you change care providers based on one negative story. Doctors and midwives are human and therefore, like all of us, have bad days and make mistakes. But if there is a pattern that develops in several stories, it can be indicative of a mode of practice or birth philosophy. It’s unrealistic to think a care provider will suddenly begin behaving differently than their history suggests they have consistently behaved in the past. When asking for feedback about a care provider, pay attention to the stories coming from people who value the same sort of birth you’re planning (whether or not they had this sort of birth). Your local ICAN chapter may also be a good place to learn about care providers who are a good fit for your birth preferences.
3. You have a bad feeling.
Trust your intuition. Even if you can’t put your finger on a specific reason, your inner wisdom has something to tell you. Those feelings coming from your gut actually play a valuable part in smart decision making!
Your choice of care provider has a big impact on your birth outcome and birth satisfaction. You and your baby deserve the best possible care at this important time.
If, after reading this list, some red flags have been raised, here’s are some posts about exploring the idea of switching to a new care provider.
Your childbirth educator, doula, local birth support network, or ICAN chapter can also be great resources for making this decision.
Have you had experience switching care providers in pregnancy? Were you glad you made the switch? Did you have an experience that made you wish you had listened to your gut and made a switch?