When a couple announces they are expecting a baby, family and friends release a barrage of questions. Do you want a boy or a girl? Have you thought of any names? Do you plan to breastfeed? Few people ask if the happy couple has started interviewing obstetricians. Even so, it’s an important decision. One that, ideally, is made before conception — especially if this is your first child or you have a complex medical history. Dr. Alok Kumar, an obstetrician at Anne Arundel Medical Center, recommends a preconception visit to give the doctor the opportunity to review a patient’s family history, discuss good nutrition and ideal body weight, and encourage the mother not to smoke or drink during pregnancy
At this time, the doctor may also ask about immunity to chicken pox and rubella and recommend blood work to determine immunities or check for worrisome traits, such as sickle-cell anemia.
The best way to find an OB-GYN is to begin with those who are most familiar with the obstetricians in your area. Your gynecologist and your primary care doctor are good places to start. Childbirth educators offer another source for referrals. An additional option is to contact the American College of Obstetricians and Gynecologists www.acog.org for a list of board certified OB-GYNs in your area.
Once you have a few names, give their offices a call. Ask is if they’re accepting new patients, then check to see if they participate with your insurance company. You do not want to schedule an appointment only to find out the practice doesn’t take your insurance.
If the practice does take your insurance and is accepting new patients, try to set up a consult visit. Such a visit allows you to ask the doctor or group of doctors questions about the practice. Don’t be afraid to ask lots of questions. If problems arrive during your pregnancy, these are the doctors who will be making decisions about your health care and that of your unborn baby’s.
At the consult, inquire about basics, such as office hours, how appointments are scheduled, after-hours emergencies and with what hospital the doctors have privileges. Also observe the office staff. Do they acknowledge you when you walk in? Do they answer your questions politely? Do they seem overburdened with ringing phones and patients waiting in line for check-in/check-out? Is the office clean? Don’t be afraid to ask the other patients in the waiting room while you wait. Most people are happy to share their opinions with you.
Ask the doctor about his or her training and certification. You want a doctor that is board certified in obstetrics. This means that he or she has passed a written examination after completion of training. Board-certified doctors will have a certificate from the American College of Obstetricians and Gynecologists.
If you want to check information about an OB-GYN’s license, log on to the Maryland Board of Physicians’ website: www.mbp.state.md.us The board is our local governing body for the licensure and discipline of physicians in Maryland. Anyone can log onto the board’s website and pull up the profile of any physician licensed to practice in Maryland, including OB-GYNs. All you need is a physician’s name or Maryland license number. Here, you can view everything from where he or she went to medical school to malpractice information and whether that physician has had a disciplinary action imposed by the board.
During your consult visit, ask about pain management, circumcision and family participation. If you wish to have your baby at home or at a birthing center, discuss this up front. If you have strong opinions about the birthing experience, find a doctor who respects your choice.
Some women have medical histories that require care from a high-risk OB-GYN. According to Mary E. Ford, OB-GYN/Women’s Health Nurse Practitioner with Women OB-GYN of Annapolis, “If you have a medical history of diabetes, hypertension, obesity, clotting disorders or multiple gestation, or are of advanced maternal age, you are considered a high-risk.”
A high-risk OB-GYN may also be warranted if there is history of a previous pre-term delivery, complications or birth defects. Often high-risk patients can still receive routine obstetric care from an OB-GYN with supplementary care from a perinatologist or high risk obstetrician.
Choosing the physician who will care for you through your pregnancy is a major decision. Not all OB-GYNs are created equal. Ask questions. If there are complications during your pregnancy or childbirth, you want to be sure you are comfortable with the doctor you have chosen to help you bring your baby into the world.
What’s Up Doc?
The following are great questions to ask during an OB-GYN consult visit:
- How long have you been practicing obstetrics?How many babies have you delivered?
- What percentage of your deliveries
- are performed by Cesarean section?
- How much time do you allow for each prenatal visit?
- How long is the average wait in your office?
- What percentage of your own
- patients do you deliver in a month?
- How do you handle routine phone calls if I have questions between visits?
- How can I reach you in an emergency?
- Who covers for you if you’re not available?
- If you’re in a group practice, how often will I see the other practitioners?
- At what hospitals or birthing centers do you deliver?
- How do you feel about pain management, circumcision and breastfeeding?
- How do you feel about having family members or a doula present for the delivery?
Joyce Heid is a freelance writer who lives in Pasadena.