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Talking About Birth

How Late is Too Late to Switch Care Providers?

How Late is Too Late to Switch Care Providers?

Today's blog was written by birth doula Amy Reitz. She is tackling the hot topic of when, why, how you can change care providers in your pregnancy. Read on to find out more!

Second opinions. Switching providers. Change. SCARY….Our minds can jump to an anxious place so quickly when we are considering the health and safety of ourselves and our babies. I have seen quite a bit of activity in online groups lately related to switching providers. Sometimes people are looking for recommendations for a new provider, but a lot of the time their questions signal to me that people are looking for validation. They want to know if they are warranted in even considering making a change. Part of this is obviously because the thought of making the wrong decision can be overwhelming. Realistically though, making a change is entirely up to you.

A positive outcome is all about making informed choices with regard to your needs and the needs of your child(ren). So, how do you do it? Where do you even start? Let’s talk about what the process looks like when it becomes necessary to explore alternate care options during pregnancy.

How does the need to look for alternate care come about in the first place? Nashville has a constant influx of people, but switching providers because of relocation is not exactly what I’m talking about here.

We’re talking getting a second opinion or electively switching providers because of one of the following reasons:

  • a need to elevate your overall experience
  • a difference of opinion between you and your provider
  • your preference regarding location of delivery has changed
  • any other reason that does not fall in the medically necessary category.

Most often there is something brewing long before someone decides to take action. In my opinion, no one other than you needs to want a second opinion or change of scenery in order to explore it further. Trust your gut!

The most common misconception about switching providers is when someone believes it is too late to make a change. Preferably, a care provider does want to begin the process as soon as possible, but that still does not mean that a first trimester switch is the only time to change things up. I’ve seen a pregnant person reference 20 weeks as being “too late in the game”. My heart sank when I read it! I could sense the mix of feelings inside this person. Halfway through a pregnancy is absolutely not too late to make a change. Eventually the visits to the office/care provider are going to become more frequent, and if you already know halfway through that something isn’t clicking, go ahead and investigate making a change prior to the frequency of your visits increasing.

As the Office Manager of a home birth midwifery practice, I see people switch providers at various points throughout their pregnancy fairly often. I asked my boss and all around badass midwife Jennifer Vines for her thoughts on this topic:

“As a home birth midwife, we are open to transfers at any time. A pregnant person can change their mind about their birthing options for a number of reasons.  When we have inquiries of late transfers we sit down and talk about what they are looking for that is different than what they are currently receiving in care.

The biggest reasons we take late transfers are:

  • A provider indicating their discomfort with things on the birth plan that they previously agreed to earlier in the pregnancy.

  • The pregnant person learning that the facility she is planning to birth at does not support her birth plan. The provider may have indicated they approved but the facility will not support the parents wishes.

  • Deciding they really want a water birth.”

See?! Not too late. Theoretically, you could walk into any hospital you want in labor regardless of whether your provider delivers there. While I do not recommend doing this unless you are going to the closest hospital out of necessity/emergency, that doesn’t make it any less true. You could also potentially find a midwife with availability to be on call for a home birth. You never know unless you ask! Instincts and gut feelings are real things. Listen to them! Don’t know where to start? Ask a doula! For real. We’re well connected, we give great references, and we are always down to talk all things birth.

Talking about...water breaking

Talking about...water breaking

Did you know that your water can break at any point in labor? It can happen before labor starts, during labor itself, or your baby can be born with the waters intact (called being born “en caul”). 

If we look at births on TV or in the movies, virtually 100% start with the water breaking. But that does not mirror reality! Research tells us that only about 8-10% of people (about 1 in 10) will have their waters break before labor starts. 

Many people report that they notice a difference in the strength of their contractions after the water breaks. In many cases, the water has been acting as a cushion for baby’s head, and with it gone, now the baby’s head is directly on your cervix. This is a good thing and helps your labor progress!

Did you notice a difference in your contractions before & after your water broke? Were you in the 10% of people whose labor started with waters breaking? Was your baby born “en caul?” Let me know in the comments!

Talking about...early labor!


Talking about...early labor!

My number one suggestion for my clients in early labor? R • E • S • T & IGNORE!

It’s the opposite of what you want to do, I know! “OMG, I’ve been waiting for labor to start FOREVER! Let’s start doing All The Things!” I get it. Really, I do!

Seriously, here are the facts to support this advice:

  1. Early labor is the most variable part of labor, and can last hours or days. Yes, days. So, saving up your energy is KEY to getting through this part of labor. 
  2. Like preparing for an endurance event, going out too hard & fast will trip you up later on when you need that energy for the super physical stages like pushing. Pace yourself well and it will pay off in the end!
  3. Distraction with an easy labor project like making a freezer meal for your postpartum time, or watching your favorite show on Netflix can help you to ignore your early labor until it becomes active. When you can no longer rest & ignore, THAT’S when it’s time to start your labor coping & comfort measures!

What did your early labor look like? Did you rest & ignore, or did you do something different? Let us know in the comments!