How to know if you can trust your midwife or OB

Trust is built little by little by small actions. It’s all the times you make yourself vulnerable and are received with connection

Trust. It’s a big one. How should you know if your provider is trustworthy? According to researcher and author Brene Brown, it can be broken down into 7 key points.

1) It all starts with boundaries. What is yours and what is mine.

Is your doctor or midwife clear about their training, skills, and what they can and cannot do? Are they able to give you firm answers to your questions about their practice style, or do their answers vary significantly week-to-week? For example, does your doctor affirm that they want you to attempt a vaginal-delivery-after-cesarean (VBAC) when you ask one day, but another day suggest you schedule a repeat cesarean? Do they hold their boundaries and respect yours? Does your midwife disrespect you if you want to circumcise your son?

2) Reliability. They say what they are going to do and do it, again and again. This means setting limitations to avoid burnout.

In those small insignificant moments in your pregnancy, your provider shows kindness.

Meeting your parents, listening to your questions, celebrating your gender-reveal, laughing with you about gobs of mucous, inquiring after your sick parent, asking for clarity over difficult questions, spending extra time with you to discuss and understand your birth plan.

3) Accountability.

Does he or she participate in continuing education and strive to incorporate the most recent evidence into their care? Do they participate in ongoing peer review? Due to the litigious nature of our country, most providers I know put tremendous pressure on themselves to be perfect. Reality is perfect does not exist. The best we can do is to have accountability. When we make a mistake, we own it, apologize, and make amends. Litigation is scary for providers think about, but people don’t pursue litigation purely because of the outcome. They do it because they feel unheard.

4) Confidentiality. Your story is yours.

The Health Insurance Portability and Accountability Act (HIPPA) of 1996 regulates privacy and security information. This act makes it illegal for health care providers to share your personal information with identifying information to the public. When you sign your HIPPA form, it does allow providers to consult with other people involved with your care for health reasons (for example, your primary care physician, therapist, or endocrinologist), to bill your insurance, and to use your case in a confidential peer review process. In the age of social media, it should be said it can also be appropriate to share your information with your specific permission.

Sadly, confidentiality is not always kept. Midwives, especially, are notorious for posting on social media in a way that betrays confidence. Some people love to gossip. I have personally heard horror stories about providers breaching confidence by telling the home birth community about so-and-so’s birth story in great detail.

5) Walking in integrity and encouraging others to do the same. Brene Brown defines integrity as “choosing courage over comfort, what is right over what is fun, fast, or easy, and practicing your values, not just professing them.”

This looks like a provider who stays and continues to provide care when their patient is refusing their recommendation. Not rushing to break waters. Doing slow inductions. Volunteering and doing pro-bono work to change health outcomes.

6) Non-judgement. You can weep in front of your provider because you didn’t know the contractions were going to be so hard. And you can ask for help, without being judged.

It goes without saying that being shamed for your parenting choices or weight during pregnancy does not build trust. Trust is built when you can ask for help and you have to be able to ask for help to keep your sanity as a new parent.

7) Generosity

Life is hard. Perhaps you failed to do your glucose tolerance testing. Your provider is worthy of trust when you are given grace if you slip up on something and are given appropriate time to explain what happened.

You and your provider can assume the most generous thing about your words, intentions, and behaviors, and then check-in.

Finally, are you able to trust yourself that you found the provider you want? If you’re not sure you can use this same kind thinking with yourself. Check in and see if you’ve been trustworthy. Do you agree with this list? Are there other things you would add to this list? We would love to hear your answer in the comments.