You just found out you are pregnant!  You are so excited, but you feel so lost on the next steps with your care for your pregnancy.  Naturally, you turn to someone who you are close to for guidance and often times for recommendations for a provider.  The number one thing I hear from women over and over is that they asked someone close to them (friend, relative, co-worker, etc) who they used for their prenatal care provider, and then set an initial appointment with them.

Please, don’t do that.  Hear me out on this.  People close to you truly care about you, and although they may have had a fantastic experience with their provider, what they wanted for their pregnancy and delivery may not at all be what you want for yours, and this is so important!

In my fourteen years in the birth related field, I have seen so many cringe worthy decisions in this category.  The ones that worry my heart the most are the sweet first time mamas wanting an undisturbed vaginal delivery using a doctor who performed a great cesarean delivery on their sister, friend, etc.  This does not work.  If you want a surgical birth, then by all means, you want the best OBGYN out there known for his surgical birth experience.

Alas, that is not the majority of women I serve or encounter.  For every woman I cross paths with, I want to help them set the stage for the best birth team, which in the long run helps increase birth satisfaction and decrease mental and emotional trauma from a poor experience.

How does one start building their birth dream team?

First, lets start with location.  What environment makes you feel safest?  It is important when deciding between hospital, birth center, and home birth that you are taking into consideration your emotions when you consider each location.  It is of the utter most importance that you feel safe in whatever location you choose.  There is not a perfect answer for each person.

I recently encountered a sweet lady who was going to start care with me.  Since I am insanely type A and detail oriented, my contract, consents, and waivers are also very detailed.  I want everyone to know risks and benefits, and to fill comfortable with her decision.  This sweet lady had a lot of anxiety, and she wanted a peaceful home birth, but her sense of safety was in the hospital.  I wished her the best, and told her that it was wonderful that she was listening to her gut, and following those instincts.  You cannot force a home birth to happen if you do not feel safe there, and vice versa.

Second.  What type of birth do you want?  There is not a one size fits all model for how to birth.  I personally prefer unmedicated vaginal deliveries, and have been blessed to have had three.  However, because that is what I wanted does not mean that is what you want.  You may not even know what you want, and that is okay.  That is where hiring a doula (see below) will come in perfectly.  I highly encourage reflecting day one on what you envision for your birth.

Third.  What type of provider do you want for your care?  OBGYNs mainly work in the hospital, where as a midwife you can find one in either category, hospital, birth center or home birth.  With a midwife, you have a higher chance of knowing which provider will be attending your birth, as well as having a relationship with any other midwives in the practice.  With an OBGYN, it is not as common for one to attend all their births.  Most often, you will have an on call doctor who attends your birth, and you will not see the doctor much during the labor process.  If using a hospital midwife, you still have the option of obtaining an epidural or other forms of medicinal pain management if desired, and a doctor is available if something such as a cesarean is deemed necessary.

Fourth.  No matter where you are birthing, every woman should consider a doula!  I find a good, well trained doula to be a valuable asset to the birthing team every time.  A doula is a non-biased person one hires to assist in helping a couple navigate their birthing preferences, reminding them things to ask of their birth provider, helps with teaching and preparing for comfort measures, and is present during the birth to provide emotional and physical support to the woman during her labor journey.  A doula will often be able to help guide you on things to read and do to help you see what type of birth you want, and how to best prepare to make that happen.

Fifth.  Family and friends.  This is a long standing dilemma so many of my clients have faced over the years.  It is amazing to me how many people feel they deserve the right to attend another woman’s birth.  It is incredible that one could forget how completely vulnerable a birth is, and guilt and manipulate a woman into allowing them to attend the birth.

Let me tell you, this is absolutely not okay!  No one deserves the right to be in your birthing space without your permission.  For every uninvited person in your space that does not have a job or make you feel comfortable in that moment will add at least an hour to your labor.

Why?  Because the body is smart.  If the body does not feel safe and comfortable, labor progression ceases.  This is not a time to people please.  Please, please, please only allow people that you truly want in your space.

My worst experience with this with a client was I had a sweet first time mom who only wanted her husband, mother, and sister with her during her birthing time.  Her husband was quite enthusiastic, and did not understand the importance of listening to her wishes, and therefore made his own decisions and invited his entire family over.  I walked into lawn chairs, yes lawn chairs, set up all over the living room for the “show.” I was furious inside with the husband for disrespecting his wife’s wishes, and needless to say, this mama ended up with a hospital birth because she could not labor with so many people watching her so closely.

So what is the criteria for friends and family?

First, I tell my clients that they have to love and support you, and be 150% okay with your birthing decisions.  They cannot be in the corner having an emotional crisis because you do not want pain medications and they can’t handle seeing you in pain.

Second, for each person there that is not part of the birth team itself, they need to have a job.  This helps keep idle hands busy, and less eyes waiting for the “pot to boil” so to say.  The jobs can be anything.  It could be having a grandmother make your favorite soup, or sister run some errands for labor snacks.  Your provider and/or doula can also help craft a busy list for those members you want at your birth to support you.

Sixth.  Is there anything else in this equation you are desiring or needing for your birth?  I would group birth photographers, birth videographers, and sibling doulas in this category.  Make sure to invest a good amount of time in the interview process for any of these people.  These people should have more of a fly on the wall role, and should know how to abide by it.  You want to be sure that who you interview gives the respect of your birth space vibe and makes you feel comfortable.

It is an interesting concept that couples invest so much energy, money, and time planning their weddings for this picture perfect day, but spend an ounce of that planning their birth. How a birth goes and how a woman feels after her experience can have effects that last a life time, whether positive or negative.

I highly encourage if you are pregnant, please invest the time into cultivating the dream birth team that fits what you need and desire.

-Midwife Shannon