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Would you go speed dating to find a obstetrician or midwife? That’s just what one local hospital is advertising. Couples have five minutes to interview each ob, and then at the end they pick their favorite and schedule their first prenatal appointment. I was immediately put off by this sham of an interview. How can you make such a big decision in just five minutes? At least Geico gives you 15 minutes. Then again, you can tell a lot by a first impression. 

Doctor Smiling in Scrubs Title: 8 Stats You Should Know about Your Obstetrician
Do you want to date your doctor? 

So, let’s go with it for a minute. What would your Mr., or rather Dr. Right have to say? What would they answer to the 47 Questions I Should Have Asked My Midwife? The first 8 questions centered around a midwife’s or obstetrician’s experience and birth statistics. If you are planning a natural birth here’s a discussion as to what the right answers to those questions might be. 

You can certainly ask all of these questions during your interviews with prospective midwives or obstetricians. However, there are now some resources that allow you to find the information online. The Birth Survey lists intervention statistics for a handful of states which may help you narrow your search before you even talk to them. 

1.  What is your philosophy regarding pregnancy and birth and your role in it? 

It is best to ask this and all the others questions on the list as an open ended question, so you can get your prospective care provider’s most genuine answer. If you are preparing for a natural birth, you will want to hear that your midwife or obstetrician is 100% on board with helping you get there. They should be as passionate as you are about helping you achieve a natural birth experience. Natural birth attendants often express a trust in a woman’s body to birth her baby naturally. They may see their role as more of an active observer and supporter rather than one of a manager. 

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2.  How many births have you attended?

No matter what kind of birth you are planning, you are certain to want an experienced care provider. The right number of births will vary based on your individual comfort level. Keep in mind, midwives who attend home births and birth center births typically stay with the mom during her entire labor and recovery. Thus, it is only humanly possible for her to attend perhaps 40-60 births per year. Many obstetricians or midwives in hospitals attend multiple women at one time or are not present for the entire labor, so their birth count may be higher. Also consider the number of years the professional has been practicing along with the types of situations and complications they have successfully dealt with. 

 

3.  What percentage of women successfully have a natural birth under your care?

National Average  <5%
vs. 
The Farm Midwives 95.1 %
 

Natural birth is not the norm in our culture, and many midwives and obstetricians may have attended very few truly natural births. The percentage of women who successfully achieve a natural birth with a specific care provider is a good indicator of their experience and the amount of support you will receive. My midwife’s natural birth rate is also about 95%. 

4.  What percentage of women need to transfer to the hospital (if planning a home birth or birth center birth)? What is the typical reason? 

If you are planning a home birth or birth center birth, the last thing you want is to have to transfer to the hospital in the middle of labor. The Farm midwives’ transfer rate was 4.9%.  My midwife’s transfer rate was also about 5%. The most common reasons for transfer should be for non-emergent issues. The Farm midwives emergency transfer rate was 1.3%. 

 

5.  What percentage of moms end up with a C-section? 

 

National Average  32.8%
vs. 
The Farm Midwives 1.4 %
 

The World Health Organization recommends a maximum cesarean rate of 10-15% for all births including high risk pregnancies. The Mother Friendly Childbirth Initiative recommends no more than a 10% cesarean rate for regional hospitals and no more than 15% for hospitals that deal with a greater number of high risk pregnancies. If you are talking to an obstetrician that attends both high and low risk births, their rates will likely be somewhat higher than a midwife’s who only attends low risk births. A higher c-section rate is a clear indicator that a care provider is more likely to opt for surgical birth. If you want a natural birth, keep this in mind. Also check the cesarean rate for hospitals you’re considering as hospital policies may dictate the doctor or midwife’s decisions during your birth. 

6.  What percentage of moms end up with an epidural?

National Average  61%
vs. 
The Farm Midwives <3.5%
 

These statistics exclude c-section births. As with the c-section rate, opt for a care provider with a lower rate of epidurals if you don’t want to have one during your birth. 

7.  What percentage of babies are transferred to NICU?

The US NICU admission rate in 2008 was 7 percent. A care provider’s rates may vary dramatically depending on whether they attend high risk pregnancies. However, a birth attendant who has a history and experience of sending babies to the NICU is likely to do so in the future. Of course, we all want any necessary care available for our babies, but the question is whether it is really necessary. Unnecessary separation for mom and baby can complicate the establishment of breastfeeding and bonding.

8.  What is the mortality rate for moms? For babies?

This isn’t a subject any of us want to think about.  As of 2006 the maternal mortality rate in the US was 15.1 per 100,000 births. The Farm had 0 maternal deaths in 2,028 births. The US neonatal mortality rate made the news in 2011 by being higher than 40 other countries in the world, including many nations with far fewer resources. In 2008, the national neonatal mortality rate was 4.3 per thousand births. The Farm neonatal mortality rate was 3.9 per thousand.

Let’s not forget why all of these awkward and icky questions are important. We all want to have the safest most healthy birth for both baby and mama. The decision you make in selecting a care provider will affect the outcome of your birth experience.

How would your “Dr. Right” answer these questions? 

Sources:

CDC Birth Method of Delivery
Ina May’s Guide to Childbirth, Birth statistics represent 2,028 births 1970-2000
Mother Friendly Childbirth Initiative
World Health Organization Bulletin
World Health Organization Mortality Data (Sorry this page is no loner available on the WHO website.)
CDC Pregnancy-related Mortality in the United States
CDC Epidural and Spinal Anesthesia Use During Labor
CDC Expanded Data From the New Birth Certificate

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