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Switching Midwives During Pregnancy Can Be The Best Option, Experts Say

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Choosing the people who will be around to support you for the birth of your child can be a daunting task and a decision that will impact your experience of bringing your baby into the world. So if you start seeing red flags once you've made your hire, you might consider switching midwives during pregnancy. Taking action sooner rather than later is crucial. After all, you will be the person doing the majority of the hard work when push (literally) comes to shove – you deserve all the support you can get.

Of course, it's always ideal to make your first pick your best pick. Brooklyn-based doula and author Megan Davidson writes extensively about midwifery care in her book Your Birth Plan and tells Romper that understanding what a midwife does is key to choosing the right one for you. "For many pregnant people, a midwife is an excellent option for prenatal care and birth support, but it‘s not uncommon for people to have inaccurate ideas about midwives — who they are, what they do, who their clients are, where they work," Davidson says.

When it comes down to it though, if you've committed to a midwife and things aren't working out, you may have to end the relationship. Here's what to look out for:

1. They Don't Support Your Birth Plan

"Whatever your birth plan is, your midwife should be willing to follow what it is. They should feel honored to be a part of your birth," Jenn Simms, a doula practicing in Austin, Texas, tells Romper. Simms says that having a supportive practitioner throughout the birthing process can help ease fears and make birth easier to handle, so your midwife should support your birth plan as long as it is medically safe.

"Most midwives are open to letting your body do what it is naturally made to do, but emergencies do happen, so being on the same page about what they would do if you needed emergency intervention is important as well," Simms says. If you and your midwife can't get on the same page about your birth plan, it may be time to consider switching care providers.

2. They Don't Have The Credentials You Want

This one can be a bit tricky thanks to the complexity of midwifery licensing throughout the U.S., but ultimately you want to be sure that your midwife has the credentials that you feel comfortable with. "The American College of Obstetricians and Gynecologists (ACOG) recommends carefully considering the type of midwife you hire to support you in your birth," Davidson tells Romper.

As many as two-thirds of midwives with the credential certified professional midwives (CPMs) do not meet the ACOG criteria for midwife education and training, according to a 2015 report by the organization. A midwife with certified midwife (CM) or certified nurse-midwife (CNM) credentials has met or exceeded ACOG education and training criteria.

Davidson explains that CNMs support clients in hospital births ,while midwives can help women giving birth in other settings, such as home and birthing centers. "Beyond training, because each state varies in how they license or don’t license CPMs, there’s huge variability in what medications or emergency treatments a midwife might provide," she says. "It is great to talk with your midwife about what they will have available to support you."

3. Your Laboring Expectations Are Different

A midwife who doesn't work with you to talk through the different ways you could labor can mean trouble. "They should know different techniques to help your body do what it needs to do, and help you labor the way you want to," Simms says.

Depending on the positioning of your baby, certain laboring positions can help your labor progress and aid in your ability to cope with the pain of childbirth, according to the Mayo Clinic. You should have a midwife who is on board with exploring these positioning options to help you have the best possible birth outcome.

4. It's Hard To Communicate

"If you feel like there is a disconnect in communication, it’s important that you tell your midwife," Shannon Stellhorn, a certified professional midwife with Sacred Journey Midwifery Services tells Romper. "Whether in person or via phone or email, I would sit down and tell your midwife in a kind way what you are feeling."

If your midwife is not open to you expressing your concern over a communication issue, a switch might be warranted. "Midwifery care is relational, and it’s important that you feel good in that relationship," she says.

5. You Feel Pressured Or Unheard

Midwives should be familiar with techniques to help your body do what it needs to do, and help you labor the way you want to. Photo: Shutterstock

The absolute last thing you need during your pregnancy and subsequent birth is to feel pressured into doing something you don't feel comfortable with. You will likely hear tons of unsolicited advice from friends and family members during this time – you shouldn't have to worry about your midwife adding to the pressure.

Although emergencies can crop up and you'll need to be able to follow the guidance of your midwife during those times, you should also be able to completely express your concerns and feel like your midwife values what you have to say. "You and your partner should fully be heard and you should fully feel safe to express yourself," Simms tells Romper. "So, if you're ever feeling pressured into a certain scenario or into a certain plan that you don't feel comfortable with, I would definitely switch."

7. They Don't Want To Be Interviewed Before Being Hired

Communicating with your midwife is something you will have to do throughout your entire pregnancy, so making sure that you can have an open dialogue is vital. Davidson recommends preparing a list of questions you might want to ask a midwife before deciding to work with one. "A good interview will help you have shared expectations and avoid a situation where you need to transfer your care to another provider," Davidson tells Romper.

8. You Don't Like Their Backup Care

Just like when you have an obstetrician handling your birth, your midwife's backup caregiver could potentially be the person who delivers your baby, so if you are not comfortable with the backup caregiver, a conversation is warranted.

"Your midwife should have some sort of backup care or team, so I would figure out what that care is in case you need their backup. You need to meet their backup in case your midwife can't come to make sure you like them as well," says Simms.

If you're uncomfortable with the backup arrangement, speak up, Stellhorn says. She adds that a midwife should have more than one person as an option for back up. Have a conversation and see if their other back-up midwife is a better fit for you.

8. You Feel Judged

"The main thing with any care is that you feel safe and welcome and not judged. Birth should be a judgment-free zone," says Simms. "That goes for race and sexual orientation — anything along those lines as well as any type of birth you want to have."

When you have a baby, you're already gearing up to be judged for many of the decisions you make. From how you choose to give birth to how you choose to feed your baby, opinions will come flying at you from many directions. This should never be the case with the person you choose and hire to support you through birth.

"Birth is not a time to try to 'deal' with things. If you have tried to communicate with your midwife and you continue to feel disconnect and even judgment, then I definitely recommend firing your midwife and hiring someone who is a better fit," Stellhorn says. "The perfect midwife for you is out there."

Experts:

Jenn Simms, doula

Shannon Stellhorn, CPM, LM, midwife

Megan Davidson, Ph.D., Labor & Postpartum Doula and Author of Your Birth Plan