Booby Traps Series: What you should hear (and not hear) at your prenatal visits

This is the second in a series of posts on Booby Traps™ during pregnancy, made possible by the generous support of Motherlove Herbal Company.

Last week I wrote about one of the first Booby Traps™ many moms encounter:  providers’ lack of education about breastfeeding.

Your comments on that post beautifully illustrated the range of what we actually experience  in those prenatal visits.  That’s the topic of this post, so I thought I’d start with a few of your comments – my highlighting added – that point out the good and bad in prenatal visits:

My OB asked about breastfeeding and some birth preferences at my very first appointment!She also has a sign in her office waiting room that says something like, “Breastfeeding is welcome here. Let us know if you prefer a private area.” This is the same OB who congratulated me when I first came to her and mentioned I was still BFing my toddler. I know that she is a rare gem, though. I wish more doctors in general were as pro-breastfeeding as she is. After all, it is pro-good health for everyone involved. – Jorie

I don’t recall either of the OBs I went to asking if I was planning on breastfeeding. Both gave me a bag of marketing materials from several companies including 3 samples of formula each. I never thought twice about asking if my docs or my baby’s future pediatrician were pro breastfeeding. Since having the little guy, we switched doctors and my first question was if the docs I had in mind were pro breastfeeding. As soon as I asked, I was transferred to two lactation nurses who are available M-F during business hours to help with any feeding issues. I never even knew that this was a free service. Its so amazing that these resources are not advertised…Great article! – Veena

I am so lucky. My Ob was my OB with my last child. I also know she pumped at work for a long time with her youngest. I told her I was planning to breastfeed and she told me that we would make sure my high blood pressure meds wouldn’t mess with breastfeeding. I know she knows I will breastfed and she totally supports me. She has no posters supporting formula in her office. Glad to have a supportive OB! – Kelly

I was with an OB until 20 weeks with my first son and never heard a peep from her about breastfeeding. All she told me was to take prenatal vitamins and stop eating fish.  I had my first son under the care of midwives at a free-standing birth center and my second with a different midwifery practice at home. In both cases, we discussed breastfeeding often during prenatal appointments. I got such great care and support after my first was born with everything from a proper latch to the range of holds and positions that I had a great breastfeeding relationship with my first son that lasted 27 months and needed no help at all with number 2. – Kim

Research tells us that we make our feeding decisions early in our pregnancies, and that our providers are very influential in those decisions.  So, what should we be hearing at our prenatal appointments?

Here are some of the things I wish all mothers would hear.  Of course, all of this discussion should occur in a judgement-free zone.

  • An opened ended question about feeding, such as “Have you thought about how you’re going to feed your baby?” or “What are your plans for feeding your baby?”  The provider should be prepared to discuss the importance of breastfeeding to her baby’s health (and hers), and about current recommendations.
  • “What questions or concerns do you have about breastfeeding?”
  • “Here’s a list of breastfeeding support resources in our area.”
  • “Have you signed up for a breastfeeding class?”
  • “Here’s what you can expect to happen with your breasts during pregnancy as they prepare for breastfeeding…”
  • (If this is not your first breastfed baby) “How did breastfeeding go with your other baby(ies)?  Is there anything you’d like to discuss about that experience that might relate to your new baby?”
  • “There are two things we like to ask so we can prepare for a good breastfeeding experience:  Have you ever had any breast surgeries?  Has anyone ever checked to see if your nipples are inverted?  If not, I can do that when we do a breast exam.”

Here are some things you should not hear or see about breastfeeding in your provider’s office:

  • (Silence)
  • “Here’s your free bag of goodies, including some formula – just in case.”
  • Anything that would make a mother feel judged for her feeding decisions, no matter what she decides

I’m not the only one who thinks that these are topics that should be covered in your visits.  The American College of Obstetricians and Gynecologists (ACOG), has a statement on breastfeeding which encourages OBs to begin supporting breastfeeding during prenatal visits – starting with the very first one.  They promote discussing the advantages of breastfeeding (specifically exclusive breastfeeding), exploring any barriers to breastfeeding, discussing normal breast changes in pregnancy and breastfeeding and checking for inverted nipples, reassuring mothers about their ability to breastfeed, and promoting prenatal education on breastfeeding. 

Remember, if you don’t like what you’re hearing or seeing, you can advocate for change or in most cases select a more supportive provider.  As you can see from the stories in this post, there are some great providers out there!

What kind of things did you hear at your prenatal visit?  Please leave a comment telling us about your experience!

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14 Comments | Last revised on 02/23/2011

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