The easiest way to ensure you do not have a C-Section is picking a doctor who supports and is familiar with natural unmedicated chilbirths.  Most doctors allow interview appointments for prospective patients to ask them questions.  If they do not, then they may not be the doctor for you.  There are many key questions you can ask to get to the heart of the matter on whether the doctor is for you.  Do not be scared, timid, or apologetic when asking the questions.  It is your right to be informed about how your doctor feels and the way they handle childbirth.  It is not only you that you are concerned about but also the care and health of your baby. 

When asking questions it is better not to have a physical list and to run through the questions machine gun style.  You do not want to be aggressive or have an accusatory sound to your voice.  You do not want the doctor to feel like they are at an inquisition being interrogated and in turn to become defensive (which would be a normal human reaction). Try asking the questions in a friendly, non-confrontive manner and insert the questions in the conversation.  The questions should not be asked so that the doctor can answer in a “yes” or “no” format.   You would want open-ended questions to allow the doctor to elaborate on their response.  The purpose is to draw out how the doctor deals with labor and delivery plus with any complications that may arise.  Be wary of short or placating statements.   Understand that you are not there to argue with the doctor or to change their mind about their practices.  It is best to continue the search for a doctor that thinks like you do and is on the same page with the key most important points you have regarding the type of birth you envision.  Also, remember that at your birth you have the right to say "no" to any procedure.  If the doctor you choose seems to change their stance on issues once you are in labor and under their care at the hospital, you can remind them of their comments at the interview and politely refuse the suggested procedure.  However, you must understand that you need to listen to what they propose and their reasons for suggesting it.  There are legitimate reasons for suggesting procedures if a complication occurs during labor.  You may not find a doctor that sees everything the same way you do so balance the answers and try and find a doctor that is most like you and has the same position you have on the most important aspects of your birth plan.  If some of the answers to the doctor questions are not important to you, skip them.  The interview should be calm and to the point.  No need to rush through a lot of questions that deal with issues you are not concerned about.

Questions to Ask Your Doctor

1)     What do you think about routine fetal heart monitoring and IV’s?  If they support routine IV’s and heart monitoring then they do not see childbirth as a natural process in which outside interventions are the unusual and not the norm.

2)     What would you do if my bag of water broke and no contractions followed?  A possible follow-up question may be, How long do you allow a woman to safely wait to give birth after her water breaks?  If the answer is 12 hours then the doctor may not be for you.  A reasonable answer is for the doctor to suggest that you routinely take your temperature at home and to come into the hospital if you have a fever.  Contractions usually follow the breaking of the water between 24-48 hours so 12 hours may not be enough time to allow for the natural birth process to begin.

3)     If the baby and I were fine, how long would you let me push in the pushing stage?  If the answer is two hours, then the doctor may not be for you. You are looking for “as long as you are able if you and the baby are not in any trouble”.

4)     What do you think about episiotomies?   If you hear, I don’t do them routinely but I find that most first time mom’s need them so they do not tear.  Then you have learned that the doctor does episiotomies most of the time if not always.  They either are not aware of the studies showing they are usually unnecessary or they like to rush the delivery for their convenience.     What you would like to hear is that they do not do them because most women do not need them and slight tears heal well without problems.  If you hear something similar to this, ask them if they known about the pressure Episiotomy and would they conduct this sort of Episiotomy.  Explain that if you needed to be stitched you would agree to the local anesthesia at that time.

5)     What positions do you allow women to deliver in?  If they say the bed, then inquire about different positions in the bed (squat, all fours…) If they say they only use the bed, ask if they use stirrups and require the mom to remain flat on her back or will allow a reclining sitting position.

6)     How do you feel about mother’s nursing immediately after delivery and not conducting any baby exams up to two hours after birth which can not be done while in the mom’s arms?  

7)     Do you have a time limit on the delivering of the placenta and if you do, what procedures do you use?  How about allowing the placenta to be delivered without pulling on the cord and without pitocin?  How do you feel about not cutting the cord until the placenta quits pulsating on its own?   Ideally you would want at least a half hour to wait for the placenta to detach and be delivered.  Since you already discussed nursing immediately after birth, they should know that the nursing will contract the uterus naturally and that pitocin would not be needed.

8)     How do you feel about purposely breaking the bag of water?  I really do not want this done.  This should be easily accepted since declining the procedure is your right. 

9)     What is their C-section rate (should not be over 10% but a lot of doctors have a rate of 30%) 

10) Do they have a required time for the progression of dilation?  If you are doing fine with labor, the labor should be allowed to progress at it’s own rate.

After the discussion is coming to an end.  You may want to say that you are wanting an unmediated natural childbirth without any routine procedures or outside interventions and would like to know if the doctor would support you in this.  Also ask them how often they have these types of births and how they felt about them.

Information above gathered from the book, Natural Childbirth the Bradley Way by Susan McCutcheon.