What If Your Size-Inclusive OB or Midwife Isn’t On-Call During Your Birth? Pregnancy is a unique journey filled with excitement, anticipation, and, often, a lot of careful planning. For individuals who desire size-inclusive healthcare, finding an understanding and supportive OB or midwife can be a crucial aspect of their pregnancy journey. 

How to Plan & Prepare for a New Midwife Last Minute

But what happens when the healthcare provider you’ve carefully chosen isn’t available during your labor and delivery? This can be a challenging situation to navigate, but with the right preparation, you can still work towards a positive birthing experience. In this blog post, we’ll discuss how to interact with an unknown provider, set boundaries, and advocate for yourself when this provider may not know anything about you or size-inclusive care. 

While there are many ways to go about adjusting to big changes during your pregnancy, and yes, it is totally okay if it includes tears and ice cream! Change is hard and when you add hormones on top of it, it can be very overwhelming to think of having a new provider. Below are six things Big Fat Pregnancy feels can help make the adjustment go more smoothly.

Bring Communication and Education to the New Provider Relationship

Acknowledge Your Feelings

First and foremost, it’s essential to acknowledge the emotions that arise when you realize your chosen OB, midwife, or doula won’t be attending your birth. Feelings of disappointment, anxiety, or even fear are entirely valid!

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It’s important to recognize these emotions, give yourself permission to feel them, and seek support from loved ones or in the case of a care transfer before delivery, adding in a therapist may provide space to process. Remember that your feelings matter, and addressing them is the first step toward accepting a different birth experience than you were hoping.

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Open Communication

Effective communication is key when dealing with a new healthcare provider, OB or Midwife, especially during labor.

As soon as you’re aware that your original provider won’t be available, try to establish a connection with the new provider.

This may be hard to do as you could be 1 hour, 12 hours, 24 hours into labor and your ability to connect may be diminished. Open communication, boundaries and advocacy (talked about below) may need to happen through your partner, support person, and/or doulas.  

Express your concerns and preferences as early and as clearly as possible. Let your new provider know about your fat-positive stance and any specific needs or considerations related to your body size. Be honest and open about your birth preferences! If there is time and energy, invite questions and discussions.

Educate Your New Provider *

It’s possible that the new provider may not be familiar with the concept of size-inclusive healthcare or challenges that individuals with larger bodies face during pregnancy and childbirth. Take the opportunity to educate them about your perspective and the principles of fat positivity. Share resources or articles that can help them understand your preferences and needs better. Remember, your new midwife or provider’s willingness to learn and adapt can make a significant difference in your birthing experience. If they are unwilling or not open to this discussion and you have time, energy, etc. continue looking for a new provider.

*this is more helpful if you are transferring care with time before delivery, not during labor

With a Last Minute Provider Change We Advise . . . 

Set Clear Boundaries

Setting boundaries is crucial during labor, especially when you’re working with a provider who is unfamiliar with your history and preferences. Clearly communicate your boundaries regarding touch, procedures, and decisions. If there are aspects of care that you’re not comfortable with, express them firmly but respectfully. Your body, your birth, your rules. If you need help setting or holding boundaries, enlist the support of your partner, support person, labor nurse, and/or doula.

Advocate for Yourself

Advocating for yourself is a fundamental aspect of a positive birthing experience, regardless of your midwife or OB. Trust your instincts, and don’t be afraid to speak up if something doesn’t feel right or if you believe your preferences are not being respected. 

Remember that you have the right to informed consent and refusal, and you can ask for explanations and alternatives if you have concerns about any procedures or interventions.

A good trick is to ask for a few minutes without staff present to discuss options presented, alternatives, and honest feelings. It can be easier to suss out your desires without a medical professional waiting for your response. 

Have a Support Person

We say this a lot at Big Fat Pregnancy, but we truly believe that having a trusted support person, such as a partner, family member, or doula, can make a significant difference in your birth experience.

This person can help you communicate your needs and preferences to the new provider, provide emotional support, and act as an advocate on your behalf if necessary.

Their presence can help you feel more empowered and confident during labor. Even something as simple as a smile or a head nod can encourage you on this journey!

While it can be disheartening to discover that your carefully chosen provider, midwife or OB, won’t be available during your birth, remember that you still have the power to shape your birthing experience.

Effective communication, education, setting boundaries, self-advocacy, and having a support person by your side can all contribute to a more positive and empowering birth, even when working with a new provider. 

Ultimately, your body and your choices should be respected throughout the birthing process, regardless of who the provider is. We know this doesn’t always happen, and so, by taking these steps, you can help ensure that your voice is heard and your preferences are honored.

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