Finding the care provider that’s right for you is a critical first step toward having a great birth experience. Dr. Robin Elise Weiss talks with Adriana about the different types of prenatal care providers and how their varying philosophies can impact the care you receive. She also shares how to go about finding the care provider that’s right for you, and what you can do if you decide they are no longer a good fit.
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- Our Best Resources for Choosing Your Doctor or Midwife in Pregnancy, Lamaze
- Lamaze Healthy Birth Practices, Lamaze
- Choices in Childbirth: How to Choose Your Provider & Get the Care and Support You Need, Every Mother Counts
- Pregnancy & Childbirth: Birth Care Providers, Our Bodies, Ourselves
- Choosing a Maternity Care Provider, Childbirth Connection
- What to Ask … A Physician Who May Provide Your Maternity Care, National Partnership for Women & Families
- Your guide to finding a birth provider who’s LGBTQ-friendly, Motherly
- Preparing for Pregnancy as a Non-Binary Person, TransFertility
- What Doesn’t Bend, Breaks: Resiliency Strategies for Trans Folks on Fertility Journeys, TransFertility
- Pregnancy among Women with Physical Disabilities: Unmet Needs and Recommendations on Navigating Pregnancy, National Research Center for Parents with Disabilities, Brandeis University
And a selection of articles from Robin herself, at VeryWellFamily.com (she’s written tons more!):
- 10 Things to Ask Your Doctor or Midwife if You’re Pregnant
- What and Who to Bring to Your Prenatal Check-Up Appointments
- Reasons to Choose a Midwife for Your Pregnancy Care
- Is Your Provider VBAC-Friendly?
- How and Why to Change Your OB-GYN During Pregnancy
Related Birthful episodes:
- How Do You Know If Your Care Provider Is Treating You Fairly?
- Eight Questions to Ask Your Care Provider
- Know What You’re Up Against When Giving Birth at a Hospital
- Cesarean Risk: What’s Your Place of Birth Got to Do With It?
Why Choosing The Right Care Provider Is Crucial For Your Pregnancy
Adriana Lozada: Welcome to Birthful, Mighty Parent or Parent-to-Be! I’m Adriana Lozada, and I’m so excited because today we’re starting our new series on “Care Providers.” This series definitely goes hand-in-hand with our “Models and Places of Birth” series— so if you haven’t listened to that one yet, I recommend you go back and listen to it first.
So in this series about care providers, I’m going to be talking to OBs, midwives, maternal-fetal specialists, and doulas, to get a really broad range of perspectives, but we’re always anchoring our conversations in the things we believe in here in this podcast, which are: the physiological support of the birth process, collaborative and evidence-based decision-making, your right to bodily autonomy, and the respect of your ability to make the choices that are right for you and your family during your perinatal journey.
To start us off, I’m going to be talking with Robin Elise Weiss who is a prolific author, an amazing and dynamic trainer of both doulas and childbirth educators, and a recognized leader in maternal-infant care. Robin is a busy mother of nine and the author of 14 books and thousands of articles on pregnancy and parenting, and her life is just really, truly imbued with the perinatal journey— both professionally and personally.
In this episode we’ll talk about why choosing the right care provider is so important, the different types of care providers out there, how to go about finding the one that’s right for you (and we’ll include some of the questions that you can ask to help figure that out), and what you can do if you realize that your original choice is not a great fit.
You’re listening to Birthful. Here to inform your intuition.
Adriana: Robin, welcome! I’m so happy to have you here today.
Robin: Thank you for having me. I’m really excited.
Adriana: So today’s topic is finding a care provider and, y’know, let’s start with the basics: Why is it important to find a care provider that’s a good fit?
Robin: Well, I think one of the things that most people don’t understand is that the choice of care provider that you choose is largely going to impact everything that happens from that moment forward, both in how you’re cared for in your pregnancy, the testing that happens, the type of questions that you ask and are answered— it really sets the tone for everything moving forward to the postpartum period.
And most people think that pretty much everybody gets the same type of care and that’s just quite honestly not true. And when you think about how the vast majority of people choose their care providers for birth, it might be… y’know, it might be they pull out their insurance booklet and do just a random, “Hey, this person’s close to me!”
It might be that you ask your neighbor, “Hey, who did you use? And did you like them?” And they say, “Yes,” and you think that’s great, but the problem is maybe your idea of what constitutes good care and their idea of what constitutes good care maybe don’t match. Or even— and I find this one a lot— is that the person who’s done your “well-woman care” (your pap smears, your birth control), that just becomes the default. “Well, I have a really good relationship with this person and I’ll stay with them.” And the truth is we have really different needs from the person who does a yearly pap smear and the person who’s going to care for us in pregnancy.
Adriana: Absolutely. And I see that quite often. So it seems that, even before trying to find a care provider, people need to take a step back and figure out what they want. How can they best do that?
Robin: Well, I think for some women it’s a little easier than others, particularly if you’ve had a baby before. You either had care that you liked, or you had care that you wish were a little bit different, and if you have that knowledge going in, then you can say, “Okay, the provider I used worked really well for me,” or “I need to find somebody who does something differently.”
For a mom who’s never had a baby before, it can be a little bit trickier because you do wanna keep your options open and think a little bit more. And your ideas may change as you learn more. I always encourage people to try and find an early pregnancy class and to take an early pregnancy class. Even in that, the first few weeks of pregnancy, a lot of the information they go over is great for your entire pregnancy, including nutrition and fitness, and just some of those early questions that you wanna get answered. But a lot of that also can help you formulate what your ideas look like about pregnancy and birth in general, to help you get the idea of “This might be what I’m looking for in a care provider.”
Adriana: And speaking of the care providers, what are the options out there that provide that difference in care?
Robin: Generically speaking, the providers that are available would be: An obstetrician, who is trained in obstetrics and gynecology. Some people use family practitioners, who are also trained in well-woman care and normal pregnancy and birth. You have nurse-midwives who care for normal, healthy pregnant women and their babies. And then also the direct-entry midwife who may have a variety of certifications, including the Certified Professional Midwife’s credential (and where they practice and with whom they practice will vary state-by-state).
Adriana: Also, can you speak to how that influences your place of birth and how does that affect your outcomes as well?
Robin: Certainly. Moms who give birth in birth centers or home birth will typically be cared for by a midwife, and people who are giving birth at home or in a birth center are typically healthy, low-risk, and they have a much lower incidence rate of having cesarean sections, of using medications because they would have to transfer to the hospital to receive that type of care.
And while it is true that a low-risk, healthy pregnant person is going to have a lower cesarean rate in general, we find that the same healthy, low-risk person who sees an obstetrician in a hospital still has a higher cesarean rate than people who are not in the hospital or who are being cared for by midwives.
Adriana: And in terms of the practitioner, you mentioned a little bit of the pros and cons— can you get deeper into that, on how they different in the care?
Robin: Well, again, these are generalities because there are certainly obstetricians who practice very much like midwives. And there are certainly midwives who practice in a more medically-oriented sense, which is what makes the interview of the practitioner so important. And I think a lot of times we forget that this is a two way street: just because you show up and have an appointment with a person doesn’t necessarily mean that you’ve hired them.
And even if you have hired them and you’ve seen them for several months, even all the way through your pregnancy, you can also fire them! But in general, what most say would be the differences would be the time that a midwife takes to get to know her clients, in terms of lengthier prenatal visits, asking about more than, “Tell me, what hurts are you feeling? Does the baby move? How are you feeling?”— taking the time to say, y’know, “How are you emotionally? How are you relating to this pregnancy? How’s work going? What’s your social life like now that you’re pregnant? Tell me about your nutrition.” So something a little bit deeper into the lives of the pregnant women that they care for would be one of the major ways that the care differs for most people.
Adriana: For a midwifery model of care?
Adriana: And yeah, like you said, yeah, there’s a huge variety of options in terms of how they practice and also how many practitioners are in the practice— because you may have a midwifery group that has 10 midwives, so you’re not quite sure who will be there, or you might have a family practitioner who’s most likely… unless they’re going on a trip… usually will be the person. So, that is something I think people forget to take into account, that the number of practitioners that belong to the practice can change your model of care. Is it your experience that even within one practice, the type of care might be different?
Robin: Absolutely! Even if it’s a small practice, you could have two or three physicians, and they practice very differently from one another. That was one of the biggest surprises when I first started working in birth was “How did these two physicians get together? Like they have nothing in common other than this medical degree!”
Y’know, it was really surprising to me! I just sort of thought, y’know, like-minded individuals would find themselves together. And we know from the Listening to Mothers survey, that many people who go to the hospital to have their baby wind up not having their care provider, whether it be because they’re in a big practice and, y’know, you’ve got nine doctors and, y’know, whichever day you go in, depends on the doctor on-call, or perhaps your labor has spanned a length of time that means the doctor that you like is now off call, and another doctor is on-call that maybe you don’t know as well. Or even in some cases, many, many hospitals are using what’s called a “hospitalist,” meaning it’s somebody that you didn’t even have a chance to see that they’re not a part of your practitioner’s practice, that they’re hired by the hospital and they stay in house and they only do labor and birth.
Adriana: Yes. And that’s popping up more and more, I find.
Robin: That is. And I don’t say that to make that seem like always a bad thing. In fact, in some ways a hospitalist might be beneficial— but it’s a surprise to many of the laboring women if a hospitalist shows up.
Adriana: There’s definitely pros and cons to it in terms of how tired a practitioner is, because they have specific shifts, as opposed to just, say, a physician from your practice that’s on their 23rd hour and kind of running a little bit on empty… but the surprise factor is something that you wanna take away from it, so having that interview where you ask, if that’s even a possibility, can prepare you for it!
Robin: Absolutely. And that’s also something that you need to ask when you’re taking a tour of a hospital, is “Do they use hospitalists?” because sometimes the hospital will go “No, we don’t today, but we will be in three months.” And then three months is near your due month. And so you’re about ready to have the baby then.
And so it might be that your practitioner’s not even thinking about it, because it’s coming down the line, y’know, and they answer the question and today, “No, no, we don’t have hospitalists.” So it’s a question that you ask everywhere you go.
The one time that hospitalists may work out really well is in the case of hospitals who have been a little more leery about providing vaginal birth after cesarean care (or “VBAC”), because then they always have that physician in-house. And so that provides the hospital with a sense of safety and security, that that person is always there, allowing the other practitioners that freedom to say “Yes, we will take clients who are planning to have a VBAC.”
Adriana: Mhm, because they can count on having somebody who can, in case of a cesarean, can be there to do the cesarean.
Adriana: Is there any other sort of surprise or consideration people should have, in that sense?
Robin: I think the surprise for most people is just many times they develop a relationship with one of many practitioners, and then sometimes at the end— while they have this idea in the back of their head that maybe somebody else in the practice is going to be there— they really just push that aside. And then a couple of things can happen: One, is that their practitioner can say, “Hey, I’m on call next Tuesday and you’re 40 weeks… Why don’t we induce you so I can be there?” And that sounds like a reasonable option to most people, not understanding necessarily what all that entails or what happens if the induction takes longer than their doctor’s call schedule. As well as then, just the stress of it, the “I don’t wanna give birth on Tuesday, because the physician that I’m not a big fan of is on-call,” and that stress that, then— when that mom does go into labor on Tuesday— she’s sitting there completely stressed out about “The doctor I don’t like is on-call!”
Adriana: Yeah. And these are things that, then, when choosing a practice is important to consider— that you should feel comfortable with the possibility that any of these practitioners will be there for you.
Adriana: So, okay, now that we’ve kind of scared everyone… Let’s bring it back.
Robin: Well, the good news is, they have a lot of control over this. So it’s not something to be frightened about— it’s something to be informed about. And once you’re informed and you know what you’re looking for, then you can make active decisions to help you choose the practitioner that’s right for you. And by doing that, you can set that tone, as we talked about before. So the key is really going to be doing those interviews.
Now, ideally people would do these prior to getting pregnant, and that’s the hard part. But I will tell you it’s really hard to do this during an annual pap smear-type of visit! I encourage people to have these conversations with their clothes on, as opposed to sitting on paper napkins, dressed in paper gowns.
Robin: So this is something, that you wanna start talking to people, “Hey, talk to me about your birth. Okay, you had a great experience with Dr. X. Tell me what was great about it,” or “You had a negative experience?” like, “Tell me, what didn’t you like?” because just because somebody didn’t like it, doesn’t mean it’s not what you wouldn’t like. And I know that sounds a little bit backwards, but we have to remember that everybody may want something a little bit different.
And so it’s important to realize that those differences… There’s somebody for everyone. And one person’s ideal birth is another person’s nightmare, so to speak— but, y’know, asking those tough questions about, “Who are your backups?”
And the same goes for midwives, “Who are your backups?” and “Who will come with you?” in the case of a midwife, if you’re having a home birth, “Who else will you bring with you to my home? Who are your assistants or who are the other midwives who will come?”
Asking whether they recommend childbirth classes or the use of doulas, professional labor support. And I think those are red flags, that they tell you that you don’t need those, that they will take care of you, simply because a well-educated, well-supported mom, no matter what her choices are, is always going to be easier on a well-informed practitioner, because they’re not going to have to do the education for the person in the moment!
Adriana: And because the time they have with them is so limited, that there’s only so much education they can give them.
What it boils down to is you have to be able to trust this practitioner in the heat of the moment. When they say “Go!” you need to go. And if you don’t have that, if you can’t talk to this person about intimate details about your life, how are you going to be able to trust them with your care—
Robin: —in an emergency? And if you can’t even be honest with them about, y’know, how many times you eat ice cream or details of your sex life— I’m always asking women, “If you can’t have this conversation with your practitioner, how can you trust them, and how can they trust you?” And it’s gotta be that two way street.
Adriana: That’s a great consideration. So let’s say they’ve taken their early pregnancy class, they’ve read about pregnancy and childbirth, and have decided to interview a few practitioners and have an idea of what they want. What are some of those good questions they ask to figure out who’s the best fit for them?
Robin: Well, I think some of the questions that they need to ask are what I call “business questions.” So for example, “Do you take my insurance? If not, talk to me about billing.” “What types of prenatal testing do you do?” “What are your office hours?” things of that nature, because that will matter if you have a job where you absolutely need somebody who has evening hours, you’re not going to be able to go to somebody who doesn’t have evening hours without some special consideration. So you certainly have to ask those questions.
But after that, you want to ask questions that get to the heart of your relationship. So, “What are the requirements that you have of me when I’m pregnant?” Asking them straight up, y’know, “What will you provide me while I’m pregnant?”
Then asking them some questions that are more statistically-based— so, for example, one of the really important questions that a lot of moms wanna know is what is somebody’s cesarean rate, but that’s a little bit of a tricky number. So I encourage people to ask their practitioners instead, what is their primary cesarean rate? And the primary cesarean rate is the number of first-time cesareans that are done, because that number is going to be a little bit more accurate in terms of what your risk as a first-time mother is, of having a cesarean.
If you just ask what a cesarean rate is, that is going to include people who are having their second or third cesarean, that maybe have opted not to have a vaginal birth after cesarean. And so that might falsely inflate that rate. I always encourage people, whether they seem interested or not in having an unmedicated birth, to ask the provider, what percentage of people have an unmedicated birth in their practice?
And the reason I do that is because how you feel at five or six weeks or eight weeks pregnant might be vastly different than how you feel at 34 or 36 weeks pregnant. And you may change your mind and decide that what you wanted at four or six weeks is very different later in pregnancy. And so you need a practitioner who can support you in either direction.
Robin: There’s a difference between being tolerant and being supportive, and that number may help you decide whether that person falls into the “tolerant” category or the “supportive” category.
Adriana: Absolutely. Now that’s a great point. And it goes back to you being able to click with your provider, having that trust, y’know, it’s how they make you feel as well.
Robin: Exactly. Also, you need to ask your provider where they provide services. Many times you will have a choice between one or two hospitals, and if you have more of a choice than that, it’s important that you actually go and choose not only your provider, but the places that they provide services, and take those tours and look around.
So I always encourage people to understand that the bedsheet they pull out in hospitals— that Laura Ashley or, y’know, some big fancy bedspreads, the only one they own— and you will not see it when you’re giving birth! Things look a little bit different on a tour than they do when you’re actually in labor. So, to keep that in mind.
Adriana: As a doula, I’m more familiar with the different hospital settings around. And I know, for example, the care or the path of your labor is gonna be different because one hospital has wireless monitoring (so, a telemetry unit) and you can even— if you were to have continuous fetal monitoring— you can walk around the halls, you can get in the tub with it. As opposed to the hospital that only has hooked-up units. So that means that you will be limited to walking and moving around the bed.
Adriana: It’s something as simple as that, is just the technology or the equipment that’s available, whether they have birth bars or squat bars or not will change what’s available, or… and an option for you during your labor…
Robin: I’ve even started telling my doula clients here locally, who do not have providers yet, that perhaps they should start by touring the facilities, find out what hospitals routinely do skin-to-skin immediately after birth, who has what rate of cesareans, who has what epidural rate, y’know, who has 24-hour OB anesthesia, who has tubs that you can labor in? How often are they used? Look around there.
And when you find a place that has a lot of options, typically the places that have a lot of options that are actively in-use— which is the key here— they’re going to have a list of physicians who are probably going to be more open to a variety of different types of birth than a place that doesn’t have as many options. So if a squat bar is what one hospital has and another hospital has squat bars, birth balls, peanut balls, and tubs that you can labor in, that second hospital is probably going to have practitioners who are more open to a variety of options. And so it’s almost the process in reverse!
And the same is true if you have an area where you have birth centers available, I encourage everybody to check out all of their options.
Here’s the thing: You look at something and you decide you don’t like it? Check it off your list. But the thing is, if you never look, then you have no idea. And you might say later, “I really wish I would’ve went to look at it,” whereas if you go and look, you’ve spent an hour and, if you choose it, wonderful, if you don’t, wonderful. You’ve checked it off your list.
Adriana: And it can help narrow down your choices, like you’re saying, by first checking off that, “Oh, this is not something I want,” but also, if you find a place that you like, then you can say, “Okay, now what is the list of providers that practice here?” And then those are the ones I’m trying to find one that fits me within that list and which is less than all the providers in my city.
Robin: Right. And the other thing is, if you hear a provider’s name who comes up a lot in a positive way, that’s a good indication that maybe that somebody and that in positive way… in a way that would be positive for you, y’know, in some type of positive criteria that you’ve set forth… that’s somebody that you probably want to give a little bit more of a look at.
The other thing I wanna tell people is that “You are also not married to this person.” It is very, very easy to leave your provider in terms of paperwork. Emotionally, it’s a little bit more difficult. A lot of people will say, “Well, I’ll just stick through it in this pregnancy.” And sometimes that’s really frustrating, because you know that another provider would have no problem doing exactly what they want and they just… that overcoming inertia, “Well, I already have the next appointment made…” The moms I’ve had who’ve switched providers, even as late as the 41st week of pregnancy, have all been very glad that they’ve changed providers— some have avoided unnecessary cesareans, some have just had more respectful care, but they have all been very, very grateful that they made that change.
Adriana: And it’s great to bring that up that it’s never too late to switch. And maybe that initial choice wasn’t the best fit or, or you didn’t think about it before then, but if you’re going to your practice and you start… I always talk about the red flags. If red flags start appearing during the prenatals, you can bet that red flags, y’know, something won’t be as fun and great during the birth, to listen to that intuition.
Robin: And that’s an important thing, is that your insurance is used to people switching providers. And when you ask for a copy of your medical records, I encourage people to send a letter explaining to the practice why they’ve left. Many people are worried that the old practitioner will somehow have their feelings hurt. I usually do not find that to be the case. Most of the time, people tell me that they don’t think the other practitioner even noticed that they were gone and that further solidified their need to move. I’ve had people say, “You know, I felt like my practitioner couldn’t remember my name, called me by a diminutive form of my name every time they walked in the room, even though I corrected them every time. I said, ‘You know, no, that’s not my name. This is my name.'”
Adriana: Right? So yeah, that doesn’t feel good.
Robin: Right? Or having to remind them, “No, remember… I’ve got such and such going on,” that’s not part and parcel of me. So just finding practitioners who are supportive of you as a person and make you feel that connection, it’s an important part of it— that’s the “touchy-feely” part. That’s a little bit harder. You can’t say, “Well, ask these five questions and it will tell you whether or not you have a good match.” Some of it is just strictly intuition and that can be a hard thing to put your finger on.
Adriana: That’s why those red flags are so important, ’cause if you’re feeling uncomfortable, then your body’s telling you, “Please, let’s get outta here, please. Let’s switch you.”
Robin: Right. I mean, if your practitioner is early on saying, “Well, we may have to induce you,” there are very few things you would know at 10 or 15 weeks gestation that would indicate you would need to be induced.
I remember at one point I actually was seeing a practitioner for one of my own pregnancies, and I made an appointment to come back the following week for my prenatal appointment. And it was my 20th week visit and the woman said, “Wow, we never see anyone here who’s 40 weeks pregnant!”
Robin: I just… I didn’t know what to say. I was like, “Uh, okay,” like, that’s really interesting. Like, what does this say? Like, I don’t… y’know, I just remember being really speechless and I think I finally mustered something like, “That’s a shame,” but, y’know… I mean, I was an office celebrity for, y’know, hitting 41 weeks and still being pregnant!
Adriana: That tells you so much about the practice and it’s more of—
Robin: It really does.
Adriana: Yeah, it’s reading between the lines. It’s not what they say, but how they say it, and what it implies. It’s harder. It’s such a hard decision when you’re—
Robin: Well, and I think it’s… Yeah, and I think it really boils down to what is your practitioner’s philosophy of birth and pregnancy? Do they see it as a medical emergency waiting to happen, or do they see it as you’re a normal, healthy person going through a normal, healthy process and they’re just the lifeguard? Y’know, they’re just sitting there, kind of watching and monitoring you and pretty much hands-off, letting the process go and making sure that you’re staying within safe boundaries.
I had a client the other day who was telling me that her practitioner had told her— prior to her even getting pregnant— that she probably, y’know, would have a miscarriage right away.
Robin: And I said, “Oh, like, that sounds really serious. Like, what’s going on, that she would say that?” She said, “I asked her that and she said, ‘Oh, it’s just a feeling I have.'”
Robin: And I said, “Well, how did that make you feel?” And she said, “Kind of scared.” And I said, “You know…” and after she had been pregnant and we talked a little bit more, she had said, “You know, I’m so glad I…”— she made the decision on her own to leave that practitioner— and said, “You know, I’m so glad I left them, because if they scared me before I was pregnant, y’know, what would they do to me while I was pregnant?”
Adriana: Exactly. And the thing is, like, for some of them, they do this in-and-out, and it depends again what they’re feeling about birth. So if they’re just, that’s what they do and that’s what they do. But anecdotally and research tells us people remember their birth stories almost forever. You carry that—
Robin: Oh, yeah.
Adriana: It’s so important.
Robin: Very important.
Adriana: So, like you were mentioning before, of thinking, “I’m not gonna switch because, ‘Oh, I’ll… I’m already here. Next pregnancy…” but this pregnancy is just as important and you will carry this experience and it will affect how you mother and how you even… how you feel about the “next” pregnancy.
Robin: Absolutely. And y’know, one of the things that you can use as a guide when you’re asking practitioners about their philosophy and about what they do, Lamaze has something called the “Six Healthy Birth Practices” that you can find at lamaze.org. And there’s six things that are evidence-based. So they show you, if you follow these six guidelines, then you will have the healthiest, safest birth possible. And just asking your practitioner, y’know, “Do you do these things?”
For example, #1 is “Let labor begin on its own.” “How often do people in your practice require an induction of labor?” Y’know, asking them: “Do you have people who make 40-week appointments or is that the rarity?” Y’know, that “Six Healthy Birth Practices,” keeping mom and baby together… “How often do babies go straight to mom and lay skin-to-skin after birth in your practice? Is that commonplace?”
Adriana: Would you mind going through the six care practices?
Robin: No, no, not at all. So again, the first one is “Let labor begin on its own,” which is talking about the induction rates. You know, labor is healthier when it starts on its own. You don’t need to have an induction for the vast majority of healthy people.
The second healthy birth practice is to “Walk,” move around and change positions throughout your labor. Just using that process of movement, to speed labor, to help comfort mom, and to help that baby move down.
The third practice is to “Bring a loved one friend or doula for continuous support.” We know that there’s nothing like having that continuous emotional and informational support when a person is in labor.
The fourth practice is “Avoiding interventions that are not medically-necessary”— and notice it doesn’t say “Avoiding interventions,” it says avoiding ones that aren’t medically-necessary. So asking your practitioner, “You’re saying that you wanna break my water, but is that because you break everybody’s water at this point, or is there a specific need for me and my baby?”
So just avoiding ones that aren’t medically-necessary for you, and then “Avoid giving birth on your back,” and “Follow your body’s natural instinct to push,” would be the fifth birth practice— so using upright positions, using gravity to help progress that second stage, that pushing phase of labor and to allow mom to push as her body urges her to do so (as opposed to what we see on TV, the “hold your breath and purple push, count to 10, a lot of cheerleading going on”).
And then the six practice is “Keeping mom and baby together after the birth,” skin-to-skin, to promote bonding and breastfeeding.
Adriana: Thank you. And having those practices in mind, can also help those people that, just because of where they live, are not gonna have necessarily all the greatest choices. There might not be a birth center in their area, even though they would love a birth center. The hospital that they need to go to may, y’know, have a laborist model and a hospitalist model and that’s what’s gonna happen. So looking at the care practices in light of what those choices might be, can help in the case of say, for example, a hospitalist, having a doula or having a continuous support person or very encouraging support team can be more important for that.
Robin: And it just helps spark questions when you look at them that way. So for example, if you’re talking about using upright positioning to give birth, “Well, do you have a squat bar? How will you help me be upright? Do your beds move? What positions do people give birth in, in your practice or in this facility?” So I find that there are six really simple things that help moms spark their own questions.
Adriana: Are there any other questions that people should keep in mind to ask that we’ve left out?
Robin: I mean, there are lists and lists of questions that you can look at. I think it’s more about having the conversation and getting that gut feel. I think every mom will have a couple of questions that are really important to her. And I think that’s more important than even going in with a list of, y’know, 50 questions.
I encourage people to look at the list of questions when you’re thinking about what to ask your practitioner and then, looking through the list and thinking, “Which of these are most important to me?” and then asking those questions.
Adriana: Yes. And then that will certainly help them get on their way to get the provider that’s right for them, because they’re starting from their uniqueness and their unique wishes for birth, because every single birth is so different.
Robin: Right. It really is. And everybody, y’know, basically you have to be able to call this person in the middle of the night and ask them really, really, sensitive questions. You might be leaking fluids outta parts of your body you don’t like to discuss with strangers, y’know! You need to feel comfortable doing that. If you’re hesitant to call somebody because you don’t wanna bother them, y’know— which to me says, “There’s something going on in that relationship”— then that’s probably not the practitioner for you.
Adriana: Thank you so, so much for being here on this show today, it’s been a pleasure!
Robin: Thank you for having me.
Lozada: That was the amazing Robin Elise Weiss, who is a birth doula, doula trainer, and certified childbirth educator as well as the author of 14 books and thousands of articles published on the web and in magazines. Robin has been supporting birthing families since 1988, and you can find her on Instagram at @robineliseweiss
You can also find us there @birthfulpodcast.
In fact, if you are not driving, it would be so lovely if you would take a screenshot of this episode and post it to Instagram sharing what your biggest takeaway was from the episode. Maybe it was learning about the hospitalist or laborist model. Make sure to tag @birthfulpodcast and @robineliseweiss so we can see it and amplify it.
You can find the in-depth show notes and transcript of this episode at birthful.com, where you can also learn more about my birth and postpartum preparation classes and download your free postpartum preparation plan.
Birthful is created and produced by me, Adriana Lozada, with production assistance from Aysia Platte.
Thank you so much for listening to and sharing Birthful. Be sure to follow us on Goodpods, Spotify, Apple Podcasts, Amazon Music, and everywhere you listen.
Come back for more ways to inform your intuition..
Lozada, Adriana, host. “Why Choosing The Right Care Provider Is Crucial For Your Pregnancy.” Birthful, Birthful. September 7, 2022. Birthful.com.
About Robin Elise Weiss
While many things have changed since Robin Elise Weiss PhD, MPH, CLC, AdvCD(DONA), LCCE, FACCE began birth work in 1988 (including the invention of the internet), one thing has remained the same— Robin’s commitment to support and mentor new birth professionals has remained strong.
Guided by both her personal experience of raising eight children and her successful professional and academic experiences that include a PhD in Public Health, Robin is uniquely qualified to support folks as they grow their businesses and gain the confidence and skills they need to be successful perinatal professionals through her work at 100% Doula Business Foundations and her podcast at The Birth Geeks.
Robin is also an author, an amazing and dynamic trainer of both doulas and educators, and a recognized leader in maternal-infant care. Robin has served and continues to serve in leadership roles in perinatal organizations locally and on the international level.
Robin brings over 30 years of relevant experience that is directly applicable to people new to the perinatal field. Her friends describe her as smart, funny, and the person to go to when a real, viable solution is needed because Robin makes things happen.
To learn more about Robin, please read her full bio on her website.
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