So you've decided you want an obstetrician to be your primary care provider through your pregnancy and birth, but how do you choose which one?
Well, knowing that you have a choice is the first step. Finding one that aligns with your wishes for your birth is the next. You should be “interviewing” a couple of different OB’s to find the perfect match so that you feel comfortable and supported on the big day. I've compiled a shortlist of questions you may want to ask to help guide you to the right decision. Remember that they are working for you and you don't have to go with one just because they were the first one you saw, your friend recommended them, or because they’ve been your family GP for years.
To get started you will first need to work out exactly what kind of birth you want. Do you want a physiological birth? Water birth? Are you trying for a VBAC? Do you know you want an epidural? Once you are clear on these things it will make choosing an obstetrician that aligns with your wishes easier.
Keeping in mind that not every birth goes to plan and that adjustments to your birth preferences may have to be made along the way, you want someone that will change in the direction that you want to go.
Once you've got a clear idea in your head of the way you want things to go, you can start “interviewing” your OB’s with some of these questions:
1 - Can we discuss my birth preferences?
First off the bat is a discussion about your birth preferences, as if your OB isn't even willing to discuss them with you, that's a big red flag. Also because this will be a great one to suss out whether or not they are going to be able to support your wishes.
2 - Do you support _______?
Fill in the blank for whichever kind of delivery you want. It could be waterbirth, caesarean, vaginal birth after caesarean, vaginal breech delivery, vaginal delivery of twins. If they don’t then they are probably not going to be the best fit for you. Keep searching until you find that OB that will support your wishes!
3 -How long have you been practising?
The answer to this question is totally up to your interpretation but is good to know. They could be fresh out of study meaning they know all of the new research, techniques and technology but possibly not that much experience. Or it could go the other way, with heaps of experience but possibly a little old school in their beliefs.
4 - Which hospitals do attend?
This is obviously quite important for you to know before choosing an OB, depending on where you will be living when you go into labour. You don't want to be travelling for long whilst in labour, however, you also don't want to accept just the closest hospital, simply because it is the closest hospital. Look at the hospital facilities and possibly ask for a maternity ward tour.
9 - What should I expect during my delivery?
Obviously, your OB cannot predict exactly how your delivery is going to play out. They should however be able to tell you exactly what to expect for every situation.
7 - What are your practices’ policies on going over my EDD, FTP or clock watching?
These are important to know as you won’t know that these circumstances are going to happen until you are in them. So it's important to get all of the information before they happen, if they happen. If you don't wish to be induced then don't choose the OB that would induce you at 38 weeks simply because he’s got lots of babies due around then and he wants to go on annual leave. The same goes for FTP (failure to progress). You could ask this question for any circumstance that you may be worried about, ie twins, breach, gestational diabetes, skin to skin
8- What is your induction / c section / episiotomy rate?
Similar to the last question, if you don't wish to have a c-section, don't choose the OB with the largest c-section rate. And no matter what they say their policies are, their stats shouldn't lie. You can also sub out for any circumstance you may be worried about. Ask them to be specific and ask for a percentage, rather than a number. They could say a number will double, but if you double 1 out of 1000, it’s still only 2 out of 1000.
5- What is the likelihood I'll need a caesarean?
If your pregnancy is high risk and you are wanting a vaginal birth, this is an important question and linked to the previous one. Look at their stats, and then ask them to compare them to previous births they have attended with the same or similar situation to yours.
6- What should I know about VBAC?
If you’re trying for a VBAC (vaginal birth after caesarean) you will want to know exactly what is going to happen and what the likelihood of it happening is. If your OB does not sound like they will support your wishes maybe try another one. Go with your gut.
10 - Who will "deliver" my baby if you are not available?
Only you will birth your baby. Your baby is not a pizza and does not need delivering. But for the purpose of the questions....Hospital policies may vary so it is important to check whether your OB will be on call for your birth, or whether you will just get the OB that happens to be on shift when you are in the final stages of labour. It is highly likely that your OB just might not be on shift, or not able to make
your birth. In this circumstance, who will be "delivering" your baby?
11-What pain relief options will be on hand?
You might want to find out what pain relief they offer, what they don't offer and when you can and cannot have them. For example, you cannot get in the shower after having an epidural, or there may be a wait for an anaesthetist, or you could want a water birth to help with pain management.
12- What birthing positions do you allow?
If you are interested in active labour or have heard the benefits of a certain position, an OB that wants to put you on your back with your legs in stirrups probably isn't going to be great. It’s important to find these things out.
13 - How do you manage third stage labour or placenta birth?
You may have heard there are a few different ways that you can manage the birth of your placenta. Different hospitals and OBs have different policies on this. Do your research on the different ways it can be managed and then find a way that aligns with you the most. Then find an OB that will support you in this.
14- What are your thoughts on doulas?
Always a fun one to find out, even if you are not planning on hiring a doula. An OBs reaction to having another support person in the room who is well versed in your rights or what could go wrong will show you part of their character. If they seem stand off-ish is it because they have something to hide? Do they know that they try to push for medical intervention when it’s not necessarily needed? Or is that something that you’re not bothered about anyway? If they seem happy and welcoming to having a doula in the room, I would say this is a positive
sign! The more support we get for mama and the more comfortable she is going to feel, is going to lead to better birth outcomes and a happier mum and bub meaning greater chances of success heading into their postpartum and breastfeeding journey!
Once all the questions have been answered and you have interviewed a few different OBs remember to trust your gut and instincts. Also that once you have chosen an OB it is not too late to change your mind on them and go with a different one, or change your model of care altogether. Happy hunting mama! You got this!
Jenise Russell, yoga instructor, specialising in prenatal yoga and mums and bubs classes, birth and postpartum doula, mother blessing facilitator. For more information please feel free to email me via email@example.com. Follow along my Instagram @jenise.yoga.doula, or my website www.jenise-yogadoula.com
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