Choosing Your Birthing Team

Malcome Paine147300X200If you or someone you love is thinking about starting family, there are many exciting decisions to make: favorite baby names and how to arrange a nursery, for instance. Among the most important is choosing your prenatal care and delivery team. Even if you already know you would like to birth in a hospital, there are a lot of choices to consider.

Previous Experience All women should see a gynecologist, certified nurse midwife, or family medicine provider yearly for routine care and screenings. If your current provider attends births, you may want to consider sticking with him or her through your prenatal care and delivery, especially if you have a good understanding of the provider’s recommendations and you feel they are a good match with your own preferences. If you’re not sure, you should ask. The provider should be able to respond directly and thoughtfully.

Recommendations For many parents-to-be, personal recommendations of family and friends make the largest impact. If a loved one had a successful outcome and built great relationships with staff at a particular practice, you may be persuaded to join them as well. Also, many also rely on recommendations from their primary care provider. Through their work, primary care doctors, nurse practitioners, and physician assistants relate with specialists of all kinds and have a sense of which are most responsive and have the best reputations for outcomes.

Safety Not all hospitals are equal. Don’t hesitate to research the hospital safety score and infection rates. These statistics are an indication of a hospital’s ability to follow the procedures necessary to keep patients safe. The following sites are good sources of information about how hospitals perform in measures of safety: www.consumerreports.org/health/hospitals/ratings, www.leapfroggroup.org, and www.medicare.gov/hospitalcompare.

Similarly, not all practices and hospitals offer the same options for new parents. Be sure to know what services the practice and affiliated hospital can do and what would happen if you needed more or different care than they provide. If you are at high risk for any complications, your providers should either consult with you about the plan or refer you to a team that has a more direct method for getting patients like you the care they need.

The Staff If you are choosing an obstetrician, I recommend looking for or one who is board certified by the American College of Obstetricians and Gynecologists (www.acog.org). Certification involves a rigorous process of testing and peer evaluation that is designed and administered by specialists in the specific area of medicine. The certification means that he or she has demonstrated exceptional expertise in the field.

Whether you are investigating a doctor or a certified nurse midwife, you may also want to ask how long he or she has been practicing. If you have any known risk factors, ask how often they treat patients like you and that they are prepared to handle any changes as they arise. Finally, be sure to find out who you call if you have a question and get an idea of how long it will likely take to get a response. You should be satisfied by the answers to all of these questions.

Almost as important as the experience of interviewing your obstetrician or midwife is the skill and demeanor of the nurses, front desk attendants, hospital staff, and others working to provide your care. You will see a lot of these professionals in the course of a single pregnancy. During your interactions with them, you should feel as if they are paying attention to you as an individual.

Facility Offerings Throughout your interactions at your provider’s office, you may learn that the hospital nursing staff offers classes and orientation opportunities to prepare you for the birthing experience and for caring for yourself and your baby when you return home. In many cases, these classes are taught by the same nurses who attend births and care for new families. These classes are excellent sources of information and often provide a preview of the people you will be working with during your birth experience.

If it is not offered automatically, ask for a tour of the unit where you will give birth. At a minimum, it should be bright, clean, and friendly. Take note whether the unit offers private rooms, a family waiting area, and any other amenities to make new families and their visitors comfortable. Finally, be sure to ask about the unit’s policies regarding who can attend the birth, the number of visitors allowed, and when guests can visit. (Some hospitals restrict guests, especially during periods of high infection, like cold, flu, or whooping cough.) Even if the policies are not exactly as you would hope, the staff should be able to provide good information for the reasons they are in place.

Proximity If you live between two or three options, more or less equal, you may consider the distance that it takes to travel there and back. Pregnant women who follow the recommended plan of care have an appointment every week for the last several weeks of a pregnancy. When the baby is born, families often spend a few days in the hospital, with the non-mom partner often traveling between the hospital and home several times to meet other responsibilities. While a 10-mile per trip difference can add up in gas, mileage, and time, birthing with a team you trust is sometimes worth the added expense and time.

Paine201X200Regardless of where who you choose to partner you as you start your family, I hope you find an experienced and warm-hearted provider and staff who help you approach this exciting time with confidence.

Malcolm Paine, MD, is board-certified OB/GYN at SVMC OB/GYN. He practices both in Bennington and at SVMC Pownal Campus. “Health Matters” is a column meant to educate readers about their personal health, public health matters, and public policy as it affects health care. For more articles like this one, visit svhealthcare.org/wellnessconnection.