When you think of pregnancy, what type of providers or professionals come to mind? I would guess that OBGYNs or midwives are on everyone’s list. Some people may be familiar with doulas and others may have used a lactation counselor, but the actual prenatal care is usually top of mind. In my experience as a doula, dietitian and person who has birthed three babies, I wanted to write this post to share about some of the lesser known professionals who can be immensely valuable and quality-of-life changing throughout pregnancy and postpartum. It breaks my heart that pregnant and postpartum people struggle alone with a variety of concerns (or just normal pregnancy and postpartum experiences!) when there are expert professionals who specialize in a variety of fields ready and waiting to walk alongside them. Here’s my list of the ten most important professionals that every pregnant person should at least consider having on their team and what I would look for when selecting one.
1. OB/GYN or midwife
In an OB/GYN or midwife, you want someone (or a team) that is compassionate, supportive and will treat you as the center of care. The care and services they provide should feel collaborative. They should include you in decision making to the fullest extent it is possible. They should provide evidence-based recommendations and encourage you to make decisions regarding your care that are in-line with your values and feel like the best fit for you and your family. I also would look for a provider who uses strengths-based decision making, as opposed to fear-based. If you are already mid-pregnancy but feeling dissatisfied with your prenatal care, in most cases it is not too late to seek another provider. You deserve to have confidence and peace of mind about the provider or care team who will be assisting you in birthing your baby into the world, so my ultimate advice is to go with your gut and if your care isn’t feeling right, consider making a change.
It’s ideal if you can have a doula on your team both for birth and postpartum. During pregnancy, a doula helps you prepare physically and mentally for birth; during labor, they provide constant support. They can be a listening ear or sounding board for you to talk through decisions you need to make or feelings you’re experiencing throughout pregnancy and postpartum. When you are otherwise occupied during labor, they can provide support for and help take care of your partner as well. They can help you understand and navigate the medical system, suggesting certain questions you may want to ask or helping you advocate for yourself. They provide a wealth of knowledge and connections to resources and other professionals. Lastly, they can be a great person to “debrief” your birth with. Each person has such a unique birth experience; if you have no one to recap it with and discuss what happened, it can leave you feeling confused, hurt, disappointed, let down, alone or a whole range of possible emotions. A doula can help you process, talk through, understand and make peace with your birth experience. A postpartum doula can also help you as you adjust to life with a newborn. Some even help with household tasks and family adjustments in that critical period when you’re feeling overwhelmed and sleep-deprived. Doulas offer a variety of services, so the best way to know exactly what a doula offers is to reach out and schedule a call with them.
If you choose to bring a dietitian on your team, I recommend searching for someone who is anti-diet and employs an intuitive eating approach. Unless you have a food allergy or a medical condition that requires a nutrition related intervention, I believe that there is no role for dieting in pregnancy or postpartum. So if they’re not going to help you diet, what do dietitians do? Great question! Dietitians can help you navigate your changing body image as your body stretches and makes room for baby. They explain your changing nutritional needs during the different stages of pregnancy. They can provide advice on managing symptoms like nausea, heartburn, appetite changes or constipation. They can give you an expert’s opinion on which supplements are necessary and what to look for in supplement brands. A dietitian can discuss ways to nourish you (and baby) sufficiently as your energy needs increase. And they can help you make a plan for adequate eating postpartum when you are suffering from sleep deprivation, physical healing and simultaneously adjusting to life with another human under your protection. Pregnant and postpartum people are the target of a ridiculous amount of diet and weight-loss centered advertising, so having a weight-inclusive, non-diet dietitian on your team can make a huge difference in empowering you to reject diet culture and care for your changing body in a compassionate, gentle and nourishing way.
An expert prenatal chiropractor can make an incredible difference in your discomfort and pain levels during pregnancy. Back pains and round ligament pains that are common during pregnancy can be helped by regular chiropractic visits plus stretching and icing routines that the chiropractor recommends. When searching for a chiropractor, I suggest looking for certain designations for advanced training in prenatal care. This web page by the American Pregnancy Association has a list of designations you can look for. They also discuss some specific benefits of chiropractic care during pregnancy. If you’re feeling especially hesitant about seeking chiropractic care during pregnancy, ask around among your peers who have experienced pregnancy and see if anyone has someone local they can recommend. A personal recommendation can be soothing and give you added peace-of-mind as you book that first appointment.
The dentist is actually so important during pregnancy that some insurances allow an additional cleaning visit while pregnant on top of whatever your plan usually covers. Pregnancy hormones increase your risk of periodontal issues like tender gums, gum bleeding, and pregnancy gingivitis. Forty percent of pregnant people will develop gingivitis sometime during their pregnancy. If you’re someone who is inconsistent about dental checkups, pregnancy is the time to step up your game and get yourself into the office. The last thing you want to be dealing with is painful and bleeding gums (or worse, gum disease) on top of all the other discomforts that go along with pregnancy.
6. Massage therapist
The benefits of a well-trained massage therapist go beyond relaxation. Massage therapists can help relieve pain, provide rest and stress-reduction, and towards the end of pregnancy may even help you go into labor. After pregnancy and during the peak of newborn care, your body may feel stiff, sore or simply exhausted. Your body is moving in different ways and directions than you’ve ever asked it to before- holding and carrying around the baby, feeding the baby, bending over a bassinet, etc- and a massage can be amazingly rejuvenating for all those muscles. I know that a massage can feel like a luxury your budget may or may not be able to afford, so this makes the perfect item to ask for as a baby shower gift, especially if this isn’t your first pregnancy and you already have a lot of the baby stuff you need!
7. Pelvic floor physical therapist (PFPT)
In my opinion, treatment by this professional should be standard of care for every pregnant/postpartum person! (It is in other countries; the United States is way behind on providing comprehensive birth and postpartum care.) Pregnancy and birth put lots of pressure on your pelvic floor- whether your birth is vaginal or c-section. Your pelvic floor needs attention and rehab just like other body parts. Most people don’t realize how big and interconnected the pelvic floor is and how it affects everything from breathing, walking, standing and squatting to peeing, pooping, intercourse and sexual pleasure. You do not want to ignore this! If you are leaking urine, have urgency to poop, feel like your vagina or rectum is falling out or you have any sort of pressure down there, try to get yourself to a PFPT as soon as possible. They’re not just for postpartum; go during pregnancy to help keep your pelvic floors strong and help prepare you for birth, then return after birth (usually around six weeks) to assess your pelvic floor and get ideas on how to restore your unique body. Premade postpartum workout plans can be good, but oftentimes it’s too much too soon. The PFPT can suggest what types of exercises are appropriate for you based on exactly where your body is with its recovery.
8. Lactation counselor
If you plan to breastfeed or chestfeed, get connected to a lactation counselor while pregnant. They can provide valuable education before you have the baby, which will help get you off to a good start right from birth. They can share best strategies for making milk and feeding baby. They can help you choose a pump that works for your body, lifestyle and insurance and show you how to use it. When problems or questions arise (and they will!) it is easier to call someone you already have a relationship with rather than finding a new provider while in a time-sensitive situation. Many LCs work in pediatric and OB/GYN offices or will come to you or do a telehealth visit, which may make it more convenient to see one. Ask your prenatal provider or your pediatrician if they have one who comes to their office or if they have a recommendation. Even if you’ve fed a baby from your body before and it’s gone well, there’s no harm in connecting with a lactation counselor just in case. Every baby is different and every feeding experience can be different.
9. Mental health counselor/therapist
The best time to find a therapist is before you’re desperate for one. I recommend having a few names and contact numbers written down (maybe recommendations you’ve gotten from peers) so you already know who you plan to call if you decide to seek mental health support. Know that even if you don’t feel “really depressed,” you can still benefit from getting help. Never underestimate the power of an objective third party to listen to you verbally process all the changes you’re experiencing and the feelings that go along with them. Anxiety and depression aren’t just seen in postpartum; they can show up during pregnancy, too. If you’re feeling off-balance in any way during or after pregnancy, I highly recommend setting up a session with a therapist. At the very least, inquire with your insurance company to see if mental health services are covered. If you’d prefer a group setting, look for a pregnancy or postpartum support group to connect with others in similar situations. Loneliness or feeling like no one understands what you’re going through can be crushing. Lastly, remember that past trauma can impact birth. Any sort of trauma you’ve experienced in your lifetime can have an impact on your birth experience, so if that’s something you’ve never addressed with a counselor or therapist, pregnancy might be a good time to do it. The list of things you may want to discuss with a counselor is long: your birth story, stress of a newborn, any special health issues for you or baby, family adjustments, postpartum depression and postpartum anxiety, adjusting to the role of parent and being needed all the time, changes in relationship with partner, changes with work or staying at home, disappointment if/when things don’t go as hoped (birth, breastfeeding, etc). But the bottom line is that mental health professionals are for everyone and I’m positive that everyone who truly cares about you would rather see you seek help than find out later you had been suffering in silence.
10. Childbirth educator
A childbirth educator can provide services in-person or online. Even with the limited clinical research on the impact of childbirth courses, we see positive outcomes and less interventions. The purpose of this type of education is to inform you of the process of childbirth, what is physiologically “normal,” what interventions might be presented, strategies for coping with labor, and what to expect at the hospital or at home. If it’s at a hospital, the classes may include tours of the labor and delivery unit and rooms. It’s extra helpful if they walk you through where you’ll arrive and check in when you’re in labor, as it may be a completely different place than your OBGYN or midwife clinic visits have been. Childbirth education classes often also cover breast/chestfeeding, postpartum recovery and taking care of a newborn, or those might be separate classes. A good childbirth educator will help you understand what your options are during labor and birth so you can make informed decisions about your care. If you’re interested in specific birth approaches like hypnobirthing you can look for a class that specifically covers this. A childbirth educator embraces the idea that knowledge is empowering and confidence building, so the more you know and understand about the process of labor, birth and postpartum, the better off you will be.
I know this list was long, and the last thing I want is for you to feel overwhelmed. If you don’t know where to start, consider sitting down with your partner or a trusted friend and talking through all the different professionals. Consider which feels most important or urgent to you at this moment. This will vary based on you as an individual, as well as where you’re at on your pregnancy/postpartum timeline, your past experiences, your current care and more. I created a handout (see below!) that you can download here, print and fill in, giving you space for both a name and a contact number for quick reference when you need help in a hurry. I send you my very best wishes for a healthy pregnancy and a smooth postpartum recovery. If you’re local to me in Vermont, I’d love to share with you about the doula and nutrition counseling services I offer. Learn more here or set up a free discovery call here!