Ep 120: Questions to ask your provider - how to find alignment with your birth support team

One key element to an empowering birth experience is carefully creating your birth support team.  Who are those people you want around you?  How do you want to feel?  What are your birth preferences?  Maybe one of the most important decisions that has the greatest influence over birth outcomes is provider choice.  In this episode, Doula Rachael and Dr. Shannon go over some ways to ask questions in a manner that allows you to feel empowered and to really hear how your provider approaches normal physiological birth.  They also provide a comprehensive list of questions to ask (yes this is geared toward hospital births, but these are questions to ask yourself and homebirth midwives too)!  

Here’s another great episode about choosing a care provider:
Ep 86: Important things to consider when choosing your care provider

Transcript

Dr. Shannon:
Hello, this is the Aligned Birth Podcast. You've got Dula Rachel here and Dr. Shannon and we are the hosts of the Aligned Birth Podcast. Today we are talking about questions to ask your OB, your provider, your midwife, when choosing who you want as your provider for your birth. I think the single most important thing as to why this is important and this is we always have little outlines that we go by for the show and in our outline the first thing we have up there is why is this important and the first bullet point that we have is that the provider has the greatest influence over birth outcomes. So that's why we're talking about it today. We want to talk about questions that you can ask, how you can ask them, why you need to ask them, why there's certain questions that we have there, how to ask them throughout your care. It's not like you just ask it once and it's done, and then ways to ask the questions as well too. So there's lots of different nuances and things that go into here, but then it's a matter of what do you do with the information that you get from their answer. And sometimes it's not just the answer that you get, right? It's the... It's how the question is answered as well too. So we'll touch on all of those things today. So welcome to the show, Rachel.

Rachael Hutchins:
Hi Dr. Shannon, thank you for

Dr. Shannon:
I'm sorry.

Rachael Hutchins:
getting us into this conversation so beautifully and eloquently. Very excited for our conversation. As always, this is one topic that comes up a lot as a birth doula when we have expecting mothers who are trying to decide on a provider, like from the beginning, like we get this a lot in consultations. because we usually that's earlier in pregnancy and they maybe haven't settled on a provider and we're always like, hey, we got this great list of questions you can ask your provider when you're trying to make a decision. And we share it with them right away, even if they don't hire us. And then this can also come up as they are getting through, like they're going through pregnancy, they've chosen a provider and we're like, okay, now really get to know your provider. You can kind of like drip the the questions throughout pregnancy to make sure you are continuing to stay in alignment with your provider and that all your preferences and desires are being addressed and met your concerns, your fears and you're learning a little bit more about their them and how they might support you or their practice. Uh, we heard, you know, recently was just talking to one of our clients and she was like, well, why should I ask these questions? Because I don't know who's going to be at my birth. And that's a valid

Dr. Shannon:
Okay.

Rachael Hutchins:
point. But we would say, you know, this is kind of just giving you some insight because a lot of times as a practice, they have overarching like ways that they approach or handle births. So you can ask like as a practice, how do you handle this or as an individual? And then each time you see a new provider, you can kind of gain some insight into that person. And so it's not saying, oh, well, you're going to be the one who's there. I need to know exactly what you're going to do. It's just an overall like insight into them and the practice. and aiming for alignment with your provider. Right?

Dr. Shannon:
I like that use of the word, you know, aligned

Rachael Hutchins:
Yeah.

Dr. Shannon:
birth to help you have an aligned birth experience.

Rachael Hutchins:
Yes. Yeah. It matters being in alignment. A lot of people are like, well, I don't care what they say because I'm just going to go in and do what I want. Hey, awesome. We don't want you to feel like you have to go in with boxing gloves though. We don't want you to

Dr. Shannon:
Right.

Rachael Hutchins:
feel like you've got to like be an uphill battle. It's good to be prepared to advocate, but you want when you're in alignment, that means you're going to have less friction, less... opportunity of like needing to put on your boxing gloves.

Dr. Shannon:
Mm-hmm. No, I'm glad you mentioned that though too because sometimes I feel like it can come across as that as like I guess with With more and more talk now about you have the ability to choose this provider. You don't have to stick with them You can fire provider at any time, you know You don't want to go into it. I don't know already like on the defensive You know end of things it's kind of coming in and asking and then getting that read on them as far as okay Well, this is this is how they responded This is what they said, you know made you feel a certain way But not necessarily going in and already being like combative

Rachael Hutchins:
Yeah. And then

Dr. Shannon:
with

Rachael Hutchins:
if

Dr. Shannon:
things

Rachael Hutchins:
they

Dr. Shannon:
too.

Rachael Hutchins:
say, give you an answer that you don't necessarily again, align with, have a conversation. Like they're your provider. They are human. You are human. Like it doesn't have to be black and white, especially if it's someone you're like, I really want to be with this provider. This is where I've been. I'm comfortable here for the most part. If they give you a response that you're not feeling good about, it's like, tell me more. Like

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
do you have like an article that I could read that's supportive of what you're saying? Or can I share this article that I found about this particular thing? It can. you know aiming

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
for this dialogue I'm not saying it's achievable in every scenario but it doesn't have to be like oh if they say the wrong thing I have to fire them. It's like well stay curious, stay involved,

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
have a con sometimes just having a conversation can soften them and bring them around and help them like okay like I can support that or whatever there can be some growth on both sides.

Dr. Shannon:
Mm-hmm. Most definitely. So we talked about provider has greatest influence over our birth outcome. So that's why this is important. And practicing throughout your pregnancy with them asking these questions can help further along if you know in asking those questions not just while you're giving birth and you know in the heat of the moment type of thing. So exercising that muscle a little bit as well too and then just increase that connection with your provider because they are going to share a very intimate space with you. So you want to feel as well in that birth space. I think one big thing with it is really helping you become an active participant instead of just that passive receiver. So I always look at it as like being that active participant in the birth instead of birth just something that like happened to you because if you're feeling that it was something that happened to you then that can impact your postpartum recovery. And I know with my first, I had a birth plan. It definitely went out the window, but I feel like, and I say this very lightly, like, yeah, I could have done that better, but I didn't know what I didn't know. So now I used that experience to impart information on the second one. But. I felt a little bulldozed and not in a bad way. Like my providers are really good, but it was more of, it just was something that was happening to me because it was like this cascade of events. And so I really didn't kind of stop to ask like questions or things there too, but it wasn't, that wasn't necessarily the best time to ask those questions. It would have been good to ask those questions kind of beforehand. So

Rachael Hutchins:
Mm-hmm.

Dr. Shannon:
that's why I do like this aspect of an approach to. creating that relationship with your provider and

Rachael Hutchins:
Mm-hmm.

Dr. Shannon:
being comfortable with them as well, kind of like early on. I know that's

Rachael Hutchins:
Yeah.

Dr. Shannon:
a big one though.

Rachael Hutchins:
And just to validate like your experience of like kind of being on the train and feeling like you can't get off, even though it's like overall okay experience, but like this, and you weren't bulldozed, but you felt just like things were happening. Like that's,

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
that's a norm, not normal, common experience.

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
Um, and, you know, I think hindsight's always 20, you can always look back and, but in the moment, like when things are happening, it's hard.

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
to tap into these things that you've never tapped into them before or weren't exposed

Dr. Shannon:
Right.

Rachael Hutchins:
to them, right? And so that's why we know it's important to have like talk about it beforehand and practice

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
and exercise beforehand to avoid that or reduce that feeling overall. We think keys to choosing a provider. So there's like questions to ask provider and then like how to choose a provider. So there's like before you've committed to a provider. And I do encourage you. If you like just found out you're pregnant and you've been like with this one practice, you know, since you were 16, that it's okay to explore other options for providers because birth is different than GYN care and finding someone who's going to support the birth in the way that you want. And you can always return to your provider for GYN care if you want, that it's not like it's okay to explore options and see if there's someone that's a better fit for you. because again, how the provider you have for the type of birth you want matters. Um, and so if you're early on exploring your options and you use these questions to sort of like interview providers. And again, I like to recommend meet with one, two or three different providers. I know that feels like a lot of work, but this is a big event for your, you know,

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
for your life.

Dr. Shannon:
It's worth

Rachael Hutchins:
And so

Dr. Shannon:
it.

Rachael Hutchins:
it's worth it. It's so worth it. And you can get a lot of, you know, meet with a midwife, meet with an OB, meet with a hospital midwife and a home birth midwife, like kind of, and that can be insightful and that can help you kind of have a whole picture of what's available out there. And then you use these questions, like you said, throughout pregnancy to build practice, you're exercising your muscle and you're building connection by using these questions. With some keys to this process is listening to your gut. What is it telling you? How do you feel in the office, in the presence of the provider, in the presence of the staff? How are you feeling? And I think we highlight this a lot in our conversations because how you feel through the process matters. Like it's not a stamp of like only midwives are going to make you feel safe and comfortable.

Dr. Shannon:
Mm-mm.

Rachael Hutchins:
It's not. It's whoever you are, it's good to kind of meet with different people to see. If you've only ever met with an OB, you don't really know that a A midwife could make you feel differently. If you've only met with a midwife, you don't know that an OB can make you feel differently. So when you have that contrast, you're able to say, oh, I felt more at ease here. I felt more comfortable here. I felt more safe. I felt more seen, heard. So really paying attention to how you feel when you're going through this process. So listening to your gut, asking questions, which we're gonna go over a list of questions to ask. And then another key is seeking referrals from people you trust. who've had birthing experiences similar to what you desire. So,

Dr. Shannon:
Hmm... Mm-hmm.

Rachael Hutchins:
you know, like there's a lot of different like places you can give birth that support it differently. But if you're really wanting a certain type of birth, like an unmedicated water birth, try and seek out referrals from people who have actually experienced that, where they did it, who they were with, and what their experience was. If you know you want an epidural, but you still wanna have like low intervention, like where, try to seek people out. who have had a similar experience and then go meet like, okay, who was your provider? And then try and use that as like a launching pad for how to choose. Cause otherwise it can feel really overwhelming. How do I choose? It's so many options where we're in the greater Atlanta area. It's like insane.

Dr. Shannon:
There's a lot.

Rachael Hutchins:
It is a lot. And so that's a good way to start. And then don't wait till it's too late to address red flags. So once you've gone through the process of committing to a provider for your birth, If there are like yellow flags, like yellow flags, meaning like you get a little bit of an uh-oh feeling, it's like an answer they gave you about something really didn't align with you and they weren't responsive to your questions surrounding or they were dismissive or they're not supportive of the most important things to you. Those are red flags, yellow to red flags. So pay attention and try to consider switching providers before it feels like it's too late because the later you get, it's never too late to switch providers, but the later you get the bigger of a deal it feels like it is for you might feel more stressful if you're

Dr. Shannon:
It's

Rachael Hutchins:
36

Dr. Shannon:
more stressful.

Rachael Hutchins:
weeks, right? So like you can minimize that by trying to pay attention and address things sooner rather than later

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
so that you're not in that like final weeks of pregnancy feeling like you need to switch. But if you are, please know, you can switch and go wherever you want. I just listened to a birth story about someone in labor. What podcast was it on? I don't know. I'd have to go back and look, but she was in labor and at a hospital and they were being they were treating her very poorly and being very dismissive and wanting to like rush things along. And I'm pretty sure the quote like the nurse, this is a birth story from the birth person. The nurse came in and was like, you need to SHIT or get off the pot. Meaning

Dr. Shannon:
Mmm, yeah.

Rachael Hutchins:
like we need to get things going. And they basically packed their stuff up. and left and drove to like another hospital where they hadn't been, it's not like they didn't have a doctor there, they didn't have...

Dr. Shannon:
But they're going to take you because...

Rachael Hutchins:
They'll take you and

Dr. Shannon:
Yeah.

Rachael Hutchins:
they have a they felt like I'm not safe here This is

Dr. Shannon:
Yeah.

Rachael Hutchins:
not a good environment for me. Whereas like if you got that kind of abuse you might feel like I'm stuck here I don't

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
have I mean again if you're in a place where there's not like another hospital, of

Dr. Shannon:
Right.

Rachael Hutchins:
course maybe you're stuck but just an example like you can just

Dr. Shannon:
Yeah,

Rachael Hutchins:
leave

Dr. Shannon:
talk about,

Rachael Hutchins:
if you

Dr. Shannon:
yeah, at the last minute.

Rachael Hutchins:
In labor, I was like, wow Wow

Dr. Shannon:
Ugh.

Rachael Hutchins:
Okay. So yeah some of those some of those keys and then the phrasing

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
which you and I care a lot about the phrasing of the question. So mindful of using allow. So like, do you allow me to go beyond 40 weeks? Do you allow me to push in other positions besides my back? What are they, what are like the answer

Dr. Shannon:
They

Rachael Hutchins:
to

Dr. Shannon:
can

Rachael Hutchins:
that

Dr. Shannon:
just

Rachael Hutchins:
question?

Dr. Shannon:
give a one word answer.

Rachael Hutchins:
Yes, yes or no. Yes

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
or no. Flip the script. how do you support and then ask your question. So how

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
do you support me going beyond 40 weeks? How do you support me laboring without an epidural? And that phrasing then gives, they have to kind of give a little bit more of an open-ended, it's an open-ended question, so they kind of got to give more

Dr. Shannon:
I think I

Rachael Hutchins:
of

Dr. Shannon:
give

Rachael Hutchins:
an

Dr. Shannon:
more

Rachael Hutchins:
answer

Dr. Shannon:
information.

Rachael Hutchins:
with more

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
words. And so you learn a little bit more about.

Dr. Shannon:
And again, it's not only what they're saying, but it's how they're saying it as well. That's where your intuition is gonna come into, because they could still give a response that, if you're saying, will you allow me go past 40 weeks? If you say, how do you support that instead? They could still give an answer that is very similar as what they would have said.

Rachael Hutchins:
Mm-hmm.

Dr. Shannon:
We don't, or something like that. So you've got to... read into what the response is as well. And that might be a little bit more of like the yellow flag aspect of

Rachael Hutchins:
If

Dr. Shannon:
things

Rachael Hutchins:
they're being

Dr. Shannon:
of

Rachael Hutchins:
evasive

Dr. Shannon:
like, what's that? Mm-hmm, mm-hmm.

Rachael Hutchins:
or not clear or we'll cross that bridge when we get there,

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
it should be unequivocally, we support you going to, you know, at 41 weeks, we will begin recommending induction or we support you all the way to 42 weeks or

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
really at 40 weeks. That's when we're going to recommend induction or whatever. It's like, like they have to sort of tell you more if there's if they aren't giving you information. Like you said, that's A yellow flag

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
or a red flag.

Dr. Shannon:
That could be red flag. I know so with these questions. I want to ask you Do you? It's not just like a one and done type of thing. Is it like you ask this question? Once maybe you ask you like it's your 12 weeks, you know, and you're starting to do You know other things are starting to come up and other questions. Is that it or do you ask them again? Like how? do you go through with these questions with clients?

Rachael Hutchins:
Yeah, I think you like we have a whole list of questions and we'll share these in the show notes. But like I say, pick the things that are most important to you. It's not like you're going to literally go in and ask all of these questions, at least in my experience. That's not typically what happens. People tend to extract the questions that are most important to them.

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
If you're interviewing providers, you're going to find some questions that help you gain like more of an overview of like philosophy of birth. how they support the type of birth you want, like some general stuff. And then once you've committed to a provider, then you can kind of like at each appointment, use that time to pick a handful of questions to ask. And then at each appointment, you're gonna kind of ask either if it's a different provider and you wanna ask the same set of questions just to get an overview of like each provider or each time you're gonna ask different questions just to sort of get all the information you need throughout your time with them. that tends to be an actual attainable approach versus like asking all the questions in one visit that just doesn't tend to be realistic. So there's like your interview questions which are going to give you more of an overview and then trying to have a few questions at each appointment that you ask to

Dr. Shannon:
Mm hmm.

Rachael Hutchins:
build throughout. But again I think it's just being willing to ask some of these questions whatever aligns with you whatever is most important to you. and honing in on those is going to be the best approach.

Dr. Shannon:
And you can ask them again too, you know,

Rachael Hutchins:
Yes.

Dr. Shannon:
when you get, when it goes later. Because sometimes too, you may have different things that pop up in your pregnancy. So maybe you weren't necessarily, um... asking things about blood sugar levels or gestational diabetes, but then you if something does pop up and you do have that You can ask for that because if it's immediately Certain things that they're recommending but they're not necessarily mentioning any dietary changes You know that you could do to help support yourself like you can ask You may not have asked that question earlier. You can ask it later or you can

Rachael Hutchins:
Yeah,

Dr. Shannon:
if you've

Rachael Hutchins:
the

Dr. Shannon:
asked

Rachael Hutchins:
questions

Dr. Shannon:
it earlier

Rachael Hutchins:
might change

Dr. Shannon:
you can ask it again

Rachael Hutchins:
then, like, because now there needs to be some things, maybe some, a different plan or different course of action. So yeah, it's again, always being curious and always asking questions that are specific to where you're at in your pregnancy, what has come up, if there's been things that have come up like,

Dr. Shannon:
Mm-hmm

Rachael Hutchins:
you know, that are

Dr. Shannon:
or fetal

Rachael Hutchins:
changing

Dr. Shannon:
positioning, you know all I mean there's yeah, there's

Rachael Hutchins:
the

Dr. Shannon:
lots of

Rachael Hutchins:
route.

Dr. Shannon:
things

Rachael Hutchins:
Yeah. So I think it's both and.

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
having being okay with asking questions kind of over and over again, being willing to kind of change what you're asking depending on what's come up. Um, and just kind of always being comfortable and exercising, asking questions so that again, I think it's more of just like this exercise that benefits your overall experience. Um, and then the other thing we tell our clients too is like, cause it's a long list of questions that we feel like are like, comprehensive and if it's too much for an appointment because sometimes either like you're ready to get out of there they're rushing you which again that's not optimal but like if it just doesn't feel right in between appointments you can always like email the office or if you have a portal with them if they're like a medical provider they sometimes have portals and you can send messages or call and ask for like a out of appointment phone call like can you have the midwife call me back, I have some extra questions I'd like to ask, or can I leave my questions with the nurse and then the midwife can call me back, like in between your appointments so that you have time to, to ask your questions and that maybe you're more comfortable sending them in an email or having a conversation on the phone versus like you're sitting in a quote unquote doctor's office feeling like stress just by being there.

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
Um, and I will say, A lot of my examples right now are like medical model of care

Dr. Shannon:
Yeah,

Rachael Hutchins:
versus

Dr. Shannon:
yeah.

Rachael Hutchins:
like home birth.

Dr. Shannon:
I didn't think about that when we were kinda, yeah.

Rachael Hutchins:
Yeah, so home

Dr. Shannon:
Kind

Rachael Hutchins:
birth

Dr. Shannon:
of did this,

Rachael Hutchins:
like

Dr. Shannon:
mm-hmm.

Rachael Hutchins:
a you have more time at your appointments like they usually a lot

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
like 45 minutes to an hour They want to get to know you they want to make sure you're eating well exercising Well, all your questions are answered like they always a lot a lot of time where it's like medical model of care And traditionally is like 15 minutes you might get and

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
that's including everything so less time So there's like less of this like environment that's fostering Like this

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
open dialogue So knowing like that there are other options if that's really important to you. And then these questions are definitely more geared towards giving birth in the hospital

Dr. Shannon:
Mm-hmm,

Rachael Hutchins:
versus at home, but they could

Dr. Shannon:
but

Rachael Hutchins:
still

Dr. Shannon:
yeah,

Rachael Hutchins:
apply.

Dr. Shannon:
no they could yeah, they could definitely still apply But yeah, do you okay? So how do we want to do this? Do we want to go through? Our questions

Rachael Hutchins:
Yeah, we

Dr. Shannon:
just

Rachael Hutchins:
wanted

Dr. Shannon:
kind

Rachael Hutchins:
to share

Dr. Shannon:
of list them

Rachael Hutchins:
with you

Dr. Shannon:
out

Rachael Hutchins:
guys a list like a sampling of some questions to ask and we're not going to like go deep on each question because then we might be here for several hours.

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
But it's just again planting seeds, helping you stay curious, helping you like think outside the box of things to ask. We're going to include these in the show notes so you don't have to like write them all down and go grab them from there. But yeah, I think we should just run through them.

Dr. Shannon:
Okay, yeah.

Rachael Hutchins:
And if you want to do the list. And then if there's anything to add at the end, we'll do that.

Dr. Shannon:
Okay, so our first one here we have, what do you view as your role and my role in achieving a safe and healthy birth? And again, too, we talked about how these can be interchangeable with, like some of these would be good for home birth, you know, midwives

Rachael Hutchins:
Absolutely,

Dr. Shannon:
as well too.

Rachael Hutchins:
because if you're interviewing providers, you want to have a set of questions that you can ask them. So that would include home birth midwives.

Dr. Shannon:
Mm-hmm. What is your philosophy on the normal processes of pregnancy, labor, and birth? And how do you support physiological birth? Another one, let's see. What kind of childbirth preparation do you recommend? That's a good one. How do you define and handle complications?

Rachael Hutchins:
And that's a

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
good one for home birth, like understanding. You can ask that at home birth advice too, because sometimes that's, a lot of people need that boost of confidence of understanding.

Dr. Shannon:
They've got a plan, you

Rachael Hutchins:
They

Dr. Shannon:
know?

Rachael Hutchins:
have a plan, they have the training, they know what they're doing. And when you hear it from them and they explain it, how they handle complications, you're like, oh, okay, that makes

Dr. Shannon:
Yeah,

Rachael Hutchins:
me feel better.

Dr. Shannon:
it makes it a lot less scary. Mm-hmm. How do you feel about working with doulas? That's a big one. Because not every hospital and not every OB is going to... It's gonna be good with that.

Rachael Hutchins:
No,

Dr. Shannon:
I just,

Rachael Hutchins:
there's...

Dr. Shannon:
I know of doulas, and I don't know if you guys are in that realm of not... going to specific hospitals because to support a birth not because they don't want to help but because it's such an uphill battle

Rachael Hutchins:
Yep,

Dr. Shannon:
and it's

Rachael Hutchins:
no, we

Dr. Shannon:
exhaustive

Rachael Hutchins:
have. There's a few

Dr. Shannon:
and so.

Rachael Hutchins:
in the area that we just don't go to for that reason. And that's unfortunate. And if we have people reaching out to us who are planning to get birth at any of the locations that we don't feel like is optimal, we share that with them.

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
And then we let them know, like the reasons. And then here, you know, if you want to transfer to one of the places we serve, we'd welcome the conversation. And

Dr. Shannon:
Yeah.

Rachael Hutchins:
sometimes that prompts them to be like, oh, like. If this place isn't friendly with doula is like, do I even want to be there? And sometimes

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
it's like, okay, you're not the doula for me. There's plenty of doula serving at all of

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
these places. Um, but yeah, it's a, it can be insightful and there are home birth midwives who don't love doulas either. So, you know, if you really want to do love, then you make sure you want to have a provider who believes in doula support as well.

Dr. Shannon:
Mm-hmm exactly. How do you support? Okay, so do you hear how the question is asked? How do you support

Rachael Hutchins:
Hehehe

Dr. Shannon:
moving and changing positions during labor? How do you support the pushing stage? Those

Rachael Hutchins:
And

Dr. Shannon:
are

Rachael Hutchins:
if they

Dr. Shannon:
really

Rachael Hutchins:
say with you

Dr. Shannon:
good

Rachael Hutchins:
on your

Dr. Shannon:
ones.

Rachael Hutchins:
back...

Dr. Shannon:
Uh-huh. Uh-huh, or they're like there's only one way. Yeah What is your rate for cesarean birth? Now as you go through these, you can figure out, okay, these are really important to me. This is what I'm gonna wanna know right off the get-go. And so

Rachael Hutchins:
Mm-hmm.

Dr. Shannon:
it's almost like you wanna maybe come up with that childbirth prep plan because then that lets you know. what kind of birth experience do you want? We did a whole episode on that because you talked about reverse engineering that birth plan. So then it's like, how do you want to feel and then how do you set yourself up for that? Then you can dictate some of the questions that you ask. So

Rachael Hutchins:
Yeah. Well,

Dr. Shannon:
that's

Rachael Hutchins:
and

Dr. Shannon:
how

Rachael Hutchins:
if it's

Dr. Shannon:
this

Rachael Hutchins:
like

Dr. Shannon:
can

Rachael Hutchins:
the

Dr. Shannon:
go.

Rachael Hutchins:
reverse engineering is like, I really, and a lot of people don't want a cesarean, but like I really want to do everything I can to avoid a cesarean.

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
Okay. Knowing the cesarean rate at each hospital can, is that like a step in the right direction? It's not guaranteeing you'll have a cesarean, but if you go to the place that has the highest rate, then you're like one, you're kind of like, it's that step towards it's increasing your chance,

Dr. Shannon:
Yes,

Rachael Hutchins:
right?

Dr. Shannon:
exactly. Maybe not setting yourself up for optimal

Rachael Hutchins:
And just

Dr. Shannon:
success.

Rachael Hutchins:
that knowledge is like, Oh, I didn't even know I could have

Dr. Shannon:
That

Rachael Hutchins:
access

Dr. Shannon:
you could

Rachael Hutchins:
to that

Dr. Shannon:
ask

Rachael Hutchins:
information.

Dr. Shannon:
that. I know.

Rachael Hutchins:
Like there's a hospital in the Atlanta area that doesn't report and they have the highest rates. I'm like...

Dr. Shannon:
So yes, what is your rate for cesarean birth? What is your hospital's cesarean rate? Those are

Rachael Hutchins:
because

Dr. Shannon:
good

Rachael Hutchins:
those

Dr. Shannon:
things.

Rachael Hutchins:
are different.

Dr. Shannon:
Those

Rachael Hutchins:
So

Dr. Shannon:
are different.

Rachael Hutchins:
provider has rates and the hospital has rates.

Dr. Shannon:
Because the hospitals, other providers are feeding into those hospitals as well too. What circumstances necessitate a cesarean birth as well? So if that is something that is very important to you to know, then I would, you know, you could bunch those questions together and you could maybe know right off the bat how you're feeling.

Rachael Hutchins:
Yeah.

Dr. Shannon:
How do you support, again, listen to the question, how do you support going beyond 40 weeks? What circumstances necessitate induction of labor? I really like that one. If VBAC. If you're looking for that vaginal birth after cesarean, you're going to want to ask their specific policy for induction, augmentation of labor. We did a whole episode on gentle inductions. You have options with inductions. You have options with those things and that's why it's important.

Rachael Hutchins:
But

Dr. Shannon:
It doesn't

Rachael Hutchins:
some

Dr. Shannon:
have to be

Rachael Hutchins:
places

Dr. Shannon:
so cut and dry.

Rachael Hutchins:
don't offer

Dr. Shannon:
Aha. Mm-hmm.

Rachael Hutchins:
induction for VBAC or augmentation for VBAC. So like that could rule you out of trial of labor if

Dr. Shannon:
Mm hmm.

Rachael Hutchins:
they aren't supportive or you don't know your options there. So like if you don't ask, you don't know and then you're

Dr. Shannon:
You

Rachael Hutchins:
there

Dr. Shannon:
don't know.

Rachael Hutchins:
and it's like, oh shoot.

Dr. Shannon:
Mm-hmm, exactly. So. That's why that's a really good one. What interventions or practices do you use routinely during labor and birth? So this might deal with and you talked about this is why our Vocab series that we did we did a

Rachael Hutchins:
Mm-hmm.

Dr. Shannon:
four-part series on vocabulary words is really important because you may not even know what some of these Words

Rachael Hutchins:
Mm.

Dr. Shannon:
mean and you know pregnancy brings out a whole

Rachael Hutchins:
How

Dr. Shannon:
new

Rachael Hutchins:
they

Dr. Shannon:
vocab.

Rachael Hutchins:
apply.

Dr. Shannon:
But we restricting eating and drinking we've done an episode on that as well, too um There's electronic fetal monitoring, IV fluids, epidural, like those common interventions in a hospital

Rachael Hutchins:
Mm-hmm.

Dr. Shannon:
setting. You want to know how often do they routinely use those.

Rachael Hutchins:
And are they considered routine? Are they doing it to everyone regardless of your circumstances and your medical state or are there options in there? Can you decline or are they like, you know, supporting, not doing things unless they're necessary. So routine means like, if you're choosing to get birthday or then these things are being offered or done regardless of necessity. Now epidural,

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
not as much, but the other four.

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
would be considered routine epidural.

Dr. Shannon:
The

Rachael Hutchins:
But

Dr. Shannon:
routine.

Rachael Hutchins:
again, are they pushing epidural? Are they supportive of you not wanting an epidural?

Dr. Shannon:
Exactly. How do you manage the second stage of labor? So that would be pushing. When do you find it medically necessary to perform an episiotomy? I hear a lot of issues with tearing in the office or just concerns, cares.

Rachael Hutchins:
Mm-hmm.

Dr. Shannon:
That seems to be a real big one. So if that is big and important to you, then you want to ask that question to kind of get a read on their answer.

Rachael Hutchins:
Well, in episiotomy too, like, um, a lot of people are like, well, yeah, no, I don't want an episiotomy. Like most people would say that that's where they cut. Right. Um, and the rates for episiotomy are significantly lower than they used to be. But this question when it's asking is like, when, when would you cut?

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
What are some medical reasons that would necessitate episiotomy versus just like letting me tear

Dr. Shannon:
Letting you tear.

Rachael Hutchins:
and tearing is superior to cutting.

Dr. Shannon:
to cutting or healing, recovery, all of that. Let's see, what... What is the best way to cut your hair? Do you consider to be delayed cord clamping? So again, that's another flip on asking of would you allow

Rachael Hutchins:
Mm-hmm.

Dr. Shannon:
to lay a cord clamping? Okay, what

Rachael Hutchins:
Yeah,

Dr. Shannon:
does

Rachael Hutchins:
let

Dr. Shannon:
delayed

Rachael Hutchins:
them explain to

Dr. Shannon:
mean

Rachael Hutchins:
you.

Dr. Shannon:
to

Rachael Hutchins:
Mm-hmm.

Dr. Shannon:
you? And what is it? Is it a timeframe are they going to give you? Is it a look and see at the cord type of thing? You know, because it might be different for everybody. So again, you want to listen to the answers that they give

Rachael Hutchins:
Mm-hmm.

Dr. Shannon:
and you can listen to the answer that they give and then digested. It's not like you've got to come up and be like, okay, you're going to be my doctor. Listen to

Rachael Hutchins:
Right.

Dr. Shannon:
these answers. You could take some time and then chat again with your partner and see. I don't know if we've mentioned this, but as far as looking at like also not only how are you feeling about the provider, but how does your partner feel about the provider and the responses that they gave,

Rachael Hutchins:
Mm-hmm.

Dr. Shannon:
you know, and kind

Rachael Hutchins:
Yeah,

Dr. Shannon:
of making sure

Rachael Hutchins:
bring

Dr. Shannon:
you don't

Rachael Hutchins:
them

Dr. Shannon:
necessarily

Rachael Hutchins:
along

Dr. Shannon:
have

Rachael Hutchins:
this journey.

Dr. Shannon:
to be on the same page. But if they're getting, you know, like a bad feeling from it, or they're just not liking the answers then too, then that can spark a conversation as far as what did you like, what did you not like and why.

Rachael Hutchins:
Well, that's the beginning process is bringing the partner in and

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
getting them engaged because they might be like, I don't know, I don't care. It's not me, but it's like kind of getting them

Dr. Shannon:
big part.

Rachael Hutchins:
to care and understand why it matters.

Dr. Shannon:
How do you manage the delivery of my placenta watchful or expectant? I remember we did that episode too about I think it was in our the terms with the

Rachael Hutchins:
Mm-hmm.

Dr. Shannon:
fungal massage and all of those and I was like wait a minute I didn't have to have that like

Rachael Hutchins:
Mm-hmm.

Dr. Shannon:
we didn't have to do it I did

Rachael Hutchins:
Are you

Dr. Shannon:
not

Rachael Hutchins:
pulling

Dr. Shannon:
know that.

Rachael Hutchins:
on the cord traction? Are you waiting for it to come on its own? What's the time frame? Again,

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
how do you manage this phase? Yeah.

Dr. Shannon:
Mm-hmm. What is the policy for prolonged rupture of membrane? So kind of over that 24-hour period, typically that 24 hours is where they want something to happen before, you know, 24 hours, but what is the follow-through kind of after that?

Rachael Hutchins:
Yeah, and there's new evidence on the timeframe

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
with certain conditions being met. So if they're like, you know, we want to see you baby here by this time, or you in labor by this time. There's some evidence on, you know, that. And so seeing what they say there is really, really important because

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
just usually for most people, they just need a little bit more time to kick into labor with the numbers, the percentages supporting like by 24 hours most it's like 80 something percent are in labor.

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
on their own, so like giving it time.

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
But how

Dr. Shannon:
I

Rachael Hutchins:
do

Dr. Shannon:
see

Rachael Hutchins:
they,

Dr. Shannon:
a

Rachael Hutchins:
again,

Dr. Shannon:
lot

Rachael Hutchins:
how

Dr. Shannon:
of,

Rachael Hutchins:
do they support

Dr. Shannon:
yeah,

Rachael Hutchins:
that?

Dr. Shannon:
I see a lot of fetal malposition in that aspect of things too. That's

Rachael Hutchins:
Yeah.

Dr. Shannon:
not the only reason why you have, you know, rupture

Rachael Hutchins:
Yep,

Dr. Shannon:
of membranes

Rachael Hutchins:
when we have

Dr. Shannon:
and then

Rachael Hutchins:
prolonged

Dr. Shannon:
nothing happens,

Rachael Hutchins:
rupture membranes,

Dr. Shannon:
but

Rachael Hutchins:
we're like, go see your chiropractor.

Dr. Shannon:
mm-hmm.

Rachael Hutchins:
Yeah.

Dr. Shannon:
I'm like curb walking, we're doing all the things. I know. And then what are the standard newborn care procedures? That is important to ask even though that doesn't seem directly related to birth, but um... What do you want to happen right after? Do you want baby immediately taken away and cleaned and washed and then given to you? Or do you want everybody to just leave if baby is fine?

Rachael Hutchins:
Mm-hmm.

Dr. Shannon:
There's, you have a say in that. I think that's the big part with the episode

Rachael Hutchins:
Mm-hmm.

Dr. Shannon:
is I hope looking at these questions and hearing these questions sparks in someone so that they're like, oh, I didn't know. that I could ask these questions. Do I feel comfortable asking someone in a white coat these questions?

Rachael Hutchins:
Mm-hmm.

Dr. Shannon:
I get that, I get that.

Rachael Hutchins:
Totally.

Dr. Shannon:
But they, I don't know, they want you to. I think if they want that meaningful relationship, they do want to have those conversations with you. So I think these are good ones to go through and check in with. how you feel and hopefully it gives you some insight into things to add maybe to a birth plan, the birth preference list. I mean it kind of, you know,

Rachael Hutchins:
All

Dr. Shannon:
childbirth

Rachael Hutchins:
builds.

Dr. Shannon:
education classes, yeah, how else can you

Rachael Hutchins:
Yeah.

Dr. Shannon:
support

Rachael Hutchins:
And if

Dr. Shannon:
yourself?

Rachael Hutchins:
some of

Dr. Shannon:
It's

Rachael Hutchins:
these

Dr. Shannon:
all connected.

Rachael Hutchins:
questions, you're like, I don't even know. Like

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
what an episiotomy is, or I didn't know there was a phase where the, what placenta

Dr. Shannon:
Yeah,

Rachael Hutchins:
who

Dr. Shannon:
the placenta is

Rachael Hutchins:
like,

Dr. Shannon:
delivered. Yeah.

Rachael Hutchins:
like all of a sudden, and so, or delayed core clamping, I don't know what that is, or I don't know my preferences there, it's a hundred percent what you're saying of like that. Exploratory, like if in this list of questions, there are things you're not sure if that's an opportunity to go learn. about

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
what it is and what could be your range of options. And then when you're learning about it, what sounds good to you as far as like the care around that thing. And then when you ask these questions, you're a little bit more prepared to like, have a response of like, I like that or I don't like that, right? But if you don't know about the thing, it's hard to

Dr. Shannon:
Thank

Rachael Hutchins:
feel

Dr. Shannon:
you.

Rachael Hutchins:
like you have a preference. And

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
so learning about it is definitely part of the keys. If you're not familiar with these, it's okay. Listen

Dr. Shannon:
Mm-hmm.

Rachael Hutchins:
to our

Dr. Shannon:
I

Rachael Hutchins:
other podcasts,

Dr. Shannon:
know. To the other person. Yep. So,

Rachael Hutchins:
take

Dr. Shannon:
I'm going

Rachael Hutchins:
a childbirth

Dr. Shannon:
to go ahead and

Rachael Hutchins:
education

Dr. Shannon:
close the video. I'm

Rachael Hutchins:
class,

Dr. Shannon:
going to go ahead and close the video.

Rachael Hutchins:
stay curious, and tap into your intuition. It will not fail you, I promise.

Dr. Shannon:
So, yep, we'll put all of those questions in the show notes. And yeah, hopefully you've learned some new vocab words today, even in our non-vocab lesson.

Rachael Hutchins:
Always a lesson.

Dr. Shannon:
Always.

Rachael Hutchins:
So fun chatting with you today. Thank you Dr. Shannon.

Dr. Shannon:
Yep, yep, always fun.

Rachael Hutchins:
Bye.