Your doctor during pregnancy will be a mainline of support and information. Here's how to make sure you connect with the best choice for you.
Q. I'm nervous about choosing the right doctor to help me through pregnancy and delivery. How can I make the right choice?
A. Your geographic location, health insurance, friends, individual health history, and family health history will all influence which practitioner you ultimately use. However, here are some key questions to ask your potential practitioner up front.
- Where do you deliver? You might be looking for a facility close to home or a birth center that allows labor coaches or family members to be present during the birth. You may also be looking for a facility that has 24-hour-a-day in-hospital anesthesia coverage or one with a neonatal intensive care unit.
- Who will deliver my baby if you're not around? No midwife or doctor can be on call every day of the year. To increase your chances of getting the provider you want, choose a small practice. Meet the backup providers early in your pregnancy to find out if you're comfortable with them. Keep in mind, however, that some practices, especially those in large teaching hospitals, have large provider groups, and meeting with all of them may be impractical. With your partner, decide what practice model will best meet your expectations.
- What prenatal tests do you suggest? Ask the provider which tests she gives at each stage of pregnancy, what the risks are, and what help you'd get in making an informed decision after receiving test results. Consider whether this provider is someone who will give you the details you need to make important decisions and who will take the time to listen to your concerns.
- When do you recommend a cesarean delivery? Cesarean births are necessary in some situations, so ask your provider how she makes that decision. For instance, how long will she allow you to push before performing this surgery? What is her cesarean rate? (Nationwide, it's about 27.6 percent.) Will she perform a vaginal birth if you've already had one cesarean?
- What's your philosophy on pain management during labor? Right now, you don't know how much pain you'll be in. However, if you're leaning toward pain management drugs such as an epidural, ask your provider how she feels about medication. The last thing you need is for someone to make you feel guilty about asking for pain relief. On the other hand, if you definitely want to experience natural childbirth, look for someone supportive of a drug-free labor and of pain management options such as massage, showers, labor tubs, or acupuncture.
- How much authority will I have as labor progresses? You'll have to follow the rules of whatever facility you choose, so it's important to know what those rules are ahead of time. For instance, if you want to walk around during labor, find out if IV hookups and fetal monitoring are optional or required. Also ask your provider her general philosophy on episiotomies.
- Whom can I take into the delivery room with me? Again, the answer to this question will depend largely on the rules of the facility you choose, so find out what they are. Your provider may also have a say, so ask to hear her philosophy on dads, children, and grandmothers in the delivery room
- What will happen after my baby is born? Ask whether you'll be moved from the labor and delivery room and how long you can hold the baby following delivery. If having the baby examined in your presence is important, say so. Finally, ask how long your provider will recommend that you stay in the facility after a vaginal or cesarean birth and what sort of follow-up care she provides.
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