Choose your provider carefully. How the office schedules your visit is important when choosing a health care provider. You want an office that is "on time" (although emergencies do occur). But if your provider is chronically late, it does suggest a lack of respect for your time. Similarly, if each visit is so closely scheduled to the next, so that there is no built-in "chat" time, you probably will end up dissatisfied.

Ask friends and family for recommendations, and review the list of providers covered by your health insurance. Check to see which hospitals and birth centers the providers use for delivery. Then schedule appointments to interview providers. Ask questions about the provider's philosophy of birth and how that philosophy is reflected in the management of women's prenatal care and labor and delivery.

Read and ask questions. Your appointments will go more smoothly if you educate yourself on pregnancy, labor, and delivery. You'll become more comfortable with the changes your body is undergoing, and you can ask educated questions. Ask your provider for recommendations on books to read, and take childbirth education classes. Becoming educated doesn't mean you can't ask any and all questions you have. No question is silly. But you'll feel more confident asking questions when you have a basic understanding of what is happening to you and your baby and why.

Share responsibility for your care. Being informed allows you to be involved in the decision-making process. Pregnancy and birth are normal physiologic events for most healthy women. Taking responsibility for your own health care helps to ensure that you will have a safer and more satisfying experience as you journey into motherhood. You may choose to allow your health care provider to make decisions for you, but ceding that responsibility should be a conscious choice on your part. Some women are uncomfortable with being involved in the decision-making process, or there may be times when it is critical that the provider be the one to make a decision in the best interests of the health of the woman and her baby. It is important to let your provider know if you don't want to be involved in this process. However, even if you prefer that your doctor or midwife make decisions for your care, you must be informed and understand all risks, benefits, and alternatives. It is your body and your baby.

Voice your preferences. Even if your care providers generally follow certain practices during labor and delivery, they may be willing to accommodate your preferences. Establish a working relationship with them so that each of you listens to what the other is saying. You may find that actually writing out a birth plan helps you and your provider focus on what is important to you during labor and delivery.

Be organized. Write down all your questions as you think of them, so you’ll be well prepared for your next visit. Keeping track of your questions, progress, and feelings will ensure that you don’t forget important information that you want to share with your provider. Many practices teach pregnant women how to check their own weight and urine and to record this information on their prenatal record after they check in with the receptionist. This allows more time to communicate and build trust with your provider.

Let this be a learning experience. Ask your provider what kind of information will be shared during each stage of pregnancy at your prenatal visits. Nutrition should be addressed at every visit, especially if there is inadequate weight gain or fetal growth. Be sure you understand about signs of preterm labor. Learn how to monitor fetal movement. Discuss whether or not you should have a birth plan and what this should include. Ask about management of pain in labor. Find out what is considered routine management. Know what your options are, including their benefits and risks.

Follow-up is essential. Ask about the results of routine tests, such as urinalysis and blood pressure readings, as well as any other lab tests or ultrasounds you may take. While the results are probably normal, it's wise to double-check and is part of taking responsibility for your own care. That also applies to asking why your health care provider has asked you to take a certain test.

Share your feelings . While it's important to understand what is happening to your body, it's also important to be in touch with your emotions during pregnancy. Your health care provider can help you deal with the myriad of feelings both you and your partner may be experiencing. Talk about your hopes and dreams for your baby's birth, as well as your fears and concerns.

Be aware of the quality and quantity of time. If your provider appears rushed or busy, ask to schedule another visit with her to discuss your concerns. You should leave your visits feeling emotionally satisfied and reassured.

Ask tough questions. A woman should feel comfortable enough with her health care provider to ask awkward questions or to discuss personal issues that are worrying her. Remember that experienced health care providers understand that pregnancy is much more than a physical condition. Frankly, they have seen, heard and dealt with most issues, so don't feel like you are the only one who feels a certain way. But they can't help you if you don't tell what is worrying you.

Be honest and direct about these concerns so that your health care provider can give you the best possible support. A good health care professional will not judge you or your situation. Their role is to make sure that your pregnancy and delivery are healthy and satisfying. If you anticipate that you will need extra time (for a lengthy discussion of an awkward question or personal problem), ask to schedule a longer appointment for your next visit so that the provider isn't rushed and can fully address the issues.

* Excerpts taken from “Making the Most of Prenatal Visits,” by Steffie Goodman, Every Baby magazine, Issue One.

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