During pregnancy, the mother’s doctor or midwife cares for both mother and baby. With so much focus and excitement being placed on the prenatal appointments, it can be easy to overlook one of the most important tasks that you will accomplish as an expectant mother: choosing a quality, post-birth healthcare provider for your baby!
Soon after birth, your baby will need his/her very own healthcare provider. In fact, in the first year alone, expect to visit this provider at least 7 times for standard check-ups, which typically involve taking measurements, giving vaccines, making behavior observations, and completing developmental screenings. While these sorts of visits are considered the bare minimum, many parents do find themselves at the doctor’s office more frequently, depending on the health of their child and the vaccine schedule they are on. Considering how often your child’s life will be impacted by this provider, it is valuable to choose one that you feel safe with and trust!
My goal, as a Childbirth Educator, is to provide you with knowledge that enables you to confidently select the healthcare provider that best suits your values, while also informing you about the healthcare choices you get to make as a parent to your child.
Your choices matter, as you are the one who ultimately cares for this precious baby. After being so involved in their health during pregnancy, I encourage you to continue to be just as involved as they grow and develop.
Now let’s take a look at 4 things to consider when choosing a quality healthcare provider for your child!
#1. Being Informed… to Give Informed Consent
In an earlier blog post titled “4 Reasons to Invest in a Childbirth Class,” I talked about the importance of informed consent during your birth process… and it’s just as important after birth too! Let’s recap:
Informed consent is the permission that is granted by a patient to the doctor for carrying out treatment.
Although informed consent implies that the patient is informed, this does not always ring true. Giving consent without having a full understanding of all the possible risks, benefits, and alternatives of that treatment can easily happen, is dangerous, and puts you in a passive position rather than one of active involvement.
How does this happen?
- A medical practice is presented as normative, causing the mother to misunderstand that it is still optional! (You have likely discovered many times during your prenatal experience that a normative practice may not be in the best interest for everyone.)
- A medical practice is strongly suggested by the healthcare provider, causing the mother to battle between simply trusting the trained professional’s word or trusting herself to weigh all of the options before making a decision. (The truth is that you, the dedicated parent, are the best person to make decisions that will impact your child’s future.)
- The healthcare provider is hurrying to move on to the next patient and gives a rushed explanation, causing the mother to lack the time or information needed in order to be truly informed. (Informed consent to the practices of the healthcare provider should be given voluntarily and without duress, meaning that you should never be forced to agree to a treatment that you do not feel comfortable with.)
- You take on a “go with the flow” approach. (Sleep-deprived mommas who are juggling a growing child, new routines, and evolving relationship roles truly do need others to step in and help them out. Even if it may be tempting to let the baby’s healthcare provider take over, this is one area that your full attention is needed.)
Regardless of how busy the health clinic is or how strongly your healthcare provider feels about a certain course of action, you ultimately hold the position of protecting the health of your child; therefore, you must be fully informed about a treatment before signing informed consent. Don’t be afraid to speak up, ask questions, or take a few days to research! Just like creating a birth plan helps prepare you for your birth experience, starting to inform yourself now (ideally, before your baby has made his/her grand entrance into the world) helps prepare you for the types of treatment that will be offered during these standard visits.
TIP: Use the easy-to-remember acronym B.R.A.I.N. (Benefits, Risks, Alternatives, Intuition, Need More Time) when making any medical decision!
#2. Having a Vaccine Plan
The reason why I want to delve into vaccines in this post is because it is important to choose a healthcare provider that will accommodate the choice you make regarding vaccines. This is a very hot topic for many people. Know that I am not trying to persuade you one way or another; I simply hope that this information will empower you to make a choice you feel most comfortable with for your child’s health.
What does the law say?
There is not a federal law that mandates vaccinations; however, some states no longer give their residents the right to decide against vaccinating their child. Many states require vaccinations for children that attend public schools, yet there are exemptions available based on religious and medical reasons. Child-Care Facilities in Texas also require that your child be getting routine vaccinations. To make it clear, residents of Texas do have a choice! In fact, not only do you have the right to decide for your child whether or not to vaccinate, but you can also decide the specific vaccination schedule.
What is a vaccine?
A vaccine is a product that delivers immunity against a disease, usually in the form of an injection. They do indeed save many lives and have been trusted by many to be safe and effective. They are credited for the decrease of many disease rates, such as polio and diphtheria. The Centers for Disease Control and Prevention (CDC) has a recommended vaccine schedule that the majority of healthcare providers tend to follow. There are over 9 diseases that the vaccines provide immunity for, and the immunity is typically built through a series of multiple injections of each vaccine. This means that there are about 29 doses of vaccines planned for children aged 0-6 years, and it is not uncommon for a child to receive 5-7 different injections during 1 appointment.
If many healthcare providers strongly agree with following the CDC’s recommended vaccine schedule, why would a parent consider diverting from this schedule or even not vaccinating at all?
Many parents and health care providers want to vaccinate yet prefer to follow a different schedule than the one the CDC recommends due to the belief that getting too many vaccines at one time – especially while the child is so young – is not the safest approach. For example, instead of getting 5 or more vaccines during 1 visit, your child may get only 1 or 2 at a time. Or they may choose to schedule only 1 aluminum-containing or mercury-containing vaccine per visit or per month. This would reduce the level of heavy metal exposure in one visit and allow the child’s body to recover before being exposed to high amounts of heavy metals and other vaccine components the next time. Dr. Paul Thomas outlines a delayed vaccination plan found in his book The Vaccine-Friendly Plan, and Dr. Robert W. Sears offers an alternative vaccination schedule found in The Vaccine Book.
Many parents – and even some healthcare providers – may desire to avoid vaccines in general due to both the belief that most infections can be effectively dealt with by the immune system, as well as the desire to prevent negative side effects from ingredients found within the vaccines (such as heavy metals and preservatives). For example, Dr. Thomas postulates that the heavy metal content (such as aluminum and mercury) in some vaccines may be contributing to problems such as allergies and autism, which are increasingly on the rise despite the advanced medical system we have. In 2008, the CDC released a study that found food allergies among children had increased by 18% from 1997 to 2007. In 2000, the CDC reported that the prevalence of autism was 1 in 150 children; but by year 2012, the prevalence had increased to 1 in 68. It is also important to note that there are also many new environmental, lifestyle, and diet changes that children are now exposed to that could also be contributing to the these increases; therefore, we do not yet understand all of the factors that are causing this significant decline in the health of children.
Ultimately, you as the parent need to assess the risks of vaccinating versus not vaccinating and make the best decision you can. If you choose to not vaccinate, are you okay with the risk of your child’s immune system not being able to fight off exposure to a disease that could have been prevented? Likewise, have you spent time informing yourself about the many ingredients in the vaccines? Have you thought about your specific family history and whether or not anyone in your family has had an allergic reaction to a vaccine?
This is a big topic to understand, so take your time researching and coming up with your plan. Once you have become informed, trust yourself to make the best decision you can with the information you have and find a healthcare provider that will work with your plan! If you choose to deviate from the CDC’s recommendations, it will be important to choose a “vaccine-friendly” physician, one who will accommodate your vaccination choices.
TIP: Ask any nearby family, friends, neighbors, and co-workers with kids who share your philosophies for healthcare provider recommendations. If you have a good relationship with your current provider, ask him/her for recommendations too!
#3. Considering Office Environment
Now we move to a less heavy topic: the environment of the office. You can call offices and ask several questions prior to your baby becoming a patient there. You could also ask these questions to any friends or family members who go to that provider!
Here are some of the questions you may want to ask:
- Are they accepting new patients?
- What are their prerequisites for new patients? (Some only accept newborns, only accept newborns born at specific hospitals, or may require that your child have the Vitamin K injection at birth – as opposed to the Vitamin K drops or no Vitamin K at all.)
- Does the practice accept your insurance? If it is possible that your insurance may change, do they accept a variety of other forms of insurance?
- How far away is the office from your home?
- If the office is a group practice, who are the other providers your child may see?
- What is the bedside manner of the provider like?
- How do they feel about breastfeeding?
- What is their philosophy on circumcision?
- What is their philosophy of antibiotic use? (Antibiotics are definitely necessary in some situations; however, there is an antibiotic resistance crisis now due to the overuse of antibiotics. Also, antibiotics kill both the good bacteria and the undesired ones, which could lead to other problems since good bacteria have a vital role in our health.)
- If your child needs to be hospitalized, where would he or she be admitted to? Is your insurance accepted at that hospital? Would your doctor go to that hospital to take part in the care of your child?
- How long does a typical check-up last?
- What is the waiting time to be seen? (This may be even more important to you if you choose to delay-vaccinate your child since you will be going to the office more frequently.)
- Will you be seen by a nurse, a nurse practitioner, or a physician? Are you okay with this?
- What are the office hours? (If you are a working or single parent, evening and weekend hours may be desirable for you.)
- What is the waiting area like? (Some offices have a waiting area specifically for ill children and one for children who are just there for routine check-ups.)
- Are the staff easy to communicate and work with?
- What is the office policy on phone calls? Is there someone you can ask routine questions to when in doubt without having to schedule an appointment to come in?
- What happens when your child becomes sick after hours?
- Is it possible to interview the healthcare provider one-on-one? If yes, is there a charge?
If a one-on-one interview is not available, be sure to ask the office if they offer any meet-and-greet sessions, which allow you to meet the providers and determine if they are a good fit for you and your child.
#4. Switching Providers
Finally, I want to end this post with an encouraging message! The first healthcare provider that you choose does not have to be the one that you stay with; it is okay to change providers if you feel like the match is not working out. I strongly recommend switching providers if you experience resistance from them or feel like your questions and concerns are not being respectfully addressed.
Some offices may ask why you are choosing to switch care, which may be a good opportunity to leave constructive feedback (wait times were too long, different medical philosophy than that of the provider, distance from home, etc.), and other times you will not be asked why. Either way, in the long run, switching will be better for both you and the provider.
It is important that you take the time to choose a healthcare provider for your child, but remember that you are not alone! Little Lilacs is happy to help you find a provider that matches your philosophies and to provide you with additional resources that will further inform and empower you.