a nine-month plan
Once you’ve gotten past the immediate excitement of learning that you’re pregnant, you may be faced with a choice. Who should medically guide you and your partner through the next nine months? Some women will simply continue seeing the same ob/gyn or midwife who has overseen their routine gynecological care, while others may want or need to make a change. Many gynecologists, for example, no longer practice obstetrics, or a high-risk pregnancy may require a different professional’s care
Choosing a practitioner generally comes down to a choice between on obstetrician and a midwife. Although both professionals are skilled in routine vaginal deliveries, obstetricians are trained to perform complicated vaginal births and cesarean section, and to care for more challenging patients. Obstetricians offer their patients the full gamut of birth options within the hospital setting. In my experience, women interested in anesthesia-free deliveries or home births find midwives philosophies and expertise more in keeping with their desires. Some midwives deliver babies in hospitals as well.
For the women interested in an obstetrician’s care and a hospital delivery, I suggest you start your search by determining what nearby hospital has the best maternity facilities. Preferably the hospital has 24/7 anesthesia services (so epidurals are available on demand) and is prepared to care for surprise early deliveries and special medical needs. Once you’ve chosen a hospital, you can obtain a list of obstetricians who practice at the facility and cross reference to see which of these practitioners participate in your health plan. Solicit recommendations from nurses or other doctors. Find out whom they or their spouses used for their deliveries. Don’t underestimate the judgment of friends, neighbors, or business associates, either. If you keep hearing the same names, you’re on the right track
Narrowing your list down to a single “best” doctor still doesn’t necessarily mean you’ve found your perfect match. Call the doctor’s office. Who answer the phone, and how do they respond to your questions? Great doctors can’t help you if their staff is difficult, rude or indifferent. Spend a few minutes on the phone asking the staff some simple questions.
How many doctors/midwives are in the practice?
Are they board certified (meaning have they passed tests demonstrating a high level of expertise)?
Will you see all the doctors for your appointments or always have an appointment with the same doctor?
Does the practice accept your health insurance (doctors are constantly going in and out of plans)?
The way these questions are answered is just as important as the answers themselves. The staff is going to arrange your appointments, handle your pregnancy paperwork, relay your messages to the doctor and greet you every visit. Make sure they’re going to treat you kindly.
Once you think you’ve made your choice, book your first prenatal appointment and bring your partner along for their opinion too. While you’re with the practitioner, see how comfortable you are with the way the visit goes. Is the doctor thorough? Were you given enough time to talk, ask questions and address all your concerns? Remember, pregnancy is a collaborative effort. If you don’t feel comfortable or have reservations, it’s in everyone’s best interest- yours and the doctor’s or midwives- for you to find someone else to provide your care.
I always believe that the first decision about your pregnancy is your most important. Establish good communication with your practitioner and be an active partner in your health care. Enjoy the nine-month adventure. and eat plenty of pickles and ice cream!
You may have noticed that we did not discuss online reviews. That will be the topic of another Blog to come…
Dr. B