There’s a wide, wide range of pregnancy care options out there, from your standard OB to, well…nothing. Each option fits some women, and there are a whole bunch of different individual providers out there to choose from. Natural-minded mamas often find this confusing, because it can be hard — especially in some areas — to find a good match. But it’s possible!!
If you need some support for more natural options…or want to know what I’m doing…keep reading!
What a Natural Pregnancy Looks Like: Choosing Care
In a mainstream pregnancy, a mama is going to call an OB by the time she’s 5 or 6 weeks along, and schedule her first prenatal visit for around 8 weeks. If she has a history of miscarriage or other concerns, she might even be seen sooner than that. Visits continue every 4 weeks until around 28 – 32 weeks; then they are every other week; and by 36 weeks, she’s going weekly until baby is born. Babies are born in hospitals with plenty of intervention and probably induced by 39 – 40 weeks if they haven’t shown up yet.
It’s not exactly a natural approach! And not one many natural mamas even want.
Obviously, for a small number of women — who are at high risk due to pre-existing conditions (like diabetes, morbid obesity, etc.), who have experienced repeated miscarriage or pre-term labor, or are otherwise high risk — early and frequent visits may truly be necessary. None of this is to say that this way is wrong; it’s just not for everyone.
For low-risk, healthy women, this type of early and intense care is really not needed. First-time moms may feel more comfortable with it, because everything is new to them and it’s nice to “check in” more often and know that everything is going okay — and get answers to questions they have.
But! Moms who are low-risk and who have had babies before often want a more…relaxed…approach to care. And this is not wrong. It is perfectly fine to choose care that is more in line with what you need or want for your situation.
In general, you can choose a doctor or a midwife. Among midwives, you can choose a CPM or CNM. Education, experience, and licensing requirements vary by state. And, any doctor or midwife will vary in their personal beliefs and approach to pregnancy and child birth, so having a particular degree, license, or credentials doesn’t mean they are a good fit for you. Be sure to interview a few before you choose one, so you know what you’re getting into. You need to trust this person and the advice and care they give you and your baby.
Choosing Very Hands-Off Care
For my last four babies (2009 – 2015), I choose a pair of CPMs to attend me at home. I had a pair who attended my births in 2009 and 2011, and a different pair who attended my births in 2013 and 2015.
This time, I’m going a little bit of a different route….
It’s important to understand that this is baby #6 for me. I’m what they consider a “grand multip.” (Someone who has had more than 5 babies.) I have a completely uncomplicated history during both pregnancy and birth. If this were not my situation, I might do differently. But it is, so…this is what I’m doing. I’m not *recommending* this to anyone else; just explaining why I choose what I choose.
In this case, I have chosen a CPM who is willing to do very hands-off care. The most hands-off care that I have done so far. Yes, this is possible, and yes, this is safe — for low-risk women who want this type of approach.
Basically, I did not do any prenatal visits yet, and have my first scheduled for 20 weeks. All I will be doing this pregnancy is:
- 3 – 4 total prenatal visits, to meet the midwife and establish a relationship
- External measurements to watch growth of uterus/baby
- Listen to baby with fetoscope
- Possible urine tests to check for glucose/protein
That’s really it.
Unless I see some kind of concerning symptom that is unfamiliar or I don’t feel like I can handle at home, I won’t be doing more than that. I will not get any ultrasounds (here’s why not). I will not do blood tests. Or doppler (a form of ultrasound). No GBS or GD tests. I really will do very little…
What I’m looking for, personally, is to stay healthy, naturally. I take care with my diet (at least most of the time), drink plenty of fresh water, and take very key supplements (this is what I do). I know, in general, what to look for as far as concerning symptoms. I also know that detecting unusual problems before birth won’t change anything for me — I’m not going to abort, and we live within 10 minutes of a hospital if we needed care.
Not seeing a care provider isn’t a lack of prenatal care. Do you really think that it makes a huge difference to go see a doctor for 10 minutes a month, who pokes and prods you and tells you what you already knew? I don’t.
These very brief visits don’t address many concerns, and are aimed at detecting any problems that may have already occurred. There are very few asymptomatic problems that occur during pregnancy…so basically, these brief visits do not provide a whole lot of new information. And as a mom-of-many, I certainly don’t need basic warnings on “eat this, not that” or “which symptoms are normal and which ones aren’t” because I already know!
If I had concerning symptoms (strong cramping, early contractions, bleeding, lack of fetal movement after 20 weeks, etc.) yes, I would seek care at that point. I’m not opposed to care when needed, I’m only opposed to unnecessary interventions.
Find Care That Works for You
It is possible to find care at a level that works for you, whether that’s extremely hands-on if you’re high risk, or very hands-off if you’re not (or even no outside care).
There are doctors and midwives who will, and should, work with you to provide individualized care!
We were lucky, and found a local midwife with glowing recommendations. She worked as a NICU nurse for years, so she has the Western medical training (just in case), but got fed up with the system and has worked as a midwife for many years now. She’s willing to work with us on minimal care and trusts that, as a mom-of-many, I know what I’m doing and don’t need a lot of hand-holding.
There are doctors and midwives out there who will work with you! I’ve talked to friends with flexible care options, as well, at many different levels.
Don’t accept “standard of care” and abdicate responsibility. Don’t decide “If they do it this way, they must have a good reason,” and just go along with it. Obstetrics is sadly one of the least-evidence-based fields, and women are often bullied into things they don’t need, and even treated with very little respect.
This is common because if something goes wrong, the doctor is liable for it. If they proceed in a hands-off way and something goes wrong, the doctor is more likely to get in trouble than if they intervene too much and something bad happens. They have to prove they “followed guidelines” and “tried to prevent” (or treat) issues in order to stay out of legal trouble. So, care guidelines are largely to protect themselves…not you.
If you have a good care provider, they will discuss your options with you and make recommendations based on your situation. They won’t insist you do anything specific. It will be a dialogue about what is best and what to do.
A bad care provider will insist on doing things because they are “protocol,” seem annoyed about having to answer questions, or bully you into things you don’t need or want. Regardless of what care level you are looking for, RUN if this happens!!
At any rate…you deserve to choose what works for you, and have a care provider who respects you.
Some more reading on specific procedures and tests:
How do you have choosing care for a more natural pregnancy?
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