Natural pregnancy : practical medical advice and holistic wisdom for a healthy pregnancy and childbirth 

Making Decisions: Practitioner, Birthplace, and Prenatal Tests

Midwives to Medical Doctors: Different Models of Care

FROM THE DOCTOR’S DESK Just a few days before her due date, Livia began to sense that her obstetrician was not the right practitioner for her. The doctor had been monitoring her for the past week because of minor fetal heartrate changes. She felt at odds with him, as he was pushing her to have a C-section which she intuitively felt was not justified. After consulting with me about her apprehension with the way things were progressing, I encouraged her to seek a second opinion. Three days later she had a beautiful natural birth in the hospital with her new obstetrician.

Stories like this are not uncommon in my practice. With changes in sophisticated communication systems and the Internet, patients are savvier and more knowledgeable compared to earlier generations who never questioned doctors.

Patients are interested in partnering with their practitioner for their healthcare, and actively seek out a patientpractitioner relationship in which they can freely engage in discussions and ask questions at ease.

Sometimes, people choose a practitioner who meets their needs, then with time realize those needs have changed, and move on to other doctors. Sometimes, as in Livia’s case, it happens at the 11th hour.

People investigate many things in life from food ingredients to mobile phone companies, and so it should be with your healthcare providers.

Increasingly, expectant parents are turning to mother-friendly practitioners (and institutions) for individualized attention and respect for the natural birth process. But whether you are inclined to choose a midwife or doctor, the patient-practitioner relationship ideally marks the beginning of a trusted relationship.

For some families, financial concerns help dictate choice of practitioner and venue.

With insurance companies taking a greater role in determining available doctors and midwives, many families find they are “shopping” for a practitioner in ways their parents’ and grandparents’ generations never did.

The concept of midwifery was totally foreign to my upbringing and my medical training. Yet, after I had done my research, I knew that I wanted to deliver at home with a midwife. I decided early in my first pregnancy that I wanted to enjoy my experience, and not try to orchestrate it.

So I decided to sit back, be a pregnant woman, and place my care with a thoughtfully chosen team, from my birth instructor and midwife to my backup doctor.

In a midwife, I was looking for a more holistic approach with someone who viewed me as an individual. I appreciated the time she spent with me during visits, and her patience during my labor.


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