Diana Korte, author of A Good Birth, A Safe Birth, said “If you don’t know your options you don’t have any.”
It is important to remember when choosing a care provider that not only do you have lots of options, but that you have the power to hire, fire, and change care providers anytime during your pregnancy and prenatal care.
Below are some generalizations on two very different ways of viewing pregnancy and birth-related care.
|Woman-Centered Philosophy||Provider-Centered Philosophy|
|Views the woman as a client and a partner; the care is holistic, taking into account physiological, emotional and social aspects of birth.||Views the woman as a patient that needs treatment and the providers expertise; the care is primarily based on the physical aspects of birth.|
|Is usually based on trust that birth is generally normal.||Is usually based on the fear that something will go wrong.|
|Assumes that childbirth is a normal, healthy, holistic process that usually happens safely and requires supporting the mother emotionally; medical interventions (drugs, technology, surgery) are rarely needed.||Assumes that childbirth is a dangerous physical event that usually requires medical management using drugs, technology, and active intervention to control the process and save or “deliver” the mother and baby.|
|The provider and the woman work together to do what is best for the woman and her baby.||The woman trusts the provider to do what is best for her and her baby.|
|Helps you “give birth” to your baby.||“Delivers” your baby.|
|The provider trusts the client to know her body’s capabilities and limitations.||The patient trusts a provider to know her body’s capabilities and limitations.|
|Respects and supports the woman’s philosophy on labor pain.||Views labor pain as something to be managed.|
|Uses words like “choose” and “the options are.”||Uses words like “allow” and “my provider won’t let me.”|
|Assumes pregnancy is normal and tests only when there is an indication to do so.||Routine tests are preformed to make sure nothing is wrong during pregnancy.|
|Is focused on maximizing health during pregnancy and birth.||Is focused on minimizing the risks during pregnancy and birth.|
|Expects that the provider will support the woman’s choices.||Expects that the woman will follow the provider’s philosophy.|
I use the below scale as an illustration in my classes for expectant parents to think about where their ideas and philosophies about birth fall.
Next, I ask that they think about where their current provider’s ideas and philosophies fall. Keep in mind that all midwives, obstetricians or family practice doctors may fall anywhere from one extreme to the other. I’ve met very mother-friendly OB’s as well as some very medicine-centered midwives, and vice-versa.
A very important set of questions to ask are, “How do my philosophies match-up with those of my care provider? How do they differ?” During birth, the last thing you want to be doing is advocating for your choices. It’s much easier to choose a provider that matches up with your ideas from the get-go.
When interviewing providers, make sure to ask open ended questions. Instead of asking, “what is your c-section rate?” Consider asking, “what are the reasons for the last few c-sections your clients have had?” Questions like the second will give you a much better idea of where the provider falls on the above scale.