Maternity Care Choices Health Suitable for stages: Pregnancy
Making the choice of health care provider needs to happen in the early days of your pregnancy. It may be worth doing your research to weigh up the options available to you in your area and ensure you can book into your preferred model of care provider. This might take some consideration if you are in a large city with multiple hospitals, birthing units, obstetricians and maternity services available.
Obstetricians and Midwives have two bodies to care for in one, so must understand both the pregnant and birthing body and the foetus/neonate/baby's development and specific needs. They are trained to diagnose and treat pregnancy and birth problems. Your options will be dependent on both your preferences and your risk of complications based on your pre-existing health conditions or if prenatal screening tests indicate a risk to you or your baby such as gestational diabetes. Your care provider choices may be reduced if you are considered a high-risk pregnancy, this usually means engaging an Obstetrician as they are trained to treat complications including performing emergency birth procedures and surgeries including C-sections.
For low-risk pregnancies, there are more options such as shared care between your GP and midwife service, or midwifery primary care. Midwives (which literally means "with-woman") are trained to monitor and support the labour, monitor for complications in labour and refer to the Obstetrician when the baby is ready to be birthed. Birth attendants, also known as Doulas, are trained to support the mother with normal physiological births. They are not a usual part of the hospital system, but rather can be hired to provide advice before the birth, attend the birth, and provide support and advice after the birth.
You can find a good summary of the common models of maternity care at BellyBelly.com.au and an explanation of the birth setting options including the advantages and disadvantages of each. The new site, Birth Review is a great resource to find birthing services in your area and make an informed choice on the type of care you access. You can find information on services as well as leave a review to help others on their decision journey.
The book Gentle Birth, Gentle Mothering: A Doctor's Guide to Natural Childbirth and Gentle Early Parenting Choices by Dr Sarah J. Buckley provides a comprehensive explanation of birthing settings and options in an Australian Healthcare context.
There is good evidence in favour of greater outcomes for more natural birth and mother's post-birth health with the model of women-centred care including midwifery continuity of care or caseload midwifery. This involves a midwife following the mother through her pregnancy and having a midwife leading the labour care and support. A good caregiver should respect your birth intentions/plans. You have the right to make informed decisions around your birth after finding out what the benefits, risks, alternatives and the time sensitiveness of the choices are to follow your intuition. This process can help you visualise how you would like to birth to progress in ideal circumstances to achieve as close as you can to that outcome. It can also help you to discuss the options with your caregiver to ensure that your choices can be carried out given the right circumstances to avoid disappointment or give you an option to change caregivers if possible. Where woman-centred care is not otherwise available and is preferred, you can look in your area for a Doula or birth attendant. They are trained in assisting birthing families through support, birthing techniques to help labour along, holding space for the birthing mother, advocating for the birthing family's wishes as well as post-birth assistance.
Educating yourself on the birthing process and how to optimise your capacity for normal physiological childbirth can help you with making informed decision making when it matters. You can choose to improve your health literacy to advocate for yourself. This relates to knowing your rights in childbirth to avoid feeling like your right to choose over your body is being disregarded and not respected. As many as one-third of women come out of their first birth experience traumatised by what has happened physically and emotionally. Some resources to discover include:
- Birth Matters: A Midwife's Manifesta by Ina May Gaskin
- Why Birth Trauma Matters by Emma Svanber
- Australasian Birth Trauma Association
- Maternity Choices Australia
- Birth Freedom - My Body, My Birth
- Birth Time Documentary
- Birth Review
- Birthary - The Doula Collective
Please note: Above all, any information on this website aims to provide general ideas for informational and educational purposes only. We encourage users to investigate several information sources, including, where necessary, independent individualised medical advice before making any decisions that could affect you or your child’s health or wellbeing.
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