If you follow us on Instagram, you’ll know that we’ve been doing a deep dive in the differences between the midwifery model of care and the medical model of care for pregnancies in the USA. We discussed the merits of changing providers and what might lead you to do so for the best possible birth outcomes. You can find that information on our IG highlight “switch.” Beyond describing how you’d go about making the switch, I wanted you to hear it from a mother whose done it herself, and at 37 weeks pregnant, no less. Holleigh’s birth was one I graciously got to attend during my certifying process as an SMC Full Circle Doula. She wanted an unmedicated hospital birth but needed to switch providers at the very end of her pregnancy to see that happen. Here’s my interview with her:

Tell us about your pregnancy and how you found the first provider you went with:

I was already with my first provider for about three years before becoming pregnant. Each time I went in for prenatal check ups things looked good every time without any red flags or concerns throughout the pregnancy. I found this first provider through a recommendation by a friend who went to that practice for yearly check ups (but had not yet experienced a pregnancy with them at the time).

What were some red flags about your prenatal experience that made you begin considering a switch?

A few months before this pregnancy, I lost my first baby around 12 weeks. While talking with my provider after an appointment, I realized there was a significant miscommunication between the ultrasound scheduling and the doctor which was never clearly addressed or acknowledged. Additionally, the bluntness and lack of professionalism or empathy with which we learned about our loss from the ultrasound technician was jarring.

During this pregnancy, all the visits went well. They were short but professional and informative. Around 34 weeks I inquired about using a room at the hospital connected with the provider that I heard it was a good option for mothers hoping to have an unmedicated birth. She informed me I have to have a midwife to use the room, and asked if I was hoping to have an unmedicated birth. When I told her yes, her response communicated that she did not believe that could be a reality for me despite not having any complications, which was discouraging to say the least. I knew in order to have the best shot at the birth I was hoping for I would need a team that was on board with me and supported me in what I wanted, and I wasn't confident I would have that with this provider. It was my previous experience with this provider in combination with the hesitancy and lack of belief in my birth plan that made me consider a switch.

How many weeks pregnant were you when you made the switch and tell us how you navigated it (were there phone calls to make? did you book an exploratory appt with the new provider? how did you choose who to switch to? how did you have the convo with your current provider about leaving?etc):

We made the switch at 37 weeks, but started the process of exploring other options at 34 weeks. I heard of this new provider from two friends who both went through pregnancies and births with him and had great experiences. After being encouraged by our doula to explore other options if we were considering it, I called the new provider shortly after the conversation about my birth plan. We set up a time to meet the new doctor about 2 weeks later, at 36 weeks. In the meantime, we scheduled a visit to the new hospital we would be delivering at if we did switch. When we had the meeting with the new provider we talked about their values, what would or would not be different in terms of care if we did switch, and any questions we had. After a week, we decided to switch and made an appointment with the new provider. I called my current provider at the time and let them know about the decision, and it was a much easier and quicker conversation than I anticipated. They transferred my files to my new provider and I started my appointments the next week.

What were some of the mental/emotional barriers to making the switch and how did you overcome them?

I was worried that it would be too late in the pregnancy to switch, or that somehow I had an obligation to continue with my doctor at the time, or they would be upset if I left. I also was wondering if it would be more stressful to switch and easier to keep going where I was, and maybe plan to switch sometime after the birth. With encouragement from my partner and our doula, I decided to at least try and set up the necessary appointments to get all the information we would need in order to decide if we wanted to switch. We had a good experience visiting the hospital and found out they have experience with moms with a similar birth plan to the one I had, which made me feel good about where I would deliver. The meeting with the potential new provider went well also, and I appreciated his transparency in saying there probably wouldn't be a difference in quality of care, but in the culture of the hospital and practice. Since it was really the culture and not the quality of care we had reservations about at the other provider, we ultimately decided that the new provider and the hospital would be a better fit for what we wanted. My certainty in the process we used to make an informed decision, and the belief that this decision was best for us, gave me courage to overcome the barriers I had about leaving and starting at a new place so late in the pregnancy.

Were you happy with your choice to change providers? What was different about your experience with the new practice and how do you think that changed your birth outcome?

Yes, I was very happy with my choice to change providers. The experience with the new practice was more personal, more enjoyable, and overall more positive than the previous provider. I do not think I would have been able to have the birth I wanted at the other hospital and with the other provider. The new hospital seemed more familiar working with similarly minded moms and with a birthing team including a doula, and the nursing staff was great. The new provider encouraged me to follow my birth plan, supported me throughout the laboring, and personally checked in the following days at the hospital. When I needed to return the day after getting home we were able to reach the provider after hours and I was able to get in and out of the hospital. I believe the birth outcome, being able to follow my birth plan, and the care afterward were due to the new practice and hospital.

How did your partner process this switch? Did they have reservations and how did you work through those as a team?

My partner supported the decision and encouraged me when I needed it in order to continue the process of gathering information. He was also uncertain about if it would make the end of the pregnancy more or less stressful. We both agreed it made sense to at least check it out, so that's what we did. He came with me to the hospital tour and to meet the new provider. We debriefed after each one and then both as a whole and discussed pros and cons. He was an emotional support by going to the appointments with me and also a thought partner in the decision making process. We decided on what we both felt most comfortable with.

What advice would you give to pregnant moms who are on the fence about changing their providers?

If you are even considering it, it is worth it to gather information and set up a meeting with the new provider, as well as the hospital if that would change as well. That way you can feel like you know what your options are and can make a more informed decision either way. Even if the experience of the new provider was worse, I would feel confident of how to go about changing again if I needed or wanted to, and would probably have a better idea of what to ask about or look for the next time.