One of the most important decisions you make when preparing for your birth is choosing a care provider who is genuinely supportive and has the necessary skills to help you achieve the birth experience you desire. This is equally true regardless of the birth you are planning. You don’t want someone who is inherently uneasy about your body’s abilities attending you in a physiologic (or “natural”) birth; just as you don’t want someone who has poor surgical outcomes performing your cesarean birth surgery.
The difficulty arises in that a birth plan is always subject to change, and half a million developments could come up that you may have never anticipated. I started my pregnancy with an OB I adored who often stated her support for the unmedicated birth I was aiming for. After agonizing debate, I chose at 20 weeks to transfer care to a group of midwives and an in-hospital birthing center. I knew if I really wanted to attempt to labor without an epidural, I needed to make an epidural more difficult to obtain than simply asking for one in my hospital room (not to mention, the birthing center was positively spa-esque and the midwives I met with made me feel so safe, secure, and valued). The point is, I loved my OB, I didn’t transfer care because of anything I disliked about her (well except for waiting terribly long at each appointment), but I found that there were actually better options with more to offer.
I made the choice to break up with my OB and continue with a care provider group I understood to be fully on board with my desired birth, rather than an OB who stated support, but was unlikely to even be on call when my time came. With my OB there were so many factors about my birth team that were impossible to plan for until the time came, and that made me increasingly uncomfortable as my baby and belly grew.
So I switched. My midwives were awesome – they offered a 6-week intensive “natural” birth class that built my confidence in my body, they made every appointment feel cozy, I rarely waited to see them at my appointments, and I never felt rushed in our meetings.
But even bigger than that, their birth philosophy supported my desires in ways I never even anticipated. My water broke unexpectedly in my 37th week of pregnancy with no signs of labor except that I was already dilated to 3cm and partially effaced (cervical thinning). But rather than admitting me and forcing labor with Pitocin that I was trying so hard to avoid, my midwife gave me some tips and safety guidelines and sent me home for a period to wait for labor to begin. Around 15 hours later, contractions rapidly started and brought about my son’s birthday party.
My point here is that in all of my preparation, I never thought to ask my OB what would happen if things developed outside of my plan (as they often do in birth!) – I didn’t know what she would recommend if my water broke without contractions, or if she was comfortable performing an external cephalic version if my baby was breech, or how patient she would be if my labor stalled, or if intermittent Doppler monitoring would be acceptable for my physiologic birth, or how long she considered “delayed” cord clamping to be (my son's cord pulsed foreverrrrr - time stamps on photos show us cutting the umbilical cord some 17 minutes after birth!), or half a dozen other scenarios.
It’s impossible to prepare for everything that birth can bring; therefore, it’s imperative that you are 100% comfortable with the judgment and birth philosophy of your care provider. And it is entirely ok to break up with your care provider at any point in pregnancy to transfer care to a more appropriate match for you! Your care provider works for you and should take very seriously the honor it is to be entrusted into your birth space.
Just because you’ve been seeing your provider since your 1st gynecologic visit as a teen, or every woman in your family goes to their office, or you even really like them, DOES NOT mean they are the childbirth care provider that is right for you. And it is ok to break up with them! There will be so many things about your birth that are out of your control, but your birth team is not one of those.
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