The ideal hospital has a full-time dedicated anesthesiologist or nurse anesthetist assigned to the labor and delivery area. In this way, laboring mothers can have pain relief based upon their need, not convenience. I can't tell you how many patients have come to my practice after having had their first baby at a hospital that offered anesthesia only to women at an advanced stage of labor!
Another major benefit to having in-hospital obstetric anesthesia is the ability to do an emergency c-section in a timely fashion. According to the standards of the American College of OB/GYN, an emergency c-section should be performed within 30 minutes. Often, delays longer than this are due to the lack of an available anesthesiologist. Even if the "30 minute standard" is met, can you imagine waiting an extra five minutes for an anesthesiologist to arrive if your baby is in stress? Believe me, it adds stress to your obstetrician, too! For those of you trying to have a vaginal birth after a prior cesarean section, this is a major issue to consider when choosing your hospital.
Many hospitals offer amenities to lure you to use their facilities. They may have created wonderful birthing suites, candlelight dinners for the new parents or other enticing features. Sure, these are nice touches and, if all issues are even, they might be the tiebreaker. However, don't be fooled by the bells and whistles. These amenities do not address the ultimate goal -- having a healthy baby.
Once you have picked the hospital, your choice of physician will be more defined.
Many of you have an established relationship with a gynecologist. Although they may be the logical choice to help guide you through pregnancy, this isn't always the best option. A good gynecologist may not translate into a good obstetrician. Your potential obstetrician should withstand some scrutiny before being allowed to handle your pregnancy.
The doctor's personality is important. You have to feel that he/she will listen to you. Pregnancy is not the time to become passive. This is a special time in your life! It is both exciting and scary. No matter how unimportant the question, it should be answered with kindness and accuracy.
Let's not forget the office staff, either. From receptionist to nurse, these people make a huge impact on your pregnancy. A pleasant, helpful staff member can set your mind at ease. Scheduling appointments, helping direct you for testing and giving you advice on insurance issues are just a few of the roles these hard working people perform. I've always told my staff that they are the ones that make our office feel like a second home. I've seen offices where the staff has a bad attitude or the office is in chaos. It can make for a very unpleasant experience.
To illustrate the point, I want to share a story about a personal friend of mine. She picked her obstetrician by networking through doctors at the hospital she'd chosen for the birth of her baby. To her surprise, she was carrying twins. She called her doctor on a frequent basis with many concerns. One time, the person who answered the phone forgot to put my friend on hold and she heard the nurse say, "It's her again!" My friend felt horrible and refused to call the doctor again. When she started contractions at seven and one half months, she called me instead of her obstetrician! I sent her to the hospital for what turned out to be premature labor. Fortunately, the doctor there was able to stop her labor. While in the hospital, she switched her obstetrician and eventually had healthy twin girls who are now thirteen years old and doing great.
I think it's easy to see how important getting along with your obstetrician and his or her staff can be. You aren't supposed to know which symptoms are normal and which foretell problems. This is why communication is the key to a safe, healthy delivery. And there is no reason why pregnancy and delivery can't be an enjoyable experience as well!
Let's move on to some of the key ingredients in selecting a doctor.