One of the best ways to find out how your doctor or midwife practices is to ask them questions. But it matters what questions you ask and how you ask them.
To get the best information, it’s good to avoid asking yes or no questions. They don’t invite the provider to elaborate on how they handle different situations or how they really feel about certain practices. It can also be helpful if you try not to hint at your desired outcome when you ask the question. After all, we’re all prone to try to please people, and doctors and midwives are no exception. But what you want is the lowdown on how provider really thinks and practices, not just a smoothed over answer that gives you what you want to hear.
The most important tip I can give you when you ask questions of your midwife or doctor is to avoid asking in a way that gives away your authority. In other words, it can be helpful if you try to avoid asking permission with questions like ,”Is it ok if I…” “Will you let me…” “Am I allowed to…” This signals you and your provider that they are the one in charge of making decisions. But the person who is ethically and legally in the driver’s seat is YOU.
So here are some questions that you may want to ask your doctor or midwife early on in your pregnancy, so that you have time to think about what you want to do if you find that the two of you aren’t a good fit.
Under what circumstances do you normally recommend an induction? It’s good to know ahead of time what your provider considers to be good reasons for an induction. Do they want to induce all their patients at 39 or 40 weeks? How flexible are they for parents looking to avoid an induction if possible?
When was the last time you performed an episiotomy? An episiotomy is a surgical cut made to the perineum during birth to enlarge the vaginal opening. It used to be a standard procedure, the idea being that a cut is easier to repair than a naturally-occurring tear. But research has demonstrated over time that birthing people who tear naturally heal better and have less pain than those who are cut. Some providers perform this procedure rarely or almost never, and some perform it regularly, yet both sets of practitioners are likely to say “only when needed,” if you ask them how often they do episiotomies. Asking the question “when was the last time” can give you a more precise idea of their actual practice.
How do you feel about people eating and drinking when they’re in labor? Evidence does not support withholding food and drink from laboring people, but it’s still a common practice in many hospitals. The idea is that if a woman needs an emergency cesarean under general anesthesia, it’s preferable for her to have an empty stomach to prevent aspiration. But the truth is that the need for general anesthesia during birth is very rare, and when it’s needed, the skill of the anesthesiologist matters more than the content of the patient’s stomach. I have seen mothers literally crying because they were so hungry after being deprived of food during a long labor. Labor is hard work, and the body needs fuel to get through it.
How do you feel about doulas? This is a good question to ask even if you don’t plan on hiring a doula. Doulas improve birth outcomes, and if your provider doesn’t like them, it’s good to find out why. It’s possible they’ve had a bad experience with a doula who behaved in an unprofessional manner at some time. But sometimes providers don’t like doulas because they view patients who ask questions about procedures and have opinions about their care to be “difficult.” It’s good to know ahead of time if your provider is open to shared decision making or if they prefer to be “captain of the ship.”
There are tons of other great questions you could ask, like “What’s your cesarean rate?” “How do you decide when a cesarean is needed?” “What does an induction normally look like for you?” “How often do you do skin-to-skin in the OR (or delayed cord clamping) for moms that need a cesarean?” and many more.
It may take a few visits to get all of these questions in, especially if you need to ask the same things of the other providers that share call with your doctor or midwife. After you’ve asked them and gotten some answers, you have to decide if your provider is actually a good fit for you and the kind of birth you want. In my next post, I’ll talk about what you can do if you decide that you and your provider are not a great match.
Did you find any particular questions helpful when getting to know your doctor or midwife? Share them below!
