How to Choose an OB/GYN
Hi Amy,
I’m hoping you can help me, because I’m terribly confused. I need a new gynecologist. My old one was really only my doctor because they were conveniently located near where I was going to grad school. I’ve graduated, work downtown and the doctor has also moved. I’m also recently married, and we are talking about having kids. So, whoever my next doctor is will most likely be the person who gives advice on getting pregnant and, hopefully, is my doctor through pregnancy and delivery. I’m not originally from here, so I don’t have a family doctor to ask for recommendations, and the family that does live around me finished having kids about 20 years ago.
I have found all sorts of information on touring hospitals and talking with your physician about their approach to the birth process, but nothing on where to start looking. Right now, I just need my annual checkup and a few answers to what I’m sure are normal “just starting to try to get pregnant” -type questions. I have always just found the closest doctor to me through my health insurance provider’s website. I feel like I need to put more thought into this decision, since I want to make sure I deliver in a reputable hospital and I want a place where they don’t view pregnancy and birth as a condition to be treated. I prefer the more natural approach, but I want the benefits of a hospital, should something go wrong.
I’ve tried googling every configuration of top hospitals for giving birth, top maternity wards, best birthing facilities etc. and I’ve come up with nothing useful. Also, friends who have recently been pregnant told me about how often you have to go to the doctor, so I need someone affiliated with a hospital within reasonable distance to my house in the suburbs (about 20 miles outside the city), but with an office within reasonable distance to my office. I’ve thought about downtown hospitals, but if I went into labor in the afternoon on a weekday, it would take my husband forever to get to me (because he works even farther north) and then a good hour and a half to two hours to get downtown. It seems like unnecessary stress during an already stressful time.
I would ask for recommendations, but the women in my office who have been or are pregnant live downtown, or close by, so their hospitals are not close to us. My one friend who lives near me likes her doctor well enough, but for one, her doctor thinks episiotomies are necessary for every birth and her doctor is a man. I am very uncomfortable with male doctors.
I’m not usually so confused, but this seems like a REALLY BIG DEAL, and I feel like I am missing something that everyone else seems to have figured out. Can you offer some direction?
Thank you!
“not yet knocked-up”
You know, I never, ever thought I would tell someone she was overthinking anything regarding her own medical care, but duuuude. You are so overthinking this. For now. Your list of requirements and contingencies and what-ifs and geographical worries made my head spin. You are not pregnant yet! I officially order you to RELAX A LITTLE BIT ABOUT THIS.
MOST of us, honestly, have chosen doctors at one point or another based on our insurance coverage and the convenience of the office and/or appointment hours. MOST of us are lucky if we have a friend who can make a recommendation that fits ANY of our insurance/location requirements. Rest assured there is no magical secret we all know and are holding out on you.
My OB/GYN, by the way, was someone I picked blindly from a list when I first moved to this area many, many years ago. He had an office close to my work and one near my house. I had no plans to have children at that time, so I didn’t even notice that he also specialized in infertility. He accepted my insurance, I went for a pelvic exam and I liked him. And I’ve been with him ever since, through regular exams and a breast lump scare and infertility treatments and counseling and two pregnancies and one labor and two c-sections.
(For your Labor & Delivery Anecdotal Files: He worked out of a hospital that was next door to my office, a decent distance from my house, and a VERY far distance from my husband’s office. I went into labor at night, and we got there in plenty of time. [10 hours or so, in time.] We lived closer to that same hospital and his office for the second pregnancy, but again the distance ended up being a non-issue due to the scheduled delivery.)
This is not to say that you shouldn’t be proactive about your choice of doctor. Of course it’s a very important decision. But it’s also a decision you can make in your own time, and a decision you can make a couple times, if need be. You are allowed to change doctors. You are allowed to interview doctors. Call the office and see if you can meet the doctor and ask a few questions before making an appointment:
1. Get a gut feeling about them, their bedside manner, the competency of the office staff.
2. Ask them about their approach to pregnancy, before, during and after.
3. Ask them about their episiotomy and c-section rates.
4. Find out if they work out of multiple hospitals (mine did), who covers for them if they’re out of town.
5. Find out what kind of after-hours help they have (like an answering service) in case of emergencies.
6. Can you email them non-emergency questions? Ask all the questions you already asked me, in your email. Â If they aren’t willing to do that, either on the phone or email or in person, they are probably not the doctor for you.
But…your email still does suggest a hint of…let’s call it perfectionism? (I recognize it because I HAVE IT.) A fear of doing something wrong or making a mistake? An overload of worry and what-ifs that is actually keeping you kind of frozen and unable to make a decision because it is such a BIG DEAL and needs to be PERFECT or else ALL IS LOST? That’s a common approach to pregnancy and it will drive you flat-out crazy, my dear, because pregnancy and birth rarely go perfectly or exactly according to plan. So…this MIGHT be something you should keep in mind about yourself, going forward. Put down the What To Expect books, take a deep breath and remember: going in for a pelvic exam does not require you to sign a pregnancy and birth contract with that doctor even if you don’t like them.
And also remember that plenty of women aren’t even on top of things enough to have a GYN in the first place, and suddenly have to scramble for one in their first trimester. So go you! Go scour the provider directory, choose a couple office locations you can comfortably see yourself making monthly, bi-weekly, and weekly and start the interviewing from there. Maybe ask your primary care physician for a recommendation. Let go of some of the what-ifs (what if I’m on bedrest and want a doctor closer to home? what if I need help getting pregnant? what if something goes wrong? what if I go into labor while visiting family in another state?). That stuff can happen, of course, but you can’t control-freak every aspect of this. Prioritize a few things that are the most important (insurance coverage, a woman, convenient office, natural & low-intervention approach) and go from there, reserving the right to change your mind after the interview, after one appointment or after 12.
One other suggestion for you — you want a natural approach with the benefit of a hospital. That still doesn’t preclude you from using a certified nurse midwife (CNMs) instead of an OB/GYN when the time comes. Many midwives deliver in hospitals, or at birthing centers that provide emergency transfers if you need them. Or, if you feel more comfortable with an OB but still want a little extra reassurance that your birth plan will be honored, consider hiring a doula to assist you once you go into labor. (If you find a doctor you really like and trust, a doula still isn’t a bad idea in case your doctor ends up being out of town or something when the time comes and you’re stuck with whoever is on call.)
The whole “on-call” thing is a sobering reminder that you can do everything right — you can interview and plan and drive yourself completely up the wall over Choosing The One Who Shall Bring Your Offspring Into The World…and STILL end up with a total stranger, or the doctor you only met once, or somebody your midwife called in because she came down with food poisoning. My friend’s last baby was delivered by a completely random doctor who happened to walk by her room and realized that her baby was crowning — her entire labor was less than two hours start to finish, and her actual doctor was at home, still looking for her car keys when my friend gave birth within 20 minutes of arriving at the hospital. WITH her husband. Thank goodness for those late-night labors.
And you know what? It was fine and perfect and she loves telling the story of how this young guy in a white coat stuck his head in the door and said, “Whoa. Uh. Lemme help you with that.”
