Choosing a Hospital and Doctor

1. Is the doctor board certified?
Our specialty has a rigorous set of written and oral tests that must be passed in order to obtain board certification. Doctors who have just finished training can't take their final tests until they have practiced for 2 ½ years. These tests are designed to ensure that your doctor has an extensive knowledge of obstetrics and gynecology. If a doctor is not board certified/eligible, you may want to look elsewhere. You may want to ask this question before going for your first visit.

2. Is the doctor in a group?
The days of the solo obstetrician are gone. Obstetrics is a physically demanding specialty and there are times when I work throughout the night. I am tired the next day. I don't believe it is in either the patient or doctor's best interest to have a fatigued physician caring for a laboring woman. Working in a group practice is a good solution. It allows doctors to share the nights on-call as well as maintain continuity of care. Some physicians have shared call arrangements (called cross-coverage). In this situation, a physician you may not have met before could deliver your baby. Although excellent care may be provided in this situation, the familiarity and comfort of knowing and trusting your doctor is missing. In our group, all the doctors know all the patients and they know us, too! Not only does this result in good medical care, it also gives women the comfort of knowing the person who delivers their baby.

3. How do you manage patients in labor?
This is a very important question. We have all heard about doctors who make a mad dash from the office to catch your baby. They are in and out in a jiffy. Although this may be a reality of managed care, it isn't always the best way to monitor labor. It goes without saying that labor has some potential risks. Having your physician watching over you and physically being around helps insure the best possible outcome. I'm not suggesting that the doctor stay at your bedside. However, I think he or she should intermittently monitor your progress and look at the baby's heart rate. In addition, doctors who sprint back and forth from their office to deliver babies are notoriously behind schedule and frequently must cancel appointments. The ideal setting is to have one physician in the group whose sole responsibility is to take care of laboring patients. In this way, your office appointment is honored while other laboring patients are adequately cared for.

4. What is the doctor's c-section rate?
Though this sounds like a good question, it can be misleading. Most obstetricians have a c-section rate between 15-20%. Higher rates may be due to a number of causes that are out of the doctor's control. For example, an obstetrician may take on more high-risk cases where c-section is required. In reality, there are better questions to ask to determine the obstetrician who is right for you.

5. Do I always see a physician at my visits?
Many groups have enlisted the aid of nurse practitioners, physician's assistants, and midwives to help make their practice more efficient. These professionals are good sources of information and are capable of doing routine prenatal visits. In some practices, the midwives may be delivering babies as well. This information is nice to know in advance.

Research Tips

When you want the real scoop, don't be afraid to do some detective work. First, decide on the hospital where you want to deliver your baby. Next, do some networking. If you like your present OB/GYN, ask around to see what others' birth experiences have been like with him or her. If the feedback is good, you can feel pretty comfortable staying where you are. If not, you may want to follow some of the tips listed below.

You can try calling the hospital's doctor referral center and make an initial list of doctors based on their office location and board certification status. Using your list, try talking to friends and neighbors. Often, a few names will come up more than once. Alternatively, if you have a doctor who you trust in another field (pediatrician, internist, etc.), try asking them for suggestions. Ask who delivered their children!