Questions to Ask Providers

Scroll down to read questions to ask providers

~ ~ ~

Obstetrician (OB/GYN) or Hospital-Based Certified Nurse Midwife (CNM)

General Information and Philosophy

  • What is your training and how many births have you attended?
  • What is your general philosophy concerning pregnancy and birth?
  • What sources of pregnancy and childbirth information do you recommend?
  • What is the length of your prenatal appointments?
  • How do I contact you between visits if I have any concerns?
  • Do you return calls, or does a nurse?
  • How many patients do you deliver per month?
  • What percentage of your patients do you actually deliver? If you’re not on call, or busy with another birth, who will deliver my baby?
  • Will I be seen before the birth by every practitioner with whom you rotate?
  • Will other practitioners respect the agreements that are made between you and me?
  • How much time do you spend with a woman in labor and delivery and during pushing?
  • How do I contact you when I am in labor?
  • When would you like me to come to the hospital once I’m in labor?
    Once my water breaks  OR
    When contractions are ______ minutes apart,
    _______ minutes long
    Other reasons or signs ____________________________________
  • How do you regard written birthing plans? Are they respected?
  • What percentage of your patients have hired a doula? What do you think of working with them? Who have you worked with as a doula? Can you recommend one in particular?
  • How do you feel about having my doula, if qualified to do so, check my cervix (with sterile gloves, as long as membranes are not ruptured) and fetal heart rate with doppler or fetoscope, and stay with me at home, coming to the hospital once I’m in active labor (5-8 cms dilated)? What about if I am a VBAC?
  • Do you think childbirth preparation classes are valuable? Who do you recommend? Why?
  • Do you have different recommendations for women who want fewer interventions and fewer or no medications?
  • How soon after I start labor will you come to see me?
  • Am I allowed to touch my perineal area during birth?
  • Do you allow showering and/or bathing during labor?
  • Can I use a warm bath for pain relief in labor, even if my water has broken?
  • What are your policies and feelings about water births?
  • Can my partner and/or doula be with me at all times, including in the operating room, if I have a cesarean?
  • How many other people can I have with me at all times? (a doula, partner, friend, etc).
  • Can I have my children with me during birth?
  • Do you allow food and drink during labor?
  • Do you encourage women in labor to walk, squat, or be in positions they find helpful during labor?
  • Do you have a set position you want me to birth my baby in?
  • Do I have a choice of positions? What laboring positions are recommended?
  • Is my partner allowed to catch the baby?

About Vaginal and Cesarean Births

  • What is the doctor’s cesarean rate? (World Health Organization recommends a cesarean rate no greater than 10-15%)
  • What is the cesarean rate of your colleagues with whom you share on-call responsibilities?
  • For what reasons do you perform cesarean sections?
  • Do you do vaginal breech births?
  • Do you encourage and attempt external version (manually turning a breech before birth)?
  • Do you encourage VBAC (vaginal birth after cesarean)?
  • How often do you deliver VBACs?

About Testing, Medications, and Other Interventions and Procedures

  • What routine prenatal tests do you require or recommend?  What is each one for?
  • What is your protocol if pregnancy goes past the due date? At what point do you insist upon induction?
  • How long do you allow women to labor before starting interventions?
  • Do you require IVs during labor?
  • What is your recommendation for the use of the EFM (fetal monitor)? Continuous? Can Doppler be used instead?  (This allows the mother to move around, which aids the progression of labor and allows unmedicated mothers find comfortable positions.)
  • How often do you do vaginal exams during labor?
  • Do you do episiotomies?
  • On what percentage of women do you perform episiotomies?
  • When and why do you perform episiotomies?
  • Do you ever use warm compresses or perineal massage instead of/prior to episiotomies?
  • What do you recommend to help me avoid an episiotomy?
  • What percentage of mothers go without pain medications?
  • What percentage of mothers have epidurals?
  • Can my partner and/or doula be present during the administration of epidural anesthesia or other medications?
  • In what percentage of mothers is Pitocin used to help expel the placenta?
  • What percentage of mothers have manual help delivering the placenta?
  • How do you handle a long labor?
  • When can I have an epidural (if needed/wanted)?
  • If I use epidural anesthesia, is it allowed to wear off for pushing?
  • If I choose to use narcotic pain relief, what would you prescribe?
  • If my labor is induced, what are your policies on Electronic Fetal Monitoring, walking around, shower/bath, bed confinement, and eating and drinking?
  • What is your policy when labor ‘stalls’?  Are there time limits to how long I can be in labor?
  • What do you do when dilation is slow?
  • On what percentage of women do you use vacuum extraction or forceps? Under what conditions?
  • How do you handle premature rupture of the membranes? (PROM)
  • What is your policy concerning artificially rupturing or stripping membranes?
  • How often is stripping of membranes used to help start labor?
  • Is it done with the mother’s knowledge and consent?
  • What percentage of mothers have their water broken artificially?
  • What is your policy concerning interventions after my water breaks?
  • Do you encourage the mother to push whether or not the urge is felt?

About Mother and Baby After the Birth

  • What happens to the baby immediately after birth? How long do you wait to cut the cord and deliver the placenta?
  • Do you allow the partner to cut the cord if that is requested?
  • Can I breastfeed immediately after birth?
  • If the baby needs the immediate care of a pediatrician, how is this handled?
  • How soon after birth can/must I leave the facility?
  • What percentage of babies have suction used to clear airways?
  • How often and under what circumstances are warmers used?
  • Do you allow the vernix to be rubbed in rather than washed off?
  • Can the family be allowed some bonding time before routine exams are given?
  • Can examination of the baby be done while being held by the parents?
  • Is weighing done in the room?
  • What is used and when is eye care done?  Can it be delayed or avoided?
  • What is your view of breastfeeding?
  • Do you encourage women to breastfeed?
  • How do you recommend mothers get breastfeeding help, if needed, once the baby is born?
  • What is your view on circumcision?
  • When, why, and on what percentage of boys do you do circumcision?
  • Do you use anesthesia for circumcision?
  • How soon after going home, and how often thereafter, do you see the mother and baby?

 


Hospitals

  • What’s the nurse/patient ratio? (American College of Obstetrics and Gynecology guidelines are 1 to 2 in labor and 1 to 1 in pushing).
  • Do women labor and deliver in the same room?
  • What are the features of the birthing room? (dim lights, CD player, birthing tub, etc.)
  • Is waterbirth an option?  What about laboring in the tub or shower?
  • Are partners and doulas welcome to remain during all procedures, including cesareans?
  • How many other people can I have with me at all times? (doula, friend, relative, etc).
  • Are siblings welcome at the birth and/or shortly thereafter?  Are there any restrictions on their visiting?
  • Are women allowed to eat and drink during labor?
  • May they bring their own food and beverages?
  • Are women allowed to move about during labor?
  • Are women allowed to choose to give birth in whatever position they find most comfortable? Does this include kneeling, being on hands and knees, and squatting?
  • What percentage of this hospital’s patients had a forceps delivery last year?
  • When a mother arrives in labor what standard procedures are done?
  • Does the hospital have a policy on required use of Electronic Fetal Monitoring during labor? If so, what is the required length of time? Can this be waived or reduced?
  • What is the cesarean section rate of this hospital?
  • What is the epidural rate?  How many women have a drug free birth?
  • What is the VBAC rate?
  • After birth, is immediate and unrestricted contact for mother and baby allowed, or is the baby required to go to the nursery for examination and/or observation?
  • Do you allow 24 hour rooming-in for the baby? For the partner?
  • If the baby requires special care can both parents visit the intensive care unit and touch and hold their baby? Can the mother breastfeed the baby in the intensive care unit?
  • What is the breastfeeding initiation rate at this hospital?
  • Are formula or other fluids (besides breast milk) routinely fed to infants?  What circumstances require it?
  • Is there breastfeeding support? Does this hospital have a lactation consultant on staff?  Is she certified?
  • Will I automatically get to meet with the lactation consultant?
  • Will I have access to her help if I give birth during the weekend?
  • What is the average length of stay for a vaginal birth? Cesarean birth?
  • What is the average cost for vaginal birth? Cesarean birth?
  • Is perineal massage and support practiced by the birth attendants (nurses and caregivers) here?
  • Can we take the placenta home?
  • Is video taping allowed?
  • What are hospital protocols for fetal distress?
  • How often do you use internal monitor? What circumstances require it?
  • Does this hospital do fetal scalp ph sampling to confirm fetal distress?
  • What is your policy on the IV? Can a Heparin Lock be substituted for the IV? What about if I am planning a VBAC? Can I eat in early labor and drink throughout?

Midwife (Home Birth)

  • What is your background, training, and experience?
  • How many births have you attended as the primary caregiver since the completion of your training?
  • Why did you become a midwife? Do you encourage family/father participation?
  • What are your expectations of me regarding self-care in pregnancy?
  • Do you use a beeper? Are you on call 24 hours a day?
  • Do you have a limit on the number of births you attend per month?
  • What is your fee and what services does it include? Which fees are separate (ask about prenatal care, lab work, newborn assessment, breastfeeding support, postpartum care, and birth control counseling)? What about payment plans?
  • Do you accept reimbursements from insurance companies? Which ones?
  • What other costs might I encounter? (Note: In the case of transport to the hospital, physician and hospital fees will ordinarily be additional.)
  • What would happen if you had two births occur at once?
  • Do you work with a partner or assistants?
  • When do you come to my home?
  • What do you bring to the birth?
  • How do you handle complications?
  • Do you offer water births?
  • Do you provide postpartum visits in the early days after birth? How many? How long do you provide postpartum care?
  • What equipment do you normally use at births? What medications and equipment do you have for emergencies?
  • Are you certified in CPR? What complications have you seen and handled? How would you handle complications such as hemorrhage, cord around the baby’s neck, baby not breathing spontaneously?
  • Do you have adequate medical backup? Do you rely on a particular doctor or hospital? Can I choose my own physician? Do I need to see him/her prenatally? What situations do you consult him/her for?
  • What is your rate of transport to the hospital?
  • What medical complications require transport to the hospital? Will you be able to continue labor support should I need to go to the hospital?
  • Do you do vaginal birth after cesarean at home? If so, what is your outcome ratio?
  • What complications have you handled? How did you handle them?
  • What emergency equipment and medicinals do you bring?
  • When will you come during labor? What happens if my labor goes on for days? What happens if it’s so fast you miss the birth?
  • Have you ever missed a birth? Why?
  • How and where do I get my lab work done? What routine prenatal tests do you require or recommend?
  • Where do you conduct prenatal examinations?
  • How long do you give each woman during a prenatal visit? What is discussed? What is done?
  • Do you do a postpartum home visit? When?
  • What pharmaceutical drugs, homeopathics and/or herbs do you use prenatally and at births?
  • Do you use a doppler or a fetoscope? Why and when?
  • What is your Cesearean rate? What are the most common reasons?

Childbirth Educator

  • Are you certified or affiliated with any organization?
  • Are you sponsored by a hospital or other business or are you independent?
  • How many classes are there in a series?
  • May I visit a class before I decide?
  • How long is each class?
  • How many couples are in each class?
  • Can you bring more than one support person or come alone?
  • What type of learning techniques are used?
  • What topics are covered?
  • Can the instructor provide references?
  • Where are the classes held?
  • What do I need to bring?
  • What is the cost for classes? Do you provide a sliding scale or help file insurance?
  • What do you think is the most important part of your job?
  • What do you feel are the main skills or abilities I need for my birth?
  • What do you think the father’s role should be during labor?
  • What books do you recommend to new parents?
  • What are your values regarding pregnancy and birth?
  • How do you feel about breastfeeding? Circumcision? Other important concerns?
  • Do you encourage a non-threatening environment that allows honest discussion of feelings and attitudes toward pregnancy and childbirth?
  • What are your credentials?
  • Observe:  Does the instructor appear to be well informed?
  • Observe:  Does the instructor appear to be well prepared to deliver the information?
  • Does the course cover each of the following topics?
    — Overview of the stages of pregnancy (physical and psychological aspects)
    — Diet and nutritional information
    — Exercise including pelvic floor exercises
    — A tour of the hospital (if appropriate)
    — Overview of typical labor and birth
    — Instruction and practice in non-medical coping techniques (breathing, relaxation, visualization, etc.) for labor and birth
    — Preparation for the partner and/or children who will be present for the labor and birth
    — Information about variations and complications during labor and birth
    — Information about possible medical interventions and options during labor and birth
    — Information about breastfeeding and preparation for breastfeeding during pregnancy
    — Newborn care, postpartum recovery

Birth Doula

  • What do you think is the most important part of your job?
  • What are the main skills or abilities you bring to the birth?
  • What do you think the father’s role should be during labor?
  • How do the doctor and the nurses usually react to your presence?
  • How do you handle a conflict with the medical team?
  • How do you feel about my doctor and my hospital?
  • Are clinical skills a part of your role?
  • Are you available around my due date (from 37-42 weeks)?
  • Are there any limitations to your availability?
  • How long does it take you to get to me?
  • Will you come to my home if I am in pain but not ready to go to the hospital yet?
  • How many clients do you take in a month?
  • What is your back-up situation?
  • What is your fee, and what does it include?
  • What are your standard payment arrangements?
  • Where did you get your training, and how many hours did it involve?
  • Are you certified? By whom? May I contact that organization to confirm your certification?
  • How long have you been practicing?
  • How many births have you attended as a doula?
  • Do you have any additional training or licensing that you use in your practice?
  • Are there two of your clients whom I may call as references?

Pediatrician

  • Can I refuse to send my healthy baby to the nursery for initial care?
  • Do you recommend prophylactic eye treatment, and why?
  • Do you recommend a Vitamin K shot or oral does, and why?
  • Do you recommend the PKU test, and why?
  • Under what circumstances would you recommend feeding my baby formula
    — During first 24 hours?
    — During first week?
    — During first month?
  • Under what circumstances would my baby need IV antibiotics or a spinal tap?
  • Under what circumstances would we need to test my baby’s blood glucose level?
  • How would we treat jaundice?
  • Can you refer me to a lactation consultant if necessary?
  • How do you feel about circumcision?
  • Do you recommend the Centers for Disease Control and Prevention immunization schedule?  Are you willing to work with a family choosing to delay or forgo all or some vaccinations?

 


Notes: These questions were compiled from the following sources:
http://www.mother-care.ca/questions.htm
http://www.socalbirth.org/resource/question.htm
http://www.childbirth.org/articles/questions.html
http://www.estronaut.com/a/midwife_list.htm

 

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s