At my first ICAN meeting the topic was interviewing health care providers. I personally had never interviewed a health care provider, or knew anyone who had, and so it made me a little nervous. Me asking the wise and all knowing doctors questions before I hire them? Do they even let you do that?
Gulp.
Now that I have experience interviewing health care providers, I understand why it is so important. I think that it is essential not only for vbac moms, but any mom who is wanting to find the right match for their pregnancy and delivery. In addition to interviewing, talking to moms and or doulas who have had experiences with the doctor/midwife can also be helpful.
With a vbac things can become more complicated with finding the right provider. Unfortunately many are limited by the medical community. In Arizona there are vbac bans at certain hospitals, a lot of doctors who don’t offer vbac, and laws prohibiting midwives from assisting in a home birth after cesarean. With the c-section rate at about 30%, and the vbac rate at about 8%, you really want to do your research to make sure you are finding someone who is going to be on your side come delivery day. There are a lot of questions to potentially ask a health care provider, and it is important to ask about the things that are most important to you.
Some of your questions/discussions might include:
-their c-section rate
-whether they do vbacs or not/if so how many do they have in a month/how many are successful?
-their protocol for going post dates(past 40wks)
-their protocol on ruptured membranes (when your water breaks) past 24 hours
-their protocol on induction/induction rate, and what they feel are reasons to induce
-how often they are on call/any scheduled vacations
-who the providers are that take over when they are not on call/what are their practices?
-their episiotomy rate
-their protocol on cord cutting, and thoughts on delayed cord cutting
-what positions they will “catch” a baby in (do you have to deliver flat on your back in bed?)
– their vbac rate
-what their orders will be like in the hospital (monitoring/IV/eating/drinking/movement/pain management options)
-what kind of support they can offer to prevent tearing
– with a vbac/vaginal/c-section delivery, ideally how would they like things to go?
and the list could go on and on…
I was also taught that the best way to get a good answer is to pose an open ended question that will allow that doctor or midwife to do a lot of talking. If your questions give obvious clues as to what you are looking for, it could easily sway their answers to something that might not be completely true.
So instead of saying:
” I REALLY don’t want an episiotomy, would I have to have one?”
you could ask:
“In what situations would you find it necessary to perform an episiotomy/ how often do you perform episiotomies?”
to get a better idea of what to expect
When I was interviewing, I also paid a lot of attention to their tone of voice and general presence. If they wouldn’t even take the time to let me interview them via phone or in person, they weren’t worth my time and money. On the opposite end, if they were welcoming and willing to answer all of my questions, it told me a lot about them.
Another important thing is not to make assumptions before interviewing the provider. For example, assuming that because they are a midwife they will not try to use a lot of interventions during labor and will automatically follow through with your birth plans. Or that because your best friend loved this doctor, that you will love them too.
Going from hiring my last provider just based on my insurance coverage, and a tip from a charge nurse, to hiring a provider based on a personal interview and lots of referrals has made me feel so much more confident that I will actually get the support I need.