5 Things to think about before choosing an obstetrical provider.

Routine gynecological care can be just what it is. . . routine. But when the time comes to choose whose hands will be the first to caress your little infant child, the choice in provider becomes ever so much more important.  Luckily, in most locations in the United States, women have a choice.
First off, yes intuitive sense or the feeling you get is one of the best ways to size someone up.  There also are some other things to consider.

1) What is your provider/group's cesarean rate? 
The cesarean rate in the United States is 32% (NY Times article) and even higher is some states like New Jersey (38%) and Florida (37%).  The World Health Organization recommends a cesarean section rate of 15% and it's completely acceptable to expect your provider to have a cesarean section rate around 18-20%.  States like Alaska and Utah boast rates of 22%. 

2) What happens when your provider is unavailable, goes on vacation, is sick, or has a special event?
Most providers have a "back-up" physician or midwife that covers their patients and deliveries while they are away.  It is helpful to know who that person would be and to see if you are comfortable with that provider.  Some physicians don't routinely work weekends or certain days of the week like Mondays, so ask.

3) How far away from the hospital, birth center or your home does your provider live?
If your doctor lives 60 minutes away and your last labor was 1 hour, then you may want to consider someone else.

4) How does your provider/group feel about induction?
Induction is something that most women don't think will happen to them, until it does. Induction can increase a woman's likelihood of having a cesarean as well as increase her need for medication interventions. There are several reasons why a woman's labor may be induced: Postdates or 42 weeks; rupture of membranes without labor; convenience or size of the baby. It is helpful to know your providers stance on induction, induction rates and flexibility on induction policies.


5) How many deliveries does your provider do in a month/year?
This can be helpful to know so you can see how available they will be for you when you are in labor. If someone does 30 deliveries a month, practicing solo, they may very well have someone else in labor at the same time as you.

World Health Organization (WHO): 10 Facts On Midwifery

At the inception of this blog, I'm attempting to serve two purposes: 1) give midwives a voice as well as a stronger presence in the field of women's health and 2) attend to the needs of women.  I hope to abate the need to persistently explain the purpose and dire need for midwifery services.  Therefore, I'm dedicating a few of my first posts to doing just that. Justifying my cause.  See below:

Taken from http://www.who.int/en/

10 FACTS on Midwifery

Worldwide, approximately 350 000 women die every year due to pregnancy and childbirth related complications. Many maternal and newborn deaths can be prevented if competent midwives assist women before, during and after childbirth and are able to refer them to emergency obstetric care when severe complications arise. Most of these largely preventable deaths occur in low-income countries and in poor and rural areas.

#1  Competent midwives decrease the risk of dying during childbirth.

About 1000 women and almost 10,000 newborns die every day due to largely preventable complications during pregnancy, childbirth and the immediate postnatal period. In addition, every year, nearly 3 million babies are stillborn. Many of these lives could be saved if every birth were attended by a midwife.

#2  More than one third of all births take place without a midwife or other skilled health staff.

The WHO aims to improve maternal health with its Millennium Development Goals (MDG 5) . "Today, maternal mortality is the slowest moving target of all the Millennium Development Goals – and that is an outrage . . .no woman should have to give her life to give life." Ban Ki-moon, United Nations Secretary-General

#3 Midwives also provide essential care after birth.

After childbirth, midwives support mothers. They attend to the health of the newborn and the mother. They also counsel the mother on newborn care, birth spacing and family planning.

Click here for the complete list of 10 Facts on Midwifery

WHO supports countries' efforts to make sure that every women and every newborn baby receive the best possible health care.