Ask the Childbirth Educator: Changing Care Providers during Pregnancy/TITLE> <META NAME="GENERATOR" CONTENT="Arachnophilia 3.9"> <META NAME="FORMATTER" CONTENT="Arachnophilia 3.9"> <meta name="description" content="Parenting information for mindful families practicing attachment parenting, offering baby items and more.. 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I am with the OB/GYN I've seen since adolescence and I really like him, but I'm starting to feel doubtful that he understands what I hope for with this birth. I'm already into my 2nd trimester though - do I have any options?</FONT> <P><FONT FACE="Tempus Sans ITC"><FONT SIZE=+4>A:</FONT></FONT> Technically it is never too late to change your provider. However, changing your provider later in pregnancy can sometimes be difficult for various reasons which I will discuss briefly. Most pregnancy care providers (Obstetricians, family doctors, midwives) charge for a total package of prenatal care and then bill the birth/delivery separately. Thus, if you decide to change sometime in pregnancy, it is difficult to determine how much of the prenatal fee is owed to that particular care provider. If you are already paying for your care out-of-pocket, this could possibly incur some added expense. If you have health insurance or belong to an HMO, there may be difficulty switching as well, especially if there is a limited number of care providers to choose from. Like you, some women feel a sense of loyalty to their care provider if they have been with that same person since adolescence. Changing to an unfamiliar care provider during pregnancy can be emotionally difficult. There is not always the guarantee that the new care provider will be 100% receptive of your birth plans. There are options for you besides changing care providers. The first is to become educated about your choices in labor and birth. Take a good consumer-oriented childbirth class. An independent educator is more likely to teach a class about your options than about "how to be a good patient." Read several different books about pregnancy, labor, and birth. My favorite authors are Sheila Kitzinger, Penny Simkin, and the Sears'. The next option is to hire a professional labor support person or doula. A doula is a woman trained in supporting a woman through labor and birth. She knows various comfort measures which can help you cope with the intensity of labor; she is educated about different options for childbearing women and can provide you with information to help you make an informed decision about your care; she is familiar with the rhythms of labor and will provide you with the reassurance that, yes, you can do this. To find a doula near you, you can contact Doulas of North America (DONA) at AskDONA@aol.com or visit the DONA website: http://www.dona.com. Several other childbirth organizations have doula training programs: ALACE, ICEA, Lamaze International, and Birthworks. To find information about their doulas or labor assistants, follow this link on my website: http://w3.one.net/~valerie/cbe.htm Remember, as a health care consumer, you have the right to change your care provider at any point if you are unhappy with your care. If changing is too costly or too difficult, arming yourself with information and support is your best step in attaining the birth you want for your baby. <P>Copyright, Valerie Malott 1999 </TD> </TR> </TABLE>  <P><CENTER> <IFRAME SRC="http://www.wearsthebaby.com/ads/ads.cgi?iframe" MARGINWIDTH=0 MARGINHEIGHT=0 HSPACE=0 VSPACE=0 FRAMEBORDER=0 SCROLLING=NO WIDTH=468 HEIGHT=60> <SCRIPT LANGUAGE="JavaScript"></SCRIPT> <NOSCRIPT> <A HREF="http://www.wearsthebaby.com/ads/ads.cgi?banner=NonSSI;page=01" TARGET="_blank"><IMG SRC="http://www.wearsthebaby.com/ads/ads.cgi?page=01" WIDTH=468 HEIGHT=60 ALT="Wears the Baby Banner Ad" BORDER=0></A> </NOSCRIPT> </IFRAME> </CENTER>  </BODY> </HTML>