Now that you're expecting a baby, you're going to be visiting the doctor -- a lot. But perhaps the doctor you're seeing isn't the right fit. She's a wonderful gynecologist, but she doesn't practice obstetrics. Or she's pro-natural birth and you want an epidural. You'd like to give birth at a birthing center but she only delivers at hospitals. Regardless of why you're looking for a new practitioner, we have expert advice that will help make your search less overwhelming.
Decide on a Type of Provider
"Most women deliver with either a physician trained in the care and delivery of pregnant women, or a midwife," says Michele Hakakha, M.D., an ob-gyn in Beverly Hills and coauthor of Expecting 411: Clear Answers & Smart Advice for Your Pregnancy. Trying to decide between the two? Consider which qualities are most important to you in a practitioner, whether it's her credentials, the hospital or birthing center she attends, her point of view on pain relief, or her rate of cesarean deliveries. Then think about the type of delivery you want, as well as special circumstances that apply to your pregnancy. "If you have a condition that would make your pregnancy high-risk, such as diabetes, or you're delivering twins, you should see an ob-gyn and deliver in a hospital," Dr. Hakakha says. If you're healthy and wish to deliver in a birthing center, consider using a midwife.
Talk to others who have given birth recently, and ask about the practitioner's bedside manner, delivery philosophy -- whatever it is that's most important to you in a doctor. Once you have a list of names, do background research on the doctors to be certain they're board-certified ob-gyns. You'll want to note if they've ever been disciplined or lost their license, as well as how often they've been sued, suggests John Connolly, Ed.D., CEO and president of Castle Connolly Medical, which publishes America's Top Doctors. "One or two lawsuits is typical, but more frequent suits might suggest a problem," he says. Visit castleconnolly.com for an online directory of links to disciplinary records for doctors in each state.
When you choose a practitioner recommended by a friend, you'll deliver at the hospital or birthing center where she has privileges. But you'll still want to confirm that your insurance is accepted there, and that the services you'll want or need are available. Is your pregnancy high-risk? You may want a hospital with a good NICU. Hoping to labor in a tub? Ask if you need to reserve a room with one in advance.
If you've found the perfect hospital but you still need to choose a doctor, call the Labor and Delivery unit, ask to speak to one of the labor nurses, and get her recommendation for a good obstetrician, suggests William M. Gilbert, M.D., a high-risk ob-gyn in Sacramento, California. "Then call back during a different shift and ask someone else for a recommendation. Once you get the same name from two or three nurses, then you've hit the jackpot. These nurses see all the doctors in action."
Pay attention to the demeanor of the doctors when you meet them, says Robert Atlas, M.D., who is a maternal-fetal medicine specialist and chair of the department of obstetrics and gynecology at Mercy Medical Center in Baltimore. "If you feel rushed during the consult visit, it's probably indicative of how you'll be treated going forward," he says. Have a list of questions ready: Is the doctor available by e-mail or only by phone during office hours? Who will deliver you? When your ob is in a large practice, you often end up with whoever is on call. Your own doctor is more likely to deliver you in a small practice. What is your C-section rate? (Dr. Atlas says 15 percent is ideal, unless you're dealing with a high-risk ob who typically performs more.) Mention any preexisting medical conditions you may have, such as high blood pressure or diabetes; if you've had a C-section, ask about vaginal births after cesarean (known as VBACs), since some hospitals don't allow them for insurance reasons.
Follow Your Gut
Choose the doctor you felt most in sync with during your consultation appointment. If you're only a few weeks pregnant -- say, you've just gotten a positive sign on a home pregnancy test -- then you won't have to deal with the awkwardness of switching doctors mid-pregnancy. Moving to a new practice later on? Keep in mind that some doctors will take pregnant patients up to their last month, while others won't take patients after their first trimester, Dr. Atlas says. It's best to talk to your current doctor about why you're unhappy, but if you're still feeling dissatisfied, move on. You should be confident that your doctor will take excellent care of you and your baby, Dr. Hakakha says. "After all, her hands will hold your baby first."
Originally published in the April 2012 issue of Parents magazine.
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