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Questions to Ask Your Careprovider


First of all, I owe a huge thank you to everyone who sent me questions to ask one's doctor/midwife. I apologize if I don't give everyone due credit, but everyone who shared their thoughts is greatly appreciated. These questions were offered by women from different lists I'm on, some have been through pregnancy, labor and delivery before, and some are first-timers. I appreciated the input from Lorie F., who is herself a physician. I found myself thinking of even MORE questions as I read through these, and I'm sure you'll each think of your own as well. Robin has reviewed and added quetions for inclusion into the web page. Special thanks go to: Krista G., Lorie F., Nora F., Mary H., Lesley H., and Karen C.

Most practitioners have an informational pamphlet which may contain much of the information requested below. It is usually a good idea to ask the office to send you any new patient forms in addition to any information on the practitioner before your first appointment so you can make the most of your time there. Doctors and midwives are like everyone else, in that they will probably do most often what they are most accustomed to doing. You will probably get whatever s/he routinely recommends for all patients. If you have a chance, asking the nurses at the birth facility about your doctor/midwife will sometimes yield lots of helpful information about him/her.

I have divided the suggested questions into categories, so that you can ask questions that are most important and appropriate for you at the stage you are in. By asking a few questions at each visit, you get to know your physician/midwife better and continually build a positive working relationship with him/her. The balance between not being a passive patient and interrogating in such a way that might put a practitioner on the defensive is one you will have to find. It may be that early in your pregnancy you will be most concerned about the development of the baby and your health, while later on you will become more focused on labor and delivery issues. Some women have very strong feelings about how labor and delivery should go, and for them, asking those questions right away is best.

Included are excerpts from the book "A Good Birth, A Safe Birth" by Diana Korte and Roberta Scaer. These are called "10 Questions for Dr. Right" and "10 Questions for Hospitals". The book is published by Harvard Common Press, runs $12.95 paperback and is 360 pages. I have put an asterisk (*) by the questions directly quoted from that book.

Lastly, I tried to make the questions flow logically, but truly, they are in no particular order.

Gail & Robin


About You and Your Pregnancy:


*What is my due date?
*What is the size of my uterus?
*Is the placement of the sac where it should be?
*Are the symptoms I'm experiencing normal?
*Are the lack of symptoms I'm not experiencing anything to be concerned about?
*Does s/he have specific recommendations concerning weight gain, exercise and diet?
*What things should I avoid?
*What kinds of exercise are ok and which are possibly dangerous?
*Is sleeping on my back as bad as some books say?
*What are his/her thoughts on sex during pregnancy?
*How often will s/he see me during pregnancy?
*What does a typical prenatal office visit consist of? (urine sample, weighing in, listening to heartbeat, etc)
*How often does s/he do vaginal exams?
*What is his/her recommendation/practice for the use of ultrasound?*
*Does s/he offer alternatives to ultrasound? (e.g. fetoscope)*
*How often will an ultrasound be performed?
*Does s/he recommend certain pre-natal classes? Which ones?
*Is s/he open/supportive of me attending Lamaze, Bradley &/or others?
*Will s/he be in town around my due date?

About the Careprovider:


*How long has the doctor/midwife been in practice?
*When and where did s/he receive training?
*Does s/he have references?
*What sources of information does s/he recommend?
*What is his/her general philosophy concerning pregnancy and birth?
*Why did s/he decide to become a doctor/midwife?
*Does s/he have any children? How were they born?
*How many babies does s/he deliver per week/month/year?
*What percentage of his/her patients does s/he deliver him/herself?*
*What percentage of his/her patients start labor spontaneously?
*Which hospitals/birth centers does s/he have privledges at?
*Does s/he do homebirths?
*If a physicain, does s/he use a nurse practitioner for visits?
*Who does s/he share on-call duties with? What is the rotation schedule?
*How long have the others been in practice?
*Will I be seen by every practitioner with whom s/he rotates?
*Do I have a choice about who I see?
*Will other practitioners respect the agreements that are made between me and the dr/midwife?
*What are his/her guidelines for a "normal" vs. "high-risk" pregnancy?*
*What is his/her definition of a high-risk pregnancy?
*Does s/he return calls personally, or ask a nurse/receptionist to call me back?
*How does s/he feel about partners being involved at prenatal exams and during labor and birth?
*Is s/he open to me hiring a doula or monitrice (personal private duty nurse)?
*How does s/he regard written Birthing Plans? Are they respected?
*What is his/her policy on induction if I go beyond my due date?*
*How long beyond term, for what reasons and what percentage of women does s/he induce?*

About Testing:


*What routine tests does s/he require?
*What tests does s/he usually perform on a woman with my background (age, history of m/c, etc.)?
*Ask him/her to explain fully each test that will be performed (CVS, Alpha Fetal Protein, hCG, etc.).

About the Hospital/Birthing Center:


*Is there a facility you prefer? Why?
*When can I take a tour of the facility? (Doing so may answer most of these questions for you).
*When a mother arrives in labor what standard procedures are done?
*Is there a one-room option in which I can labor, give birth and recover?*
*Is this room always staffed?*
*What are the features of the birthing room? (dim lights, tape player, tv, etc.)
*What is the nurse to patient ratio? (according to ACOG, one nurse for two women in early labor, and then one to one for those in the pushing stage is ideal)*
*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?
*Do you have a squat bar or birthing chair?
*Do the beds break down?
*Are water births done at the facility?
*Is there access to a whirlpool/tub for those in labor?
*What percentage of mothers go without chemical pain relief?
*What is the hospital's cesarean rate?*
*What is the epidural rate?*
*Can my partner and/or doula be with me at all times, including in the operating room, if I have a c-section?*
*How many other people can I have with me at all times? (a doula, friend, relative, etc).*
*Will my baby be with me at all times while I'm in the facility?*
*Is video taping allowed?
*Is there a place for my partner to lay down or sleep somewhere during labor?
*Can my partner spend the night in my room if he wishes to (after the birth)?
*Is there a lactation consultant on staff?*
*Is she accredited?*
*Is she full time or part time?*
*Is she on call to be available for me, when I need her?
*Will I automatically get to meet with her? When?
*When can family and guests visit me?*
*Is there an age limit on visitors? Does that apply to my own children?
*Is there free parking?
*How soon after birth can/must I leave the facility?
*What is the average cost or vaginal birth? Cesarean birth?*

About Labor & Delivery:


*At what point in labor does s/he recommend coming to the birth center?
*Do you have different recommendations for women who want less interventions and fewer medications?
*How long does s/he allow women to labor before starting interventions?
*How soon after I start labor will the doctor/midwife come to see me?
*How much time will s/he spend with me when I'm in labor?*
*What is the dr's c-section rate? (suggested that dr's not limited to high risk pregnancies should not exceed 15%)*
*What is the c-section rate of his/her colleagues with whom he/she shares on-call responsibilities?
*For what reasons does s/he perform cesarean sections?
*Does s/he do vaginal breech births?
*Will s/he encourage and attempt external version (turning a breech before birth)?
*Does s/he encourage VBAC (vaginal birth after cesarean)?
*Does s/he require IVs during labor?
*What is his/her recommendation for the use of the EFM (fetal monitor)? Continuous? Can doppler be used instead?*
*How often does s/he do vaginal exams during labor?
*Does s/he do episiotomies?
*When, why and on what percentage of women?
*How often do your clients give birth with intact perimeums?
*Does s/he ever use warm compresses or perineal massage instead of/prior to episiotomies?
*What does s/he recommend to help me avoid an episiotomy?
*What percentage of mothers go without chemical pain relief?
*What percentage of his/her patients have epidurals?*
*Can my partner/doula be present during the amdinistration of epidural anesthesia?
*Other drugs?*
*What is his/her standard IV medication?
*What is his/her policy for using Pitocin in labor?
*When, why and on what percentage of women do you use it?
*In what percentage of mothers is pitocin used to help expell the placenta?
*What percentage of mothers have manual help delivering the placenta?
*Does s/he use pictocin routinely after birth?
*How does s/he handle a long labor?
*What is your policy when labor 'stalls', are there time limits?
*What does s/he do when dilation is slow?
*Does s/he use vacuum extraction or forceps? Under what conditions?
*On what percentage?
*How does s/he handle premature rupture of the membranes at term? (PROM)
*What is his/her policy concerning artificially rupturing or stripping membranes?
*How often is stripping of membranes used to help start labor? And is it done with the mother's knowledge and consent?
*What percentage of mothers have their water broken artifically?
*What is his/her policy concerning interventions after my water breaks?
*Do you encourage the mother to push whether or not the urge is felt?
*Am I allowed to touch my perinial area during birth?
*Does s/he allow showering and/or bathing during labor?
*Can I use a warm bath for pain relief in labor, even if my water has broken?
*How do you feel about water births?
*Is video taping allowed?
*Can my partner and/or doula be with me at all times, including in the operating room, if I have a c-section?*
*How many other people can I have with me at all times? (a doula, friend, relative, etc). *
*Can I have my well prepared and attended children with me during birth?
*Does s/he allow food and drink during labor?
*Does s/he encourage women in labor to walk, squat or be in positions they find helpful during labor?
*Does s/he have a set position they want me to birth my baby in?
*Do I have a choice of positions? What laboring positions are recommended?
*Is the partner allowed to catch the baby?
*What happens to the baby immediately after birth? How long does s/he wait to cut the cord and deliver the placenta?
*Does s/he 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?

About Baby After the Birth:


*What percentage of babies have suction used to clear airways?
*How often 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 baby be done while still held by parents?
*Is weighing done in the room?
*What is used and when is eye care done, can it be delayed?
*What is his/her view of breastfeeding?
*Does s/he encourage women to breastfeed?
*What is his/her view of circumcision?
*When, why and on what percentage of boys does s/he do circumcision?
*Does s/he use anesthesia for circumcision?
*Will s/he participate in religious rituals regarding circumcision?
*How soon after going home, and how often thereafter, does the dr. see the mother and baby?

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