Choosing the right hospital, OB/GYN, midwife and doula - even choosing the right friends and family can/will have an impact on the birth experience. It is well worth your thought, time, and questions to find just the right ones to do the job.
Choosing your DOCTOR:
First on your list may be the right doctor. He/She will likely have the final say in some important things (because mothers have a hard time resisting suggestion as labor progresses). A doctor who's supportive of your ideals is vital to the success of your plans. EVEN if things don't go according to plan, you'll be able to feel that your doctor is reliable and that the choices were made by you, not forced on you.
A good way to find a like-minded doctor is through local chat groups of moms...like: motheringdotcommune.com or bcsmoms.com. Ask questions like: Has anyone used doctor so-and-so? Were you looking to have a "natural birth" (fill in your own special desires) and was he/she supportive throughout the labor/birth? Did you feel that another doctor would have not "allowed" some of the things you wanted? (Be creative, you're smart...ask whatever questions you need to have answered to make your choice and feel good about it).
Sometimes a doctor will seem to be very supportive, but toward the end of pregnancy he/she may change their tune and start encouraging you to think of yourself as unable to meet this demand. They may feel you are too small, or your baby is too big...if your doctor seems to be thowing a shadow of doubt over you it may be necessary to find another one- even if it is the very end of the pregnancy. You can do this; it isn't too fun- and some doctors won't accept new patients who are close to the due date, but it may be worth it...only you can decide this.
General warning signs that your doctor might not be the right one:
Choosing your Hospital:
Most hospitals will be chosen because of the doctor you choose, but sometimes a doctor works at more than one hospital. If you have a serious consern about the hospital, you may need to change doctors to get the hospital you really want (but it is probably more worth-while to go with the better doctor.) Sometimes hospital policies are prohibitive towards things you may want (water birth, intermittent monitoring, walking around, etc.). It is worth your time and effort to find out exactly what the standards are. Sometimes a mom can get policy changed, but a lot of times it is just easier to find another hospital or put up with their rules.
Choosing your Doula:
First, you have to decide if it is important to have a doula. I wouldn't be a doula if I didn't feel there was an urgent need for them. This is not something I do for income purposes...and most doulas feel the same. There is plenty of evidence that a doula assisted birth is far more likely to have shorter labor, less interventions, less need for epidurals, pitocin and forceps...and on and on. There is more information on the FAQ's page.
What doula should you use?
Whatever doula you choose will be seeing you sick, uncomfortable, naked, crying, angry...etc. It is important that your doula makes you feel completely at ease. Her experience level may be important to you, or her personality or her general knowledge. Just be sure you are comfortable and relaxed when she's around. ALSO, if your doula seems to be really unhappy about some of your birth choices or if she seems to be putting pressure on you to do things according to her ideals, she may not be the right one for you. Even if she doesn't totally agree with you she can present her reasoning, but it wouldn't be good to have hired a doula who is strongly opposed to your plans.
Choosing your Midwife:
A midwife is a birth "doctor" and a doula wrapped up in one. She has dual tasks and must be well educated, kind and able minded. She should be able to show you evidence of her abilities and she should be supportive of your plans. It isn't always good to assume that she's going to be exactly what you're wanting just because she's not a doctor...so get to know her and find out if she is truly on the same page as you. It is also good to meet her assistant. Remember also, a homebirth midwife and a nurse midwife may not always be the same. You may want to find out from her what her "philosophy of birth" is, what she normally will transport to the hospital for, how long after the due date she will "allow" the pregnancy to continue without interventions and what she likes to do for inducing (if she must induce).
Choosing Friends/Family:
Mom or Aunt Tilly? That can sometimes be a difficult decision. The people you love most may not be people who are helpful to you in a labor/birth environment. People who tend to make you feel you need to perform, or who make you feel nervous or uncomfortable will not help you in labor to relax and focus the way you need to. The last thing you need in labor is someone who's nervous or who doesn't believe birth is safe, so choose carefully.
Options:
How many???
I recently attended a birth where there were MANY friends and family members. Each time the mother's labor started to progress the crowd would migrate to the labor room...and her labor slowed down, even seeming to stop. She seemed to want all of them there, but her body and mind needed more privacy to do the job well. It has been observed that extra people at a labor can slow the labor as much as an hour per person...something to consider when choosing your birth team. I recommend that each person chosen be chosen for the purpose of helping...not watching. A couple of well selected friends or family members will likely serve you better than a host of onlookers.
FINALLY:
If someone in your birth team becomes a real problem, you can ask them to leave. You can have your nurse, doula or the father ask that they leave. Even nurses are sometimes uninvited when they are hindering the mother's ability to labor well. Obviously, this shouldn't be done for minor reasons, but in the case of a serious problem - don't be too shy to ask.
