Building the ideal birth team takes a little planning and a lot of personal choices. Who will be there for the labor and birth? How long are they welcome? Who is not welcome?
To start with, you'll want the right care provider. This means choosing between a home birth, birth center birth and hospital birth. Some women have traveled far to track down and use just the right doctor, midwife, birth center or hospital. It is very important that you be willing to make hard choices and be very proactive in putting together your birth team.
A very friendly doctor that is extremely likable and fun to chat with may not be actually supportive of the idea that you'll be in charge of your own labor and birth. Some don't tell you their true feelings until they feel you've been with them long enough that you'll want to please them and will be compliant. Others like the ideal of natural birth but aren't true believers. They may talk like they really want you to have autonomy in your labor, but may feel like you're being silly or naive to think it will go well. Signs your care provider may not be right for you:
NEVER have a serious conversation while undressed or while sitting on the exam table. Have your questions ready to discuss and ask them while dressed and sitting in a chair or standing - take your example from your care provider. If he/she is standing over you while you're trying to talk and get details - stand to talk with them. If they sit down with you - great! Sit to ask. Remember this person is your employee and you have the legal right to choose someone else if you aren't feeling good about the quality of time or care they are giving you. They have a kind of authority, but that has it's place and you need to establish your relationship and goals before you put yourself into their care.
Family is the next major question. Very often your sister, mother or mother-in-law are going to one and all want to be there for this birth. While this may seem great, the reality is that the laboring mother is like a radio that picks up the emotional energy of those in the room with her. If you are inviting people into your labor room you need to be sure that they trust birth as well as you do or are willing to learn what you've learned. The last thing you need while you're dealing with a strong contraction is a close relative that thinks you're dying and starts telling you to get the medical interventions you don't want. Birth can be extremely intense and those who attend it must be supportive of it. You may need to tell some one you love that they will not be in the labor room with you. I have seen this happen time and again - a mom says some one can come in just for a few minutes and the some one then makes sure they are in the room to the bitter end. EVEN returning after being asked to leave or stepping out of the sight of the laboring mom without actually leaving. Please, be sure that you have clearly defined boundaries set long before labor and that all birth attendants are on the same page - supporting you in your choices and trusting birth to work! I recommend that all birth attendants be required to attend the same childbirth class you're taking...and maybe even read the same books too. You want them to be helpful and not influencing you when your guard is down you're vulnerable. If you allow friends, family to come into your labor room please have a designated time allotted and be strict about it. It is far too easy to feel obligated once they are in your room to let them stay.
If you know you want a midwife, there often isn't much interviewing to do. There are only a handful in our area...and so far I've only had good experiences with them. However, I do know that there needs to be a mutual respect and understanding. Your midwife should have some proof of her skills and should be able to guide you well in your birth choices. She will send you to another professional if your medical needs are greater than her qualifications. It is always good to meet her assistants or trainees too. And please make sure you really feel safe and secure in her care. There is a list of local midwives on my links page.
In the labor room at a hospital you may just get assigned a random nurse on duty. She may or may not be ideal for your needs. I've had some amazing nurses that I would be proud to work with any day! And there is a small percentage that may be technically good, but who have no trust in the birthing process. If you get the feeling your nurse is cold or doesn't like your birth plan, doula, natural birth ideals - it may be appropriate to ask for another nurse. People do it all the time. A nurse is an employee too and her primary goal is to be sure you and your baby are safe. If she views the whole of labor as a disaster waiting to happen you may have some struggle getting the mobility or options that you would like to have. NEVER fire a nurse without good cause. One of the best ways to change nurses is to simply ask to talk to the charge nurse and request that you be assigned a new nurse. If the shift change is coming you can always ask your nurse or the charge nurse to be sure you're assigned one that likes the extra work of having a natural birth. Most hospitals work on a 7am to 7pm schedule. You can also ask that your doctor put in his/her notes that you are planning a natural birth and would like a nurse that is eager to support that.
Choosing your doula is very important as well. Your doula needs to be a person you feel a good vibe from and a healthy connection. Please do not hire a doula that you feel will push you harder than you want to be pushed or who is unwilling to support your plans. You doula should be well informed about birth options and normal birth variations. She should make you feel safe above all - a mothering nature without the smothering! A good doula should help you to think through your plans and prepare in realistic and meaningful ways. She should come to you with open arms, ready to serve your needs and not pressuring you with hers.
Remember that all your birth team will be seeing you naked, possibly sick, irritable and working at your very hardest....choose people you will not feel a need to perform for in any way.