Monday, March 25, 2013

4 tips on how to choose the right Ob

If you've been around the blog long enough to follow my second pregnancy, you may have noticed a few things about my views on medical care during pregnancy.  Namely that I was not a huge fan of my first Ob experiences and looking for something different.

During my second pregnancy, I happened on a somewhat unusual but rather interesting scenario of being followed by both a midwife and an Ob separately.  Because of this, I was able to really get a good view on how the types of care differed as they did, vastly.  And the results were honestly not what I expected.

I will say this now, but looking back, I was 100% with the wrong care providers during my first pregnancy.  From the doctor to the nursing staff while birthing, it just wasn't a good fit for me.  I appreciate the care given to myself and my son, but it was not the ideal scenario for me.  During my pregnancy, the doctor was knowledgeable and polite, but not quite as natural-friendly as I'd hoped.  Whenever I ran ideas past him for my birthing, he seemed to be accepting but not incredibly supportive- the opposite of what a birthing mother needs.  The nursing staff was actually worse, asking me about interventions or doing things that I didn't want even after I'd explicitly stated my desire against them.

It really left me with a poor taste in my mouth of obstetrical care.

So, when I became pregnant with my second child, I wanted something different.  However, due to complications during my first trimester, I required much more medical care than I'd anticipated thus causing me to spend some time with an Ob.  We were unsure if we could have a home birth with a midwife like I'd wanted, so we continued to be followed by the Ob group.

The midwifery care we received while pregnant was excellent.  Appointments with the midwife were so much better than appointments with the Ob group.  We sat and chatted in my living room while my son played on the floor, spending time discussing the birth and my progress, but also talking about parenting and life at the same time.  The midwife was a knowledgeable, kind birth partner as opposed to the doctor in charge of my care.  It was such a warm experience.

Up until the end of the pregnancy, I still expected that we'd be able to have a home birth with the midwife.  We were medically cleared to do so, but other circumstances got in the way, in the form of a blizzard and the midwife's inability to make it to us.

When we entered the hospital for my second birthing, however, it was a completely different tale than my first.  The Ob we'd chosen for this pregnancy was far and beyond both more accommodating and more supportive than the last we'd had.  My husband and I were basically left alone to let my body progress on it's own time after my water had broken, instead of being given medication to progress my birthing as I'd had with my first child.  The nursing staff we had the second time around was also much more supportive as well, allowing me to do my own thing but were at the same time present when I needed support.

Because we had better care providers the second time around, the very similar birthing was much more enjoyable and much less stressful.  With that said, I've compiled the top four tips I wish I had known the first (and beginning of the second!) time around:

1. Really know who your provider is.

With our first pregnancy, we took the recommendation of several friends to use our first Ob.  I was a first time mom, so hearing, "Dr. ___ was excellent in my pregnancy, I'd definitely recommend him!" was good enough for me.  As a second time mom, I would have looked further.  If I didn't have any friends who had natural deliveries, I'd be checking local breastfeeding, babywearing, or cloth diapering support groups.  Typically, in those groups (either in person or online), you can find TONS of information on which Ob's are the most supportive of natural birthing, including specific experiences on what those mothers liked and didn't.  Most of the mothers I know are happy to share what they liked and didn't like about their birthing experiences, you just have to find them to ask!  I'd have also been checking the hospital's C-section rates and asking the aforementioned women about their nursing staff experiences as well.

2. Watch for red flags.

If your provider doesn't seem to be supportive of your birth plan, you may seriously consider switching.  Just because you start with one Ob doesn't mean you have to finish with them.  If you're not happy with how your provider is responding to your questions, then that's a good sign you may not be with the right person.  Definitely ask your Ob how they feel about different scenarios.  I asked all the normal natural friendly questions, regarding no forceps, no vacuum, etc, but don't think I ever asked the one question that mattered in both of my pregnancies: how long would I be able to progress on my own after my water had broken?  With my first Ob, the answer was 24 hours.  With my second Ob the answer was 48 hours.  Those extra hours on my own allowed me not to have to take pitocin the second time around, for which I was so thankful!

3. Bring your own support team.

As a first time parent, I'd expected the nurses and doctor to constantly be around to help me through my birthing, and that just wasn't the case.  They were there when I needed something, but were right out of the room as soon as that need had been met.  There was no support or helping me through contractions, and being who I am, I would have felt uncomfortable asking.  Having my own little "birth team" was immensely wonderful and helped me to get further in each birthing without interventions than I'd expected.  Whether it's a friend who had a natural birth, a husband who has read up on comfort techniques, or a doula you've hired, to be successful in your goals you need help getting there, from your OWN people.

4. Don't be afraid to jump ship.

Coming from someone who started with one Ob and then moved to another mid pregnancy, I'm a huge proponent of switching if things don't feel right.  As a mother, you may find that you develop a keener sense of knowing when something seems off in a situation, and this can start even while you're pregnant.  If you just don't feel right with your Ob or have any doubts whatsoever, no one is going to blame you for switching.  It's YOUR body and YOUR BABY'S care.  You are paying for these professionals to attend your birth, so why shouldn't you get the care that fits you better?  I will say that when we switched providers, we did have to pay a small fee to the previous Ob.  It was totally worth it to be able to move on for us.  You'll definitely have to look into your insurance first before you switch to find out what the financial ramifications would be for you personally.

What are some tips you'd add to this list?

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  1. Well said. I just switched my care to a new practice. It was hard this far along in the game, but I just imagined why my birth was going to be like, if my prenatal care was this bad. I had to go with my instincts and drive a little further than wanting too, but it's working out so far! 6 more weeks and counting.

    1. You are so close lady! Hope you are comfortable and feeling well!

  2. Loved reading every second of this post! So true... I have so many regrets about not seeking a midwife for my first and it still bugs me to this day, but my daughter turned out happy and healthy so at the same time it's hard to be upset. I was a victim of the snowball affect, one unnecessary intervention after another. Sharing this with a friend who is due in July :) Thanks for writing this!

  3. I agree - many people spend more time shopping for the right car than the right healthcare provider! You need to do your research on your obstetric provider/hospital/lactation consultant/pediatrician etc. As an OB myself this always hits close to home. It's important to note that just b/c one is an OB doesn't make them bad/knife-happy, and just b/c they are a midwife that they are automatically supportive. It's getting beyond the label and really feeling comfortable with whomever you see- OB, midwife, family pracitioner etc. I am glad your OB the 2nd time was a better fit and you had more support! There is nothing worse than being scared, in pain, and alone. I agree with all your tips!


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