There are many reasons a mother might have to find a new care provider for her pregnancy and birth. Some reasons are out of necessity, some out of personal choice. If a care provider moves, retires, or takes a new position, then a mother will need to find a new provider. If a mother moves or her insurance coverage changes significantly, she might need to reassess her care. And sometimes, after asking some questions, she realizes that her doctor or midwife (or even the hospital) will not be a good match for what the mother desires for an upcoming birth. Depending on your circumstances and the protocols of the doctor, midwife, or practice you wish to switch to, you may be able to change as late as 40 (or more!) weeks. Broadly speaking, though, OBs and Family Medicine doctors will be able to take patients very late (if they are amenable to taking new patients late in pregnancy at all), and midwives usually face more restrictions, with 34 or 36 weeks of gestation being a normal cutoff. So, you know you need to change, now what?
1. Start by finding a new care provider.
Ask for suggestions from your doula, your local independent childbirth educator, or other independent childbirth professionals in your area. Find someone who will fit your needs. Are you looking for a specific location? Someone who is covered by your health insurance? Someone who will take your desires and concerns seriously? Are you looking for specific options, like labor tubs or waterbirth? Ask questions now. It might seem like a lot of work, but care providers you want to work with will want to talk to you about these things. If they don’t answer your questions, it might not be a good sign of how they treat current patients. Also included in this process: If you are planning a hospital birth, find out if the options for the hospital meet your needs.
2. Make an appointment with your potential new care provider.
If you are approaching 33 weeks, do this very soon. If you are approaching 40 weeks, do this NOW! Each clinic and practice has their own process for taking in new patients. Explain your situation and ask how they best like to handle the change.
3. Get your old records.
Sometimes it’s a matter of filling out a form with the new provider. Sometimes the process is best handled by filling out a transfer form with your old provider. Either way, in this age of HIPAA, there will be a form (or two). If you are moving to a different city or are close to your Estimated Due Date, it might not be a bad idea for you to get an actual paper copy of all of your pregnancy-related records to have for yourself just in case there is any delay in the transfer of the old records. It is a very unfun process to have to wait in labor while someone tries to find your chart; not only does it create some chaos for the staff, it may mean that you are treated as a high-risk patient until you prove otherwise. No matter what, once you place the records request, stay on top of it! Check in every couple of days to make sure you did not get lost in the shuffle somewhere.
4. Move forward!
You did the hard work! Hooray! Once you get started with this new provider, you might have lingering feelings of uncertainty, especially if it was a change due to circumstances out of your control. That’s understandable. But know that you will move forward and feel good about a decision that you put thought into.