Your relationship with your obstetrician/gynecologist is one of the most intimate professional relationships you may have. Although it can take time for this relationship to develop, you should feel comfortable with this person and should be able to trust your obstetrician/gynecologist with your most private concerns.
Important questions to consider when selecting an obstetrician/gynecologist include:
1.Does she/he have experience caring for and delivering high risk pregnancies?
None of us want to experience a complicated, high risk pregnancy. However, an attending of mine in my training used to remind us at the beginning of every call night, “The sickest patient will be the one you least expect.” Even if you consider yourself to be healthy, pregnancy and labor can unexpectedly become risky to mother and baby. You want to make sure that your obstetrician has the training and experience to handle any surprises from severe pre-eclampsia to acute hemorrhage. If you live in a major metropolitan area, you also want to know if your obstetrician delivers at a level 3 center with in-house anesthesia and an experienced NICU. Hopefully you don’t need those services, but if you or your baby were in grave danger, you would want to feel confident that your obstetrician can manage your care and that she/he has the resources needed to do so.
2.How will she/he manage a pregnancy that goes beyond the due date? At what point will she/he insist on induction?
These questions tell you a lot about your obstetrician’s medical beliefs and style of practice. Some providers believe that babies should be delivered as soon as possible while others may take a wait and see approach. A seasoned obstetrician may tell you that the answer is not easily defined because she/he will need to consider multiple factors specific to your situation in deciding when and how to recommend an induction.
3.What are her/his views about the use of doulas?
Again, this question tells you a lot about your obstetrician, whether she/he is open to a holistic approach and whether she/he is going to help create a supportive environment. Doulas are labor companions who can help ease anxiety during labor and offer emotional support. A great doula may be someone you hire or it may be a family member or friend. In any case, knowing your obstetrician’s opinion will give you insight into their practice style and if it matches with yours.
4.Will she/he deliver my baby?
No one physician can be on-call 24 hours a day/ 365 days a year. Most obstetricians share call with other doctors in their practice or community. You should know who the other doctors in the call group are and how the call rotation works. Some groups are extremely large so you may not have an opportunity to get to know all of the doctors who may attend your delivery. Other groups are smaller and may have a system in place for you to meet the other doctors who may deliver your baby. Also, in many communities ob/gyn’s perform circumcisions upon request. If this is relevant to you, don’t forget to inquire about it and whether or not she/he uses anesthesia.
5. What is the practice’s policy for handling emergencies?
For example, will your doctor be able to see you on a regular office day or will you have to wait for an opening or see a mid-level provider? Who can you reach by phone during office hours or after hours for an emergency? How long does it typically take for the doctor or a nurse to return your call? Many large groups utilize a nurse telephone triage system, while in a small group you may be able to reach your doctor or nurse directly.
Thankfully routine pregnancy is only 40 weeks, give or take a little bit, so you should also consider your gynecological needs when selecting an ob/gyn. Consider some of the following:
1. How far in advance do I need to schedule a routine annual if I want to see my doctor?
This gives you insight into how accessible the doctor really is. As a mother and working woman myself, I want a physician I can actually see even if nothing is wrong and I am not pregnant. Everyone’s schedule is different so consider how important this is to you. I have had friends tell me they haven’t seen their doctor in years because they cannot get an appointment scheduled for months.
2. Does she/he prescribe birth control?
There are many patients and physicians who do not believe in the personal use of contraception, and this is to be respected. As a woman’s health care provider, however, I believe that an ob/gyn should be comfortable and knowledgeable discussing the factual pros and cons of all methods of contraception. Some birth control regimens may not be suited for women with certain medical conditions. On the other hand, some providers will not place IUD’s in women who have not had children. Be sure that the ob/gyn you choose is able to meet your individual needs.
3. Are you comfortable with the ob/gyn?
I think this is crucial. If you need to discuss STD testing, vaginal dryness and hot flashes or …something smelling badly down there, you need to feel able to do so. Moreover, if you are going to have surgery you need to feel confident that your surgeon is going to take good care of you. You should also consider your own value system and lifestyle. She/he may not live exactly as you do, but your healthcare relationship will be more comfortable if there is understanding and respect.
For additional information about a prospective physician, you can verify licensure with your state’s medical board. You can also verify that your physician is board certified through the American College of Obstetricians and Gynecologists. Both will offer information on a public website.
You can also contact Capital Ob/Gyn Associates of Texas directly at 512-83-OBJEN or visit our website www.capobgyn.com.