If you’ve just found out that you’re pregnant, or you’re planning a pregnancy in the near future, one of the biggest decisions you’ll have to make is the kind of maternity care that you would like through your pregnancy and the birth of your baby. There are a number of options available in Ireland, and far and away the most popular option is consultant-led care with an obstetrician.
If you’ve taken a look at your options and decided that having a consultant is the way to go for you, don’t let the decision-making process stop there. The next step is deciding who is the best obstetrician for you.
Many women will choose their obstetrician because their sister or their friend went to a particular one. Personal recommendations are a great way to evaluate any service that you use – but the fact that a particular consultant was the right one for your sister or your friend doesn’t necessarily mean they are the right one for you. If you have someone recommending a doctor to you, find out exactly why it is that they liked them. They might tell you that they were lovely – and a good bedside manner is great. But your sister might have had different expectations from you.
Think about the kind of birth that you would like and then go about finding the right consultant to support you in your birth plan. Different obstetricians have different practices and policies. What’s important is that your own expectations are aligned with those of your consultant. Some questions you might like answers to are:
- What is their induction policy? This means at how many days over 40 weeks they like to induce. You might prefer to go into spontaneous labour, so this will be important to know.
- What is their Caesarean section rate?
- What is their episiotomy policy? An episiotomy is a surgical cut made to the perineum with a scissors during labour as the baby is emerging. If you’ve never heard this term before, then it’s certainly worth doing some research into common birth interventions and your own personal preferences in this regard, because the day you go into labour is not the day you want to learn about interventions that may be suggested.
- Who covers for them when they’re away on holidays? Do you get to meet this person? What are their policies?
- If you’ve had a previous Caesarean and would like a natural birth, what is their vaginal birth after Caesarean (VBAC) rate?
- If you’ve had a previous Caesarean and would prefer to opt for another planned section, will they facilitate this for you?
- How amenable are they to alternative pain relief methods? This might be important to you if you’re planning a natural birth and would like to try methods such as water immersion, GentleBirth techniques, etc.
- How do they feel about things like delayed cord clamping, a physiological third stage of labour (the delivery of the placenta without the aid of an injection to speed things up), and letting your waters break naturally? If you’re not sure about those things, take the time to research them and see what you think.
- If you know you’re having a planned Caesarean, is your consultant supportive of a “natural Caesarean“?
Some, all, or none of these things might be important to you. Establish what is and then try to find a consultant who’s on the same page. But how, you wonder? Ask your friends who have had consultant-led care specific questions about their own experiences. Join a Facebook group of mums in your county. Ask your doctor, your yoga instructor, an independent antenatal teacher; or talk to the consultant yourself. You’ll be surprised how a few good questions will get you the answers you’re looking for.
Don’t think that choosing a consultant is exclusive to women paying for private care. Different consultants run the semi-private and public clinics in maternity units, so if you identify a consultant that you’d like to look after your care, then make sure you book into their clinic. The same applies if you identify one that you’d like to avoid! It’s also possible to switch consultants at any time during your pregnancy, so do keep that in mind.
Trusting your healthcare provider is such an important part of your maternity care – so go with your gut! It won’t steer you wrong.© Sylda Dwyer, AlphaBirth 2014. Unauthorised use and/or duplication of this material without express and written permission from the owner is strictly prohibited. A version of this article first appeared on www.parent.ie