You’ve decided to go with an OB/GYN. There are several advantages to using an OB for your care and delivery. Physicians tend to have experience with and knowledge about high-risk pregnancies and complications. If you know you are high risk due to advanced maternal age, diabetes, or any medical condition, you can have peace of mind knowing your OB is equipped to handle it and to manage medications if needed. If your intuition is telling you that you feel more comfortable knowing you have access to all the medical procedures and personnel a hospital offers, this is the route to go. OBs have access to advanced medical testing and screenings, and are connected in a network of specialists and colleagues. If you’re still considering a midwife, there are many midwives that work in collaboration with OBs so you don’t necessarily have the rule that out either. Talk to your care providers and come up with a plan catered to all of your needs.
Where to start in finding the OB that’s just right for you? You’ll definitely want someone you feel completely comfortable with, and that you trust to take care of you and your baby. This is your life (and emotional well-being) and your baby’s health in someone else’s hands, so it’s a big deal. Here’s some ideas to help you get started.
Where to look first
Ask around. Your best bet is going to be word-of-mouth. Talk to everyone you know and trust about their OB/GYNs. What things did they like/dislike about him? What was their prenatal care like? How was their delivery experience? Would they go back to this same person? The more details the better, just start asking. Of course it’s important to keep in mind that not everyone wants the same type of birth experience so the doctor that was a good fit for your sister may not be right for you.
Join Facebook groups in your area. There are many Evidenced Based Birth local groups that you can join where the admins and members are knowledgeable about the OBs in your area and which ones follow evidence based practices. What is Evidence Based Birth?
If you don’t know many recent moms personally, get in touch with your hospital’s Childbirth Educator. She or He should be familiar with doctors and nurses at the hospital, and know the ins and outs of the kind of care they give (and their bedside manners). She’d be able to give a few recommendations that you can then do more research about. Of course keep in mind that they work for the hospital so may not be able to be completely forthcoming.
Ask for statistics. Hospitals keeps track of things like induction rates, episiotomy rates and cesarean rates so asking for these facts will give you a good idea of hospital practices. Unfortunately, even if you love your OB sometimes the hospital policies limit their ability to provide the care that you may be imagining.
Do you currently have a gynecologist that you like? Do they practice obstetrics as well? Asking a few additional questions can help you get a feel for if it would be a good fit or not. If they don’t deliver babies, they could recommend some colleagues to you, that you could then check out. Keep in mind that prenatal and birth care is MUCH more involved than an annual exam so don’t just go with your current doctor because it’s convenient. You want to make sure it’s a good fit and that their maternity care is in line with what you want for your birth.
Once you have a few names of potential doctors, there’s a lot of things to mull over before the interview process. Here’s a few considerations:
Your health history
Do you have specific concerns about your pregnancy that not every doctor would have experience with? Plus-size pregnancy, previous recurrent miscarriages, diabetes, or trying for a VBAC (Read more in our post What you need to know about VBAC?) can be uncharted territory for some practitioners. Look at the websites and reviews of doctors to find out if they have specific experience in the areas you are concerned about.
What does the provider value? What is his/her overall outlook on pregnancy, birth, and labor? Are they super medicalized or do they lean toward the more natural route—and which do you prefer? What are his opinions on certain medical procedures like continuous electronic fetal monitoring, scheduling inductions, episiotomies, and epidurals? Do they tend to take control of how a labor is progressing, or allow the mother to take the lead? How pushy will they be?
Do you click? Do you feel comfortable? I had a friend who went in for a breast exam and the doctor chatted for a few minutes and then said, “Okay, flash me.” That exchange made her feel so uncomfortable she never went back. Bedside manner and professionalism matter! Do you trust their experience and judgement? Do they listen to your concerns and questions or just plow through the appointment as fast as possible? Are their credentials up to date? What does your gut say?
Are they supportive of you having a doula with you during labor/delivery? How comfortable are they with extra people in the room in general, and does your partner get a good vibe from them as well?
This is public information that you can request from your hospital. However, doctors don’t usually post their own personal stats. You can get an idea of how things go by calling the front office and asking some questions. Many offices don’t give out specific numbers, or may not even keep track, but you can get an idea by saying something like, “Out of the last 10 deliveries this provider performed, how many ended up being c-sections?” Or “Out of the last 10 attempted VBACs, how many were successful?” Get an idea of how willing they are to work with you. Keep in mind that specific hospital rates are higher than others for cesarean. Which brings us to our next item…
What are the c-section stats? You can search online to find this info. In general, what is the hospital like? Do they have natural birthing accommodations and tools if you’d like to go that route? Birthing tubs to labor in? Is the hospital friendly to natural delivery? Do they require IVs, continuous electronic fetal monitoring? Do they have VBAC policies? What are their standard procedures right after the baby is born? Do you get to have skin-to-skin bonding for a while? Does the baby get to stay in your room? Calling the Labor and Delivery floor is your best bet to getting answers to these questions. A nurse can help you out, or refer you to someone else who knows the specifics. Nurses generally want you to be informed about the hospital policies so that there aren’t any surprises when you come in.
Office Protocol—Questions to Consider
- What is the OB clinic experience like?
- How easy was it to get an appointment?
- How many doctors are in the practice?
- Are you a number who is shuttled through the routine, or are you treated like an individual?
- How long do you typically wait in the office?
- What are the after hour policies?
- Will your OB be the one to deliver you, or do they rotate who is on-call, and will that bother you?
- Is there an on-call nurse that is available to answer questions?
- What is the staff like?
Think about how you feel about all of these things.
Once you’ve thought about all of these issues, and researched a few doctors, narrow it down to a couple. You can either take the plunge and make your first appointment with the one you want, or you can be even more thorough and schedule a consultation, where you can bring your list of questions.
Above all else, keep in mind that you are not stuck once you make your choice. If at any time you start to feel uneasy about your care giver, or feel like you don’t align with his philosophies, shop around. It’s completely acceptable, and it happens all the time. If you feel uncomfortable firing your OB, simply call the front desk and ask them to transfer your files to your new doctor. You don’t even have to speak to the doctor you are leaving. This experience will be one of the most important of your life, and you deserve to feel as safe and as comfortable as possible. Follow your gut!
Interview Questions for Potential Obstetricians
- What is your general philosophy on pregnancy, labor, birth, and postpartum care?
- What is your role as physician? What is your role during labor and delivery?
- How long have you been practicing? How many births have you performed?
- How many births do you anticipate attending month? Is there a limit to the number of patients you take on?
- What is the chance of you delivering my baby? Who delivers when you are not available?
- What is your c-section rate?
- If there is a complication beyond your expertise, who would you refer me to?
- What is your after-hours policy? Are you reachable during an emergency?
- How often am I required to meet with other doctors?
- How much time do you spend with each patient during an appointment?
- Are you available in between visits if I have a question or concern?
- What is your view on nutrition and weight gain?
- What prenatal tests do you require and/or recommend?
- What childbirth education resources do you recommend?
- How do you feel about birth plans? Do you help with writing them?
- What experience do you have with high risk pregnancies?
- What would the procedure be if I become high risk?
Labor and Delivery
- When will you arrive on scene? Who will support me in the meantime? How often will you be with me during labor?
- If you have two simultaneous labors/deliveries, what do you do?
- How do you feel about a support team? A doula? Other friends and family?
- What if I approach my due date without going into labor? How long will you let me go past? What is your induction policy?
- Do you ever recommend induction for an estimated large baby?
- How long will I be able to labor after my water breaks if no signs of infection?
- What routine policies during labor do you recommend/require? What does the hospital require? (Continuous fetal monitoring, IVs, etc.)
- Am I allowed to move around during labor? Eat and drink?
- What are your views on pain management during birth, both medicated and unmedicated? Will you recommend different positions and coping techniques?
- What percentage of your patients deliver without an epidural? What resources are available to me, should I want to labor without drugs?
- What percentage of your patients get epidurals? What is your view on epidurals?
- How do you handle a “stalled labor”? What do you consider a stalled labor?
- What birthing positions do you allow for labor and delivery? What is most common for you?
- Do you perform episiotomies? How often? How often do you use forceps or vacuum extraction?
- Do you encourage and support VBACs? How many VBAC attempts have been successful? (60-80% is norm). What is the hospital policy for VBAC?
- At what point in labor do you recommend c-sections?
- Have you ever performed a vaginal breech birth? Twins?
- What procedures do you perform on the baby? What can wait?
- Is delayed cord clamping okay?
- What happens if there is postpartum hemorrhaging?
- Will I have uninterrupted skin-to-skin bonding time immediately following birth? For how long?
- Will the baby stay with me in my room?
- Do you assist in breastfeeding? Is there someone else available to help me?
- What if I hemorrhage?
- Can my partner stay in my room?
Questions to ask yourself after the appointment
- Do I feel comfortable with this person? Is he/she flexible?
- Do our philosophies line up? Or are they willing to work with me? (You want them to enthusiastically support your wishes not just be “willing to let you try that”)
- Do we have a mutual respect?
- Do I trust his expertise and judgement?
- Is the office staff friendly and helpful?
- What was the wait time? Did I feel rushed in and out?
This guest post was written by Austyn Smith.