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Choosing a Health Care Provider
Many of us put more research into buying a car than we do when choosing a doctor or midwife to deliver our baby. The reality is that through this decision, you’ll be choosing a partner for a remarkable journey over the next 9 months. This choice is likely to colour your experience of the pregnancy and birth. It’s best to select an experienced clinician whose values resonate with your own, who provides informative and supportive care, and who can enhance your pregnancy and birth experience.

Here are some issues to consider:

1. Where do you want to deliver? Your choices are a hospital, free-standing birthing centre or home. Make sure the provider you select has authorization to deliver at your preferred location. A hospital or birthing centre can provide you with a list of providers who are authorized to deliver at their facility.

2. Do you prefer an obstetrician, a family practitioner or a midwife to attend your delivery? The first two are physicians. A family practice doctor will be able to care for routine pregnancies and deliveries, and can provide health care for other family members as well, including your new baby. An obstetrician has specialized training in high-risk pregnancies and deliveries, and can handle unexpected complications. A midwife can provide attentive care for low-risk pregnancies, and will need the back up of a physician if complications arise.

3. Is the office friendly and convenient? Are staff members helpful and welcoming? Are waiting times in the office reasonable? Some popular doctors may have long waits for each appointment; if your own schedule is busy, you need to take this into account.

4. Does your provider work solo, or as part of a group? If you prefer a solo practitioner, what kind of coverage will you have when she is unavailable or on holiday? If you choose someone from a group practice, will you have a chance to meet the other practitioners prior to your delivery day?

5. Is your provider part of a call group – a group of clinicians who take turns doing deliveries on nights and weekends? What percentage of patients does your health care provider deliver herself?

6. Does your provider communicate well with you? Does she allow ample time for questions to be answered? Does she seem interested in you, or impersonal? Thorough or abrupt? Does she provide eye contact when she talks to you and does she help to put you at ease during exams?

7. What should you expect at the time of labor and delivery? Does your provider “labor sit”, staying with you for extended periods of time during the labor, or does she provide more intermittent contact? Does she encourage movement during labor? What strategies does she advise for pain relief during labor? How often are cesarean sections necessary? Does she have techniques to reduce the chance of episiotomy? Does she work with labor coaches or doulas? There are a variety of ways to approach these issues, and these questions will help you learn your provider’s style.

8. Does your provider encourage family involvement during prenatal visits and the delivery? If you have another child already, would he/she be welcome at prenatal visits or at the birth?

9. What are the fees charged by this provider? What percentage will be covered by your insurance plan?

To find a provider you’ll be comfortable with, ask for the recommendations of family, friends and other health care providers. Don’t hesitate to schedule interviews with a couple of clinicians to help you make your final choice. After all, you’ll be giving someone the privilege of joining your family for a very special event!
Laura E. Stachel M.D. Obstetrician & Gynecologist