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  health > women > story page AIDSAlternative MedicineCancerDiet & FitnessHeartMenSeniorsWomen

Looking for Dr. Right: How to choose an obstetrician

July 29, 1999
Web posted at: 4:42 PM EDT (2042 GMT)

In this story:

Put the grapevine to work

The right stuff


By Ann Douglas

  • The decisions you make in choosing an obstetrician -- and those you make with him or her -- are a part of your overall birth plan, a comprehensive list of what you need and want in your ideal birth experience. Factors to consider when creating your birth plan include:
  • Where you would like to give birth
  • Techniques to be used if augmenting labor is necessary (the drug pitocin, breast stimulation, breaking of membranes)
  • Types and uses of pain medication and pain management (acupuncture, local analgesia, tranquilizers)
  • The type of monitor used on your baby (a Doppler or fetoscope)
  • Positions in which to deliver (lying on your side, squatting)
  • Birthing equipment you'd like to use (birthing bed, birthing tub)
  • Forceps vs. vacuum if an assisted birth is necessary
  • (WebMD) -- The moment you discover that you're pregnant is the beginning of a journey with highs and lows that will rival any roller coaster. It's only natural for you to want to have the right person along for the ride, whether that person is an obstetrician, a family physician or a midwife. If you decide to go with an obstetrician -- the choice of 80 percent of American women, according to recent figures -- doing your homework now will pay great dividends in the end, for both you and your baby.

    Put the grapevine to work

    You wouldn't dream of entrusting your car to just any mechanic. You'd want to know that the mechanic had the necessary expertise and could be trusted to be honest. The same principle applies to your obstetrician. Rather than simply picking the first obstetrician on your HMO's list, you need to tap into the grapevine in your community and find out which obstetricians have the best reputations.

  • Talk to other women who have recently given birth and who have birthing philosophies similar to yours.

  • A number of other people can also give you the inside scoop: your family doctor, your gynecologist (assuming she doesn't do deliveries herself!), the staff of the birthing unit at the hospital where you'd like to deliver, an obstetrical nurse, a childbirth educator, a lactation consultant and anyone who knows many of the doctors and midwives in your community.

  • You can get names of reputable obstetricians from the American College of Obstetricians and Gynecologists.

  • The right stuff

    Once you've come up with a shortlist of highly recommended obstetricians, you should set up a preliminary appointment with each doctor.

    The first thing you need to assess during this meeting is whether you and your partner feel comfortable with this person. Is the obstetrician warm and welcoming? Does he or she encourage you to ask questions about how the practice operates?

    Next, you need to go on a fact-finding mission. Here are some questions that will help you determine whether you've met your match:

    Learning about the practice:

  • How long has the obstetrician been in practice?
  • Is he or she certified by the ACOG? (This indicates that the obstetrician graduated from an accredited residency program and has passed rigorous examinations in the field.)
  • Which hospitals and/or birth centers is the obstetrician affiliated with?
  • How many babies has he or she delivered?
  • What percentage of patients' babies does the obstetrician deliver?
  • Does the practice incorporate residents or interns? (Some women want assurance that only their OB or a backup OB will be delivering the baby, while others feel good about contributing to the education of the next generation of doctors.)
  • Who will provide backup if the obstetrician is unable to attend the birth?
  • What percentage of the obstetrician's fees are likely to be covered by your HMO?
  • Learning about the obstetrician's approach to pregnancy:

  • What is the obstetrician's recommended schedule of prenatal visits, and how long does he or she spend with each patient?
  • Under what circumstances, if any, might it be necessary for the obstetrician to transfer you to the care of another health-care practitioner?
  • Under what circumstances would the obstetrician induce labor?
  • What types of tests might the obstetrician order during your pregnancy? (For example, does he or she routinely test for gestational diabetes?)
  • Learning about the obstetrician's approach to birth:

  • How much time will the obstetrician spend with you while you're in labor?
  • Does he or she have patients write birth plans?
  • How does the obstetrician feel about natural childbirth?
  • How would he or she react if you decided to have someone other than your partner at the delivery (a doula, for example)?
  • Are you and your baby likely to be separated after the birth?
  • Does the obstetrician provide breastfeeding support and postpartum care?
  • What percentage of women in the obstetrician's practice have medicated births, episiotomies and cesareans, and what percentage have induced labors? (If a large percentage of patients have induced labors, you'll want to know why -- is it for the convenience of the doctor or the health of the patient?)
  • Take the time to find a good match, and nine months down the road you may be feeling teary-eyed knowing that it's time for the two of you to say goodbye -- at least until next time.

    Copyright 1999 by WebMD, Inc. All rights reserved.

    Pregnancy and Childbirth

    American College of Obstetricians and Gynecologists
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