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Our Philosophy of Care

General principles

Pregnancy and birth are very special events in the lives of women and their families. At Dartmouth-Hitchcock, we recognize that this experience is unique for each woman. We see our role as supportive of the woman and her family, understanding that ultimately the experience of pregnancy and birth belongs to them. We are guides during this natural process, and we respect the right of each woman to determine, within reason, her experience. We feel privileged to participate in this journey.

We see pregnancy as a state of health, and while most pregnancies have a normal outcome, pregnancy is not always an easy process. Some pregnancies may be affected by chronic illness, or by new problems related to the pregnancy. You can be assured that we will use the combined expertise of our providers to optimize the outcome of each pregnancy even if complications arise. We encourage women to gain an understanding of the natural processes of pregnancy and birth, and to recognize variations from the normal process. We also acknowledge that women who seek our care may not always see personal value in our recommendations and have the right to refuse our advice.

Timing of birth. We believe:

  • The best timing for a full-term pregnancy is when labor begins naturally, on its own.
  • Labor should only be induced when the health of the mother or baby will be helped by this intervention.
  • Vaginal birth is the best for the majority of women.
  • Forceps delivery, vacuum-assisted delivery, second twin vaginal breech delivery, and cesarean birth can be used safely to assist a woman with birth in specific situations.

The labor experience. We believe:

  • Women should labor at home until they are in active labor, unless the health of the mother or baby is at risk.
  • Women should move around during labor to gain the beneficial effects of gravity and to allow them to find comfortable positions. We recognize that there is much variability in the process and progression of normal labors, and we will recommend interventions in labor only for significant variations from the normal process.
  • It is our responsibility to provide comfort and pain relief to women in labor, in accordance with a woman's individual needs.
  • Intrusive monitoring should be limited to women who have specific risk and need for these technologies.
  • The role of providers and of the woman's family is to discover how best to guide and assist the woman through labor and delivery.

When it comes to your pregnancy, childbirth, and family, one size does not fit all. We provide these choices because we recognize that women are individuals, and that they have individual needs - emotionally, physically, spiritually, and as part of their family and community.

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