What Is Your Careprovider REALLY Saying?

Sometimes it’s easy to spot the caregiver that doesn’t have your best interests at heart. Sometimes it’s easy to recognize someone who wants to coerce, sell you their philosophy or otherwise convince you of their choices. We’ve put together some real statements made by real careproviders in our presence or related to us by mothers returning to share their birth stories with newly-expecting mothers. In America the majority of births take place in hospitals with obstetricians so it's possible to feel that these are most common among obstetricians. The truth is you may hear these responses with any type of careprovider. Always do your homework and interview your careproviders with new questions as they come to you throughout your care.

As a mother’s birth support partners are also advocates, speaking for her as she gives herself over to her labor. You can practice this role now by going to prenatal appointments with her, completing various birth location tours with her and knowing why she’s identified the final birth place of her choosing. Help her ask the questions she wants to ask, ask your own questions and pay attention to the answers you’re both getting. Do they make sense to both of you? Can you explain the answers back to the careprovider? Do you foresee problems with the answers or do you foresee support in the answers? Will you be able to ask and answer questions confidently for her, for your child, and be able to support her choice if you’re faced with a provider’s advice that flies in the face of what she wants?  Incidentally, the aspects of questionable care below aren't restricted to birth care.  You wouldn't want to receive these responses about any health care you've hired.  Birth care isn't special in requiring self-advocacy.  All health fields demand humane and respectful treatment of the people being served.

Brushing your thoughts aside.
“Don’t worry about a thing; just leave everything to me.” “I’ve seen the research. In my practice we are very careful how we use (technology/drugs/etc.)” Careful isn’t an answer. Is your careprovider comfortable then in providing you with the research he/she read AND telling you how procedures are practiced, taught and ever modified in their practice?

Instilling fear as fact.  
"Well, if you don’t care what happens to the baby...” “If you don’t do this your baby could die.” “You can choose that if you’re going to take all of the responsibility for the risks and sign this waiver.” “I’ve seen the research on birth in third world countries where they don’t have access to the help you have here.” Making your own choices doesn’t absolve the careprovider of their responsibility to you: providing healthcare. The beauty of choice is that: choice. You can have a safe, healthy and enjoyable birth without technology. The research tells us that what is safest for mom and baby also contributes to having an enjoyable and happy birth experience.

Hostility. 
“I know there are a lot of ways to birth but my motto is, ‘My way is the best way.’” “I know you don’t agree with anything I have to say..(complete with a rolling of the eyes)” If you have a careprovider skilled in the normal, natural, organic process of birth then they won’t be reaching for interventions first and be angry with you for asking questions. If they don’t trust the natural birth process then why believe you can convince them of your views in the thick of labor?

Mixed signals. 
Your pregnancy and labor are humming along normal and things could go either way. “We want you to go into labor on your own but we’ll induce if you don’t go into labor by your due date.” Humans like to be in control of their lives…doctors especially are trained to always be in control of their medical situations. Birth does not start as a medical situation but it becomes one once interventions are begun (such as an induction) or should several indications occur together to foresee a medical situation (ineffective routine procedures often prompt additional medical interventions and can lead to unnecessary cesareans). 

Vague answers. 
If your careprovider says every labor is a case-by-case give him specific cases! Ask what do you consider to be a ‘slow’ labor? When would you advise an episiotomy? It is also bad when the caregiver says you can do anything you want during labor and won’t specify specific situations that lead to denying you your options.

Attempts to define your partner as friend or foe. 
Does your careprovider address your partner and ignore you? It can be a hypnotic lure to caring, inexperienced and otherwise unprepared partners who want the wrong ‘someone’ to help them help you. On the other hand treating your partner like a nuisance to be dealt with isn’t a good sign either.

Belittling your ability to participate in decisions about your care.
“You’ve been reading those women’s magazines and internet sites.” “You want a natural childbirth? Natural?” A careprovider skilled in addressing concerns as required for you to give informed consent wouldn’t respond in an act/react basis.



Learn more about “red flag responses” in The Thinking Woman’s Guide To A Better Birth by Henci Goer © 2005 Independent Childbirth.  Permission to reprint hereby given by Independent Childbirth and Henci Goer with all text intact and unmodified.