Choosing the Right Obstetrician and Hospital
Author: Dr. Anna Kaplan
If you are pregnant already, or seriously thinking about getting pregnant and planning ahead, picking the best obstetrician to follow your pregnancy and the best hospital for you to have your baby may be one of the most important decisions you make. The right doctor and hospital are critical to having a good experience, as well as a good outcome - meaning the baby is healthy and so are you after delivery. Depending on where you live and what you want, you may have few choices or many choices. Often, the obstetrician and hospital go hand in hand. You can start by looking for an obstetrician, and then look at the hospital(s) he or she uses; or you can pick a hospital, and then try and meet obstetricians who do deliveries at the hospital you like best.
You may not have made a birth plan yet, but you should have some idea of what you want. If you think you might want an epidural for pain control, you have to pick a hospital with anesthesiologists who can give you one. If you plan on a "natural" delivery and want to be able to do things, like walk around, sit in a bathtub, or deliver in a sitting position, you need a hospital with a birthing room that allows that, as well as a doctor who is sympathetic.
Here are some of the factors to consider if you are anticipating a normal delivery. If you have significant medical problems, or there are concerns about the baby's health, you would look at this process differently. But let's assume everything will go well. If you are thinking about a home birth and/or a midwife, the information here will not be specific enough to help you.
Do you know an obstetrician? Perhaps you are already seeing the doctor who you want to take care of you during your pregnancy. If your doctor does not do obstetrics, can he or she recommend anyone?
If not, you can ask family and friends for recommendations. If you are new to an area, you can try to talk to women you meet who have had babies. You might get a recommendation from someone at work, church, or any other place where you are meeting new people.
You may have an idea of whether you want a male or female obstetrician. Keep that in mind.
If you are able to gather a list of promising names, you can either set up appointments to meet with each doctor, or check which hospitals they use first.
When looking at hospitals, if you are young, healthy, and have no reason to expect a complicated pregnancy, you may want to find a hospital with birthing suites in the labor and delivery area. These can have room for multiple people, not just your spouse or labor coach, showers and tubs, rocking chairs, televisions, and other amenities to make labor easier. Many hospitals offer these types of birthing rooms. Since they are inside a hospital, they are also safe choices because you are just minutes away from a delivery room if something goes wrong.
Does the hospital you are looking at have enough of the rooms you might want? You should try and pick a hospital with multiple birthing suites. Ask whoever gives you a tour how often there are too many women in labor for them all to get a birthing suite. By all means, look at the other labor rooms as well. They may look like plain hospital rooms, or they may have been made more labor friendly and therefore more acceptable as alternatives.
Are there breast feeding specialists and nurses on staff to help you with the baby? Do they let the baby "room in" with you? Are they committed to helping you breast feed if that is what you want?
If you live in a large city, you may be able to look at a number of hospitals and see which ones meet your requirements. You can ask the nursing staff for names of doctors who do deliveries at the hospitals you like. If you meet a labor and delivery nurse who has had a baby, ask her who delivered her baby. That is a very good recommendation.
Practically speaking, you need to make sure your insurance allows you to use the hospitals you are evaluating. The same goes for the doctor - is he or she on your plan?
After collecting as much of this information as possible, you should have an idea about which hospital you prefer, as well as the names of some doctors.
Back to picking the doctor - are you thinking of a doctor in a solo practice or a group practice? Most obstetricians cannot be available every minute of every day. Who might do your delivery if it happens on a weekend or in the middle of the night, which seems to be what always happens? If it is not your regular doctor, who might it be? Is there a way for you to meet the other doctors?
When you meet with the doctors on your list, you will also get a chance to evaluate the doctor's personality, or "bedside manner." Is he or she responsive to your questions? Does the doctor seem willing to try and help you deliver in the way you want? Most women want their husband or partner with them when meeting the obstetricians. Your partner will be communicating with your doctor during labor. In fact, whoever you chose to help you with your labor may have to remind the doctor and nurses what you want when you are actually in labor.
At the end of the process, you should be able to find a doctor with whom you feel comfortable, and who is responsive to your requests as much as possible. You want to deliver at a hospital where you can try and have the childbirth experience you want, but where you can get more help very quickly if there is a problem with the delivery. You should also know for certain that your pregnancy and delivery will be covered by your insurance, and know what you might have to pay in terms of a copay or a percent of the total.
If you are lucky enough to find more than one doctor and/or more than one hospital that meets your needs, you should probably follow your gut instinct about which doctor is best for you.
Remember, you can change your mind and switch doctors later on if you feel like it is not a good match. You don't want to do this late in your pregnancy, so try and use every prenatal visit as another chance to ask your doctor questions that will give you an idea of his or her ways of handling pregnancy and labor.