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How to Choose an OB/GYN

By Amalah

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.  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.”

Don’t forget to visit Amalah’s Pregnancy Calendar. It’s 40 weeks of Amalah’s informative & hilarious pregnancy advice.

Amalah
About the Author

Amy Corbett Storch

Amalah

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to [email protected].

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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Diane
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Diane

Oh sweetie, you just have to stop and take a breath! I agree with everything Amy said. I went to a practice that had both an OB and a nurse practitioner/midwife. The hospital and office weren’t close to my house, but I knew they were good, so I made it work. And please keep in mind that going into labor is rarely how they make it look in the movies. With my first, my water broke, I called the midwife, she asked if I’d started contracting. I hadn’t, so she said “go ahead and have something to eat, take a… Read more »

Clare
Guest
Clare

Look for a CNM! Most are affiliated with an OB practice, so you can switch if your pregnancy becomes high risk. I had a hospital birth with a CNM for my first, and a hospital birth with an OB for my second (we had moved across the country in between). If I have a third, I want another midwife. The experiences were night and day, as much as I liked my young, female, mother of 4(!) OB. Even my husband (who thought I was a bit odd for having a midwife the first time around) commented that the appointments with… Read more »

Olivia
Guest
Olivia

I’ll chime in as one who did not have a OB/GYN before getting pregnant or had even had an interview with anyone before I was 8 weeks along. I had relied on Planned Parenthood (and whoever was on call there) for all my annual exams since I was 16 because I never had insurance. I asked a few cursory questions about getting pregnant there, and fortunately had no trouble conceiving. And, all I knew at the time I peed on the stick was that I was looking for a homebirth CNM. Choice was limited in my area, but I found,… Read more »

Meagan Francis
Guest

Ditto everybody else, and also, keep in mind that Googling may not be the best way to find the kind of doc/hospital you’re looking for. If you Google “best birthing facility” you’ll probably find the hospital with the biggest budget for SEO and website marketing. Hospitals with the biggest budgets aren’t always the mom and baby-friendliest in the end, though they may certainly make themselves look that way. When you get to that point, I recommend looking here for recommendations: http://www.motherfriendly.org/index.php They have criteria that hospitals/birth centers must meet before they receive designation. I thought there was a searchable database… Read more »

Karen
Guest
Karen

I used to be at a ginormous practice that was a block from my office. Muy convenient for pelvics. Got pregnant, was uncomfortable with the 20 rotating docs idea and also knew they weren’t taking my Bradley-classed, au natural ass seriously. Switched to a far less convenient practice so I could see a CNM. Come labor time, her pager didn’t work, she didn’t come until 14 hours after we arrived at the hospital, an OB broke my waters 24 hours after labor started, and I ended up in deep transverse arrest once I started pushing and had a section after… Read more »

Amy
Guest

Wonder if the question-asker could leave a comment with her location – maybe there’s a reader in the same area who could not only offer a doctor recommendation, but also could provide info on MOPS programs, etc.
In my local area (Lafayette, IN) the local newspaper has a group for moms, and there’s a lot of amazing information on there. http://lafayette.momslikeme.com/members/exploregroups.aspx
Amy @ http://prettybabies.blogspot.com

Laura
Guest

Amy
Thank you thank you thank you for mentioning doulas!

Jessica
Guest
Jessica

Another way to find a good CNM or OB is to tour the hospital you would like to give birth at, and talk to the L&D nurses to get their thoughts on the doctors who practice there. These nurses see the docs and CNMs in action day in and out, are very familiar with their styles and can probably give you some names to start your research. You may also have luck through a local breastfeeding support facility in your area. The lactation consultants often have a line on area providers and can give recommendations based on what you are… Read more »

Rebekah
Guest
Rebekah

I can so sympathize!! I am doing the exact same thing with the friggin’ dentist. I have been asking for recommendations and researching so long, that I’ve missed tons of cleanings! I get so caught up in the worry over the provider, office, locations, reputation that I’m actually hurting myself by missing the actual cleaning. I could have gone to tons by now and either found a great one or ruled a bunch out!

qwyneth
Guest
qwyneth

These comments are all great! Seriously, listen to everyone about looking for a certified nurse midwife instead of an OB. Many of them deliver at hospitals (although birthing centers also work with nearby hospitals and emergency transportation is very quick and smooth), and you are likely to get much more personal, natural-friendly care. I am currently 37 weeks pregnant and I switched from my OB and Big Name Hospital at 30 weeks when it became clear that there was simply no way they were going to honor my wishes for a natural birth. (There were a lot of other issues… Read more »

erin rae
Guest
erin rae

Background: I had a fabulous birth a couple months ago with a CNM at a birthing center – no interventions whatsoever, got my fluids from my water bottle, got to be in the tub, etc. I found that a number of OBs would tell you what they thought you wanted to hear, but if you actually asked patients about their experiences, the reality was quite different. Therefore, I went with someone convenient who I liked for well woman care, and then started calling and interviewing doulas once I was pregnant and had a doula. The local doulas can provide great… Read more »

Aimee Greeblemonkey
Guest

Amy, this is a great post. I am lucky that I found my OBGYN soulmate a long time ago, and it really came into play when my son was born via emergency c-section – but this is great advice for so many women!

bessie.viola
Guest

Chiming in with everyone – Amy, this was a perfectly comprehensive post. I have a friend who was talking about this very issue the other day, and I’m definitely going to forward.
Also: HURRAY for CNMs. I planned a natural, no-meds hospital birth, but ended up with stalled labor and a c-section. My CNM was INCREDIBLE – she came into the operating room with me before they let my husband in. She held my hand and took pictures of the actual birth – she recorded all the moments I couldn’t even see.
So… rambling, but they are an amazing breed. 🙂

Genevieve
Guest
Genevieve

I had a friend who changed her doctor two weeks before she was due. She was getting more and more pissed off with him as the pregnancy went on and she said she was glad she made the decision. So even if you start off with one OB/GYN/CNM you aren’t locked in like you are with a cell phone plan. I like my OB a lot but she wasn’t there when I gave birth and I really disliked the doctor who helped deliver my son. (the nurses were amazing. I wanted to send them all fruit baskets for their good… Read more »

Jane Doe
Guest
Jane Doe

I will add my support to those that have already recommended having a midwifwe – thanks Amy for bringing it up as an option. I will be very frank with you, as it seems most women are reluctant to really tell the truth about their birth experiences, and the portrayals of birth in mainstream media and entertainment are unhelpful at best and patently false at worst. Please do not watch “Birth Story” or other reality type birth shows, all they will do is contributeto the culture of fear already overwhelming in our society. Your chances of finding a “natural-friendly” OB… Read more »

Tiffany
Guest
Tiffany

I’m a wuss. I thought I wanted a med free labor, but as the day got closer? NO way. I’m so glad I went with an OB, but my office also offered a CNM as well had I wanted to take that route. If the issue of hospitals close to a certain location at a certain time … if your city is big enough, it’s entirely possible your doctor has privalges at more than one. With my OB, when the time came I had a choice of three hospitals (one being down the street from my house!). She had a… Read more »

Kate
Guest

What Amy and others have said. Having an annual exam is not the same as having a baby, so you might find bedside manner once a year is not what you want for appointments of increasing frequency and discussions of increasing importance to you. So…it’s never to late to switch providers, for any reason. I switched at 14 weeks pregnant w/#1 because my GYN, who I liked a lot, had an office that was far from where I worked and from where I lived and was always (ALWAYS!) running 30+ minutes behind schedule and I didn’t want to get fired… Read more »

ikate
Guest
ikate

Go for an OB practice that has CNMs on staff – you get the best of both worlds. I was lucky that my exisiting OB/GYN office had this set-up. My first 2 visits were with my OB, I told her I wanted to go the natural route and as I had no foreseeable complications I started seeing the 3 CNMs on the staff on a rotating basis. Liked them all but liked one the best and I luckily had my baby when she was on call. But, I echo what others have said – start with the hospital you want… Read more »

Katie
Guest
Katie

You could try Yelp.com for reviews of local doctors, or Angie’s List. I haven’t used Angie’s List but Yelp was very helpful when I was choosing a doctor and a dentist.

Gillian
Guest

My first kid is 8 months old – surprise pregnancy – and my GP who did my yearly paps does not do maternal fetal medicine. I picked my GP,by the way, by choosing the university med services I wanted to be associated with (Duke or Chapel Hill? Both are awesome, I chose Chapel Hill), and then picking the practice closest to my house. He was the one doc taking new patients, so I went for my first pap with him, LOVED him, and stuck with him. If I hadn’t liked pap #1 I would have tried another doc. Really, there… Read more »

Liz
Guest
Liz

I just wanted to chime in and say how extremely useful everything everyone said was to me. I am in the exact same situation as the question-asker (including the tendency toward perfectionism) and I am also looking for a pre-conception doctor, having just graduated. Your advice about CNMs and doulas was extremely useful. I’m lucky enough to have a hospital nearby that I know something about, and doubly so that they fully support doulas and mid-wives. I made an appointment with CNM later this month, and for the first time ever I’m actually kind of excited to go!

Ellen
Guest
Ellen

I am a healthy woman of 36, any chances I can give a natural birth other than using c-session? What I need to do to prepare myself for a natural birth? I am not yet pregnant.Thanks a lot.

Della
Guest
Della

Just a note. I found my doctor by randomly picking a name on a list. I had actually called another office first, one that had female OB/GYNs but the receptionist was so mean, I cancelled my appointment there, even though that had been the only OB/GYN office affiliated with my family practicioner’s office that actually had female OB/GYNs. So like I said, I then randomly picked the current doctor’s office. They randomly assigned me to the doctor I’ve got now. When I told my husband his name, I got an Interesting Look. Turns out this doctor also delivered my stepdaughters.… Read more »

Jeff Madison
Guest
Jeff Madison

I appreciate your tip on checking with your obstetrician to see if they work out of multiple hospitals. It seems that it would be important to know if their other work will take them out of town. My wife and I just moved and she is looking for a new OBGYN, when she finds one she’ll have to be sure to ask him or her whether she works out of different facilities.