While there are plenty of uncontrollable factors that go into every birth, one of the most significant choices you can make is that of your care provider. So, how do you decide which care provider is right for you?

First, write down what your ideal birth looks like. Do you want an epidural? Would you prefer a water birth? While you're laboring, do you want to be left alone or have extra support? Do you have strong opinions on procedures like episiotomies or IVs during labor? When you interview care providers, ask what their opinions are on the things that are important to you.

The most important thing is to have a care provider who supports your view of birth and is willing to work with you and your birth team to help you feel supported and empowered no matter what kind of birth you end up having.

Here is a sample list of questions to ask when interviewing care providers:
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• What things are routine procedures for a laboring woman under your care?
  
• If my water breaks, how long before you will induce or augment labor?
  
• What is your cesarean rate?
  
• What is your episiotomy rate?
  
• How often do you find it medically necessary to use pitocin? Can you give me examples?
  
  • Time? Wellbeing of baby? Position? Be specific
    
• What is the procedure for going to the hospital (call first? Just head in?)
  
• What is your policy on pitocin in the third stage?
  
• How often do you use vacuum or forceps extraction?
  
• What methods of fetal monitoring are available?
  
• Do you restrict food/water intake?
  
• Who is your backup if you are unable to attend my birth? Will that person honor my wishes?
  
• Do you require an IV during labor?
  
• When working with a care provider team, how do you make sure everything goes smoothly? (doctor, midwife, nurses, doula, partner)
  

Last year, the CDC published a study that has been tracking the age of first time mothers. The study concluded that the age of first time mothers has increased across every ethnicity, mostly due to the decrease in teen pregnancy since its peak in 1990. 

Age during pregnancy can be a factor in calculating a woman's pregnancy risks, specifically if she is 35 or older. These factors include having a baby with Down syndrome, as well as a higher rate of spontaneous miscarriage. 

If you would like more information on the risks of advanced maternal age on pregnancy and childbirth, check out this article from Evidence Based Birth. And, as always, discuss your personal risks with your care provider.

The most common question a birth professional gets (after "am I in labor?") is: When should I head to the hospital? In our culture, there is a huge fear of 'not making it' and having an accidental unassisted birth at home, in the car, or on the side of the road. It's also becoming more common for women to want to labor at home as long as possible to avoid being 'on the hospital clock.' So how do you know when to leave?
Basic rule to remember is: 5-1-1. When your contractions are 5 minutes apart, 1 minute in length, for 1 hour, you are definitely in active labor. If you head out earlier, the adrenaline and excitement of getting in the car, driving to the hospital, and going into triage can cause your labor to stall. This usually means they will send you home, but at some hospitals, they will admit you. If you are concerned about being 'on the clock,' this is definitely something you want to avoid.
As always, talk to your care provider about when they want you to call them and what their recommendations are for arriving at the hospital.