Friday, May 13, 2011

List of Questions for my Doctor

As I mentioned in my last post, I had a large list of questions for the doctor side of my birth team. I'm going to post them here. I got a bunch of the questions from My Best Birth which is a worth while read. It's not a huge book and it explains the obstetric myths quite well. Let me know if you have any questions in the coments and I will help define what I can :).

Policy and Procedures
1.       Can I walk and move around during labor?
2.       Do I have to deliver lying flat on my back? I prefer just going with the position that feels right at the time. I’ll be open to suggestions but not supine.
3.       Do you use continual fetal monitoring? What form do you use? Is intermittent monitoring an option? Do I have to be strapped down for it.
4.       Do you routinely perform episiotomies?
5.       I don’t want an IV is that tolerated? Is a hep lock an option?
6.       Do you support natural childbirth?
7.       Is there a time limit to labour? What is it?
8.       Can I eat and drink during labor?
9.       What is your c-section rate? Under what conditions do you require a c-section?
10.   Can I have a copy of every waiver?
11.   How long do I have to stay here after the baby is born?
12.   How often must I be vaginally examined while in labour.
13.   Does the hospital use cytotec?
14.   I want to follow my body and push when I have the urge, will that be an issue?

Baby Safety
1.       I want to hold my baby immediately after birth, they won’t take my baby away will they? Can I nurse my baby immediately?
2.       I am not comfortable with pitocin at all. If I must induce are there better methods I can use? Are cervical balloons used here? How long can I be pregnant before I must be induced?
3.       Is the hospital equipped for emergencies 24/7 or are there specific hours when OR and anesthesiologist are available?
4.       If for some reason I am separated from the baby and cannot breast feed, I don’t want the baby fed any dairy based formula or animal milk. If there must be something, please use soy.

Preparedness
1.       Who delivers my baby? You, team member, on-call doctor?
2.       Do you honour birth plans?
3.       Is there a way to see what the rooms are like?
4.       At what stage in labour must I come to the hospital? I would like to labour at home as long as I can.
5.       I don’t want an epidural, will I be under pressure by nurses?
Comfort
1.       Are the rooms private? Will there be lots of people coming in and out?
2.       Can lights be dimmed?
3.       Are there any restrictions on who is allowed in the room?
4.       Will I have to change rooms during my stay?
5.       Are there rules about what I can wear and what I can bring?
6.       I may hire a doula, is that tolerated?
7.       I might try a bunch of alternative pain management methods, is that ok?
8.       Will I have access to…
a.       squat bar
b.      tub
c.       shower
d.      ball

Gathering a Birth team that Suites Me : Part 1

"Who is your family doctor?" This is a question I have been asked countless times since I got pregnant. I don’t have a family doctor. People look at me with the glare of judgment when respond to their question. “I have a naturopath” I will add. No one seems interested in that information, despite my naturopath being capable of everything regular doctors are capable of.
The truth is, I have not had a family for about 6 years. I haven’t needed one. I went to walk in clinics early on if I needed anything and I have not been sick in the last 3 years so why have a doctor on retainer. I go to a naturopath not to fix health problems but to get even healthier. Well, apparently I need a family doctor to be released from the hospital after I have my baby so checkmate medical system, you win. I suppose I will have to find one.
Assembling your birth team without a family doctor can be tricky, here is what I did and though it was hard work, it seems to be paying off quite well. My naturopath can’t deliver so I had to find someone who could. There are no midwives in my area (very disappointing) but I was put on a waiting list to be tended to by one out of town. Unfortunately, I could not get a spot. They called me up to inform me they did not have an opening and before I started crying in the bathroom at work, I asked the midwives if they could recommend a doctor for my maternal care. They gave me three names.
I called one name on my list to find out that she only delivers her own patients babies and was not accepting new patients. I looked up the second name and found her number in a directory. I called and they gave me a different number to call. I called that one and they tried to give me my original number to call. I said that wouldn’t work, then I’m on hold . . . for a really long time. They can’t tell me anything. I call the original number, they give me a new number who gives me yet another number and I finally reach the perinatal clinic. They tell me I need to go to a walk in clinic to get a referral. Fine, I can do that.
I get the referral. I tell the on call doctor that either of the two doctors on the list will work. He says it’s not a problem and sends me on my way, problem solved . . . ? No.
I wait a week. I figure the referral might take some time, and then I start calling the hospital. Over a few days I call 3 times leaving 3 messages on the automated message system before I get to speak to anyone. They give me a different number to call. Grrr. I call that number and reach someone who sounds like she has it together. She tells me a referral was never received and gives me her direct fax line. I call the walk-in clinic and they agree to resend it to the new number and she calls me back with an appointment. I love this mystery woman.  So competent.
I go in for my appointment with my husband. He comes to all baby appointments because he’s awesome. We go in expecting one doctor, the one on the referral and are surprised to see another doctor is working in her place. The two doctors are a team so one of the two of them will be delivering my baby and I am so fortunate as to get to meet them both early on in my pregnancy (well, 4 months in actually). We talk to their nurse first for a good long time. She has all the time in the world for me to go through all my questions. As I brought a list of over 30 (a bunch from reading Your Best Birth: Know All Your Options, Discover the Natural Choices, and Take Back the Birth Experience), I didn’t get through them all because I got tired. The nurse was absolutely great. We really clicked. I could see why the midwives had recommended this team.  Even the doctor had time for me.  They supported my idea of how a birth should go, set me up with a meet n’ greet for a family doctor and gave me info on the doula program. They don’t do any of the stupid, crazy stuff other doctors do routinely that the WHO is against and they made me feel in control of the situation. I was happy leaving that appointment and I’m still pretty stoked the next day!
It’s so important to have a birth team who you see eye to eye with and I’m glad to have found this team of doctors who mesh well with my personality. The first maternity doctor I saw was nothing like this one. She took offence to my intention to have a natural birth which I found to be unprofessional. I left her office feeling like she was trying to take my control away and I simply won’t have that. So I guess basically what I am saying here is don’t settle for a doctor you are not comfortable with. It might be a lot of work finding your perfect match but it is well worth it.