Prenatal Care

I have been thinking about pregnant women a lot lately.  Over my career, and on my own journey as a mother,  I have come to see that we are missing opportunities to support women as they grow into mothering.   When I see pregnant women out in the world, I ask them about where they are getting their care, because I care.  I know what a transformative time pregnancy is, and I know how impactful thoughtful care can be.

I assume that they ARE getting prenatal care somewhere, because most women do.  Unless they don’t have easy access to care (more about that in a different post).  What I find, not surprisingly, is that the majority are getting their care in the traditional manner – quick visits over the pregnancy without much opportunity to dig into the important work of becoming mother.  When asked about their experience, they shrug their shoulders, “it’s okay”.

They block their schedule to attend appointments, drive, park, wait, wait some more, and then get an appointment that is often brief and focused on identifying complications and timing of interventions.


I have provided this type of care.  From the provider side of things, we have many patients in a day, with little time for self care for ourselves.  It’s not uncommon to miss lunch, or to eat while charting.  Providers too are pressed for time.  It’s not a healing environment for any involved.  From my perspective, as a health care provider who focuses on wellness throughout the lifecycle, our traditional model doesn’t work and we are missing the huge opportunity this time in life provides for growth – in all areas.  Women take precious time from their full schedules to get prenatal care, it’s time we make that care more than a “medical check in”.

Recently, I attended a presentation at the University of Colorado, about research that is finding complications in pregnancy are predictors of health complications later in life.  Kind of common sense, I think.  It will be another twist in maternity care to see how these findings impact a Western Medicine point of view.  From a wellness focused perspective,  I contend that the reverse is likely as well, wellness in pregnancy and the postpartum period are predictors of wellness later in life.  What are we doing in this important time to promote health and wellness? Sadly, not much.

I know women and providers often focus heavily on labor and birthing.  I understand why this is and definitely believe that there is so much that needs to be explored and learned in preparing for that day.  But often in our focus on that day, we miss that the big work that comes after the birth.  From my perspective, pregnancy, labor and birth provide the learning field for parenting.  We get many opportunities, big and small, to work with discomfort, uncertainty, loss of control, surrender and anxiety.  AND: joy, connection, love and growth. Will we lean in, and work with these opportunities?  Are we supported in doing this work, or does our provider enable us and sometimes even guide us away from those opportunities?  How about after the baby arrives.  A 10-20 minute follow up appointment at 6 weeks, does little to support a new family.

There are exceptions to the traditional model of care.  We need to get the word out about these options so people can make choices about what their maternity year will look like. Women need to be encouraged to ask for better care, if not from their current providers, then by deciding to seek care elsewhere.  There are practices offering Centering Pregnancy, a group model of care with excellent outcomes for moms and babies.  There are birth center and home birth practices offering longer visits with a broad focus on wellness during the childbearing year and beyond.  There are small, independent practices providing a model of care that has a lasting impact, not just on the labor and birthing, but on the long journey of parenting.


Questions to ask when looking for pregnancy/postpartum care:

  • How long are appointments?
  • How often are appointments?
  • Who do I have access to when I have needs or questions between appointments?  Am I encouraged to check in with those concerns? Via what method: phone, text, chat, email, teleconference?
  • Who provides my care?
  • Are there any group appointments?
  • What about postpartum care?  How many visits with the provider?  Any groups?
  • What is the content of my care?  What topics do we cover?
  • What is the practice’s philosophy of care?
  • Do the providers model wellness?  Is the environment supportive of wellness?

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